Behavior Therapy : First, Second, and Third Waves

This book provides a comprehensive overview of first, second, and third wave behavior therapies, comparing and contrasting their relative strengths and weaknesses. Recent discussion and research has focused intently on third wave behavior therapies, in particular Dialectical Behavior Therapy and Acceptance and Commitment Therapy (ACT). This is in contrast with first wave behavior therapies (what today might be called applied behavior analysis or clinical behavior therapy) and second wave behavior therapies brought about by the “cognitive revolution”. The editors aim to provide a fuller understanding of this psychotherapeutic paradigm, tracking how behavior therapies have evolved through history and various paradigm shifts in the field. To this end, the book is organized into five sections covering: Introduction to the three waves of behavior therapy Assessment and measurement strategies Comparative issues and controversies Applications of the three waves of behavior therapy to 7 major disorders: anxiety, depression, obesity, psychosis, substance abuse, ADHD, and chronic pain Implications of and future directions for behavior therapies This volume provides a useful perspective on the evolution of cognitive behavior therapy that will inform the study and practice of a variety of mental health professionals. Preface Contents About the Editors Part I: Introduction The Three Waves of Cognitive Behavior Therapy: Scientific Aspirations and Scientific Status History and Revolution of CBT: A Kuhnian Perspective Wittgensteinian Fibres and CBT Scientific Epistemology and CBT Agnotology and CBT Overview of Chapters in the Present Volume References Personal Perspectives on the Development of Behavior Therapy and Cognitive Behavior Therapy Earliest Influences Cognitive Factors in Behavior Therapy – The Development of Cognitive Behavior Therapy The Person as an Active, Thinking Agent Relaxation as an Active Cognitive Process Countercontrol Attribution Perceived Control Science and Practice: A Two-Way Street Principles of Change Not Treatment Packages Abnormal Psychology Textbook Clinical Complexity and Psychotherapy Integration The Therapist’s Thoughts and Feelings During Interactions with Patients The Phenomenological Essence of CBT Early Involvement in Basic Cognitive Research Cognitive Assessment Ethics and Psychotherapy of All Kinds Clinical Problems as Clinicians’ Constructions Conclusion References Meta-science and the Three Waves of Cognitive Behavior Therapy: Three Distinct Sets of Commitments An Overview Science and Problem Solving First Wave: Skinner, Behavior Therapy, and Applied Behavior Analysis B. F. Skinner’s Views of Science Skinner’s Philosophy of Science and Evolutionary Epistemology Skinner’s Indigenous Evolutionary Epistemology The Second Wave: The Stoics and Neo-Popperians The Stoics Popper and the Neo-Popperians Bartley’s Pan-Critical Rationalism Pan-Critical Rationality and Evolution Pan-Critical Rationality and Rational Emotive Therapy The Third Wave: Post-Modernism and Contextualism Functional Contextualism Evolutionary Epistemology Basic and Applied Science: A Reticulated Model Middle-Level Terms and Constructs Conclusions References What Is First-Wave Behavior Therapy? A Representative View of Behavior Therapy Neobehaviorism Behavior Analysis Conclusion Foundations of Behavior Therapy Long Past: 500 B.C.E.–1900 C.E. Conclusion Short History: 1900–1950 Recent Origins: 1950–1960 Institutional Founding (1960–1970) Yesterday and Today Yesterday Today Conclusion References What Is Second Wave Behavior Therapy? Essentials of CBT The Origins of CBT Overcoming the Limits of First Wave Behavior Therapy REBT and CT Albert Ellis’ Rational Emotive Behavior Therapy Aaron Beck’s Cognitive Behavior Therapy The Relationship Between Second and Third Wave Therapies CBT Strategies What Do Patients Learn in CBT? Conclusion References What Is Third Wave Behavior Therapy? Third Wave Behavior Therapies History “Anomalies” in the Context of the Second Wave Change in Content Versus Change in Context The Role of Differing Assumptions Treatment Methods Acceptance as Key Process Evidence Contextual CBT Third Wave and the Rise of Process Based Treatment Summary References Part II: Assessment and Case Conceptualization Second Wave Assessment and Case Formulation Two Levels of Assessment Targets of Self Report Assessment Theoretical Critiques Second Wave Formulation Implications for the Third Wave Summary and Conclusion References Dialectical Behavior Therapy: Assessment and Case Conceptualization The Development of DBT The Biosocial Model The DBT Treatment Structure Research Evidence The Role of Assessment in DBT Case Conceptualization in DBT Similarities and Differences Between DBT and Other Therapies Training and Certification in DBT Conclusion References Radically Open Dialectical Behavior Therapy: Theory, Assessment and Case Conceptualization Overcontrol Defined Development of RO DBT: Similarities and Differences from ‘Standard’ DBT Biosocial Model of RO DBT Distinct Aspects of RO DBT Treatment Research Evidence Treatment Resistant Depression Anorexia Nervosa Autism Spectrum Disorder Transdiagnostic Psychiatric Conditions Assessment in RO DBT Four Session Orientation Subtypes of Overcontrol Validated Questionnaires Case Conceptualization Treatment Hierarchy RO DBT Suicidal Behavioral Protocol Therapeutic Alliance: Ruptures and Repair Five Behavioral Themes of Social Signaling Chain Analysis Conclusion References Part III: Comparative Issues and Controversies The Advantages of First Wave Behavior Therapy and Problems with the Others Before the First Wave The First Wave First Ripples A Russian Wave The South African and European and Wave The American Operant Deluge Ripening and Expansion of Applied Behavior Analysis: 1980’s–2020 A New Profession Problems with Waves Two and Three Treasures from the Deep or Flotsam and Jetsam? References Cognitive Therapy and the Three Waves: Advantages, Disadvantages and Rapprochement Historical Context of the Cognitive Therapy The Cognitive Revolution in Psychology Beck’s Cognitive Model Cognitive Model of Therapy How Are Other Approaches Viewed? Does the Content of Thoughts Matter? Behavior Counts Case Conceptualization Parsimony vs. Complexity Disengagement and Decentering Can Be Helpful Acceptance Is Helpful—Even Necessary Relevance of More Complicated Problems Philosophical Problems with Behaviorism Different Approaches for Different Problems Final Thoughts References Advantages of Third Wave Behavior Therapies Arrival of Third Wave Behavior Therapy Aims of the Present Chapter Third Wave Behavior Therapies Characteristics of Third Wave Behavior Therapy Movement Contributions of Third Wave Behavioral Therapies Clarifying the Assumptions of One’s Own Philosophical Worldview and Those of Others Being Deliberate About Treatment Development and Using Philosophy as a Guide Development of Pragmatic Theories High in Precision and Scope: A Unified Model of Behavioral Adaptation and Behavior Change Continued Commitment to Empirical Verification Additive Advantages of Third Wave Behavior Therapy Behaviorally-Informed Unified Models of Optimal Health and Behavior Change Additive Conceptual and Applied Elements Reflection and Conclusion References Part IV: Treatments for Specific Disorders First Wave Conceptualizations of Anxiety Disorders Early Behavioral Models Classical Conditioning and Generalization Counter-Conditioning and Reciprocal Inhibition Two-Factor Theory Rescorla-Wagner Model Safety Signal Theory Vicarious Conditioning Contemporary Learning Models Influence of Symbolic Generalization on Models of Fear Learning Influence of Personality and Latent Inhibition on Models of Fear Learning Influence of Evolutionary Factors on Models of Fear Learning: Biological Preparedness and Species-Specific Defense Reactions (SSDRs) Influence of Neuroscience on Models of Fear Extinction: Inhibitory Learning Challenges from the Second and Third Waves of Psychotherapy Challenges from the Second Wave Challenges from the Third Wave A Case Example Conclusions References Third Wave Conceptualization of Anxiety, Obsessive Compulsive Disorders, and Obsessive Compulsive Related Disorders Overview of Exposure Therapy in the Third Wave Research Overview Mindfulness Based Therapies for Adult Anxiety Disorders Dialectical Behavior Therapy for Adult Anxiety Disorders Acceptance and Commitment Therapy for Adult Anxiety Disorders Mindfulness Based Therapies for Anxiety Disorders in Youth Dialectical Behavior Therapy for Anxiety Disorders in Youth Acceptance and Commitment Therapy for Anxiety Disorders in Youth Mindfulness Based Therapies for OCD and OCRDs in Adults Dialectical Behavior Therapy for OCD and OCRDs in Adults Acceptance and Commitment Therapy for OCD and OCRDs in Adults Third Wave Therapies for Youth with OCD and OCRDs Thoughts on the Three Waves Process of Change Research Clinical Example Using ACT Conclusion and Future Directions References Depressive Disorders: First Wave Case Conceptualization Description and Diagnosis Behavioral Model of Depression Operant Conditioning History of Development Empirical Evidence in Support Empirical Evidence Against Behavioral Activation Description Empirical Evidence in Support Empirical Evidence Against Use with Different Clients Clinical Case Example Description Application Potential Difficulties Ambivalence Homework Compliance Resistance Summary References Second Wave Treatment for Depressive Disorders Cognitive Theories of Depression Rational Emotive Behavior Therapy Cognitive Therapy The Cognitive Triad in Detail Negative View of the World Negative View of the Self Negative View of the Future Treatment of Depressive Disorders Conducting REBT Conducting CT Cognitive Techniques Other Aspects of Beck’s CT for Depression CT Case Illustration Initial Evaluation Case Conceptualization First Session Second Session Third Through Ninth Sessions Termination Session Empirical Research Outcome Research REBT CT Research Examining Treatment Models and Processes/Mechanisms of Change REBT CT Conclusion References Depression: Third Wave Case Conceptualization Current Standard of Care for Depression Rationale for Adapting Mindfulness Meditation to Prevent Depression Relapse Mindfulness-Based Cognitive Therapy (MBCT) Structure of MBCT Efficacy of MBCT Therapeutic Change Mechanisms of MBCT Cost-Effectiveness of MBCT Emergent Themes from Qualitative and Case Studies of MBCT MBCT Case Illustration Concluding Remarks References First Wave Treatment of Obesity Biology of Obesity Basic Factors Related to Obesity Biopsychosocial Factors Related to Obesity Physiological Measurement of Obesity Behavior Analysis and Obesity Behavioral Assessment of Obesity Behavioral Interventions for Obesity First Wave Behavioral Treatments of Obesity Recommendations from First Wave Behavioral Treatments of Obesity Limitations of First Wave Behavior Analytic Approaches in the Treatment of Obesity Second and Third Wave Behavioral Treatments Conclusion References Obesity: Third Wave Case Conceptualization Theoretical Rationale Mindfulness-Based Interventions (MBIs) Acceptance-Based Behavioral Treatments (ABTs) Treatment Overviews Mindfulness-Based Interventions (MBIs) Acceptance-Based Behavioral Treatments (ABTs) Research Support and Future Directions Mindfulness-Based Interventions (MBIs) Acceptance-Based Behavioral Treatments (ABTs) Conclusions References First-Wave Behavior Therapies for Schizophrenia and Related Psychotic Disorders Early Behavioral Research with Psychotic Disorders Landmark Studies of Teodoro Ayllon and Colleagues in the State Mental Hospitals First-Wave Behavior Therapies for Specific Problems and Their Derivatives Delusional Speech Hallucinatory Behavior Social Skills Personal Grooming and Hygiene Vocational Skills Recreational Behavior Functional Analysis of Psychotic Behavior Summary and Conclusions: Past and Present Contexts of First-Wave Behavior Therapies References Schizophrenia Spectrum and Other Psychotic Disorders: Second Wave Case Conceptualization Overview of CBT for Psychosis Clinical Methods and Indications Review of Research Limitations Cognitive-Behavioral Therapy for Delusions Cognitive Biases and Distortions Stages of CBTp Stage 1: Engagement and Assessment Phase Potential Problems in The Early Stages Stage 2: Education and Orientation Phase Stage 3: Verbal Disputation of Delusional Beliefs Stage 4: Behavioral Challenging and Disputation Phase Cognitive-Behavioral Therapy for Hallucinations Overview of Cognitive-Behavioral Therapy for Hallucinations Stage 1: Engagement and Assessment Phase Stage 2: Education and Orientation Stages 3 and 4: Cognitive and Behavioral Disputation Methods Summary References Schizophrenia Spectrum and Other Psychotic Disorders: Third Wave Case Conceptualization ACT for Psychosis Theoretical Rationale Treatment Processes Common Strategies and Techniques Clinical Considerations Supporting Research Other Third Wave Interventions for Psychosis Case Illustration Client Description and History of Illness Assessment of the Client’s Problems, Goals, Strengths, and History Case Formulation and Treatment Plan Description of Therapy Course Therapy Monitoring and Use of Feedback Information Concluding Evaluation of the Therapy’s Process and Outcome Comparing ACT vs First and Second Wave Approaches Conclusion References Substance-Related and Addictive Disorders: First Wave Case Conceptualization Introduction Operant Conditioning Clinical Applications of Operant Conditioning Neurobiological Findings Community Reinforcement Approach: An Applied Extension The Use of Incentives: Alternative Rewards Development and Effectiveness of CRA Contextual Factors That Influence the Promotion of Healthy Alternative Reinforcers Characteristics of Community Reinforcement Approach CRA Treatment Plan: Happiness Scale and Goals of Counseling CRA Procedures Functional Analyses Sobriety Sampling CRA Skill Training Job-Finding Skills Social/Recreational Counseling Systematic Encouragement Relapse Prevention Medication Monitoring Relationship Therapy Case Illustration Background Information Case Conceptualization Course of Treatment: Introductory Session Treatment Planning Skill Training Treatment Plan Updating Treatment Plan Updating and Relapse Prevention Case Conclusion Community Reinforcement Approach & Contingency Management Adolescent Version of Community Reinforcement Approach (A-CRA) Community Reinforcement Approach and Family Training (CRAFT) Conclusion References Substance Use Disorders: Second Wave Approaches Social Learning Theory Harm Reduction Relapse Prevention Motivational Interviewing Group CBT CBT for Specific SUDs Alcohol Cannabis Use Disorder Tobacco Cessation Stimulant Use Disorders Opioid Use Disorder Comorbidity with Other Mental Health Disorders CBT SUD Technologies CBT SUD Implementation Conclusion References Third Wave Therapies and Substance Use Disorders: A Case Example Case Description Session 1: Awareness and Openness Session 2: Acceptance and Engagement Session 3: Awareness, Acceptance, and Engagement Empirical Support Meta-analytic Findings and Reviews of ACT and Other Third Wave Therapies. Alcohol Use Disorders Smoking Cessation Research Other Addictive Behaviors Research Third Wave and Second-Wave Therapy Comparisons Understanding Mechanisms of Action Conclusions References Attention Deficit Hyperactivity Disorder: First Wave Case Conceptualization First Wave Behavior Therapy: An Overview Attention Deficit Hyperactivity Disorder: An Overview Intervention Approach for Behavioral Deficits Reinforcer Identification Self-Control Academic Performance Social Skills Take Home Points Intervention Approach for Behavioral Excesses Behavioral Excesses Maintained by Social Positive Reinforcement Behavioral Excesses Maintained by Social Negative Reinforcement Behavioral Excesses Maintained by Automatic Reinforcements Take Home Point Case Application: A Case of Mark Overview Step 1: Assessments Step 2: Development of Behavior Intervention Plan and Parent Training Summary & Conclusions References Attention Deficit Hyperactivity Disorder: Second Wave Conceptualization and Intervention Cognitive Behavioral Conceptualization of ADHD The “Waves” of Therapy for ADHD Review of Second Wave Interventions for ADHD Interventions for Children and Adolescents Interventions for Adults Conclusion References Attention Deficit Hyperactivity Disorder: Third-Wave Behavior Therapy Conceptualization Setting the Stage: Third-wave Behaviorism and Primary Care Overview of ADHD and Implications for Clinicians Research Related to Third-Wave Interventions and ADHD Third-Wave Conceptualization of ADHD ADHD Case Illustration and Conceptualization Summary References Chronic Pain: Perspective on the Second Wave Variations in Chronic Pain Treatment Across Waves of Behavior Therapy First Wave Second Wave – Cognitive-Behavioral Therapy Beliefs About Pain Catastrophic Thinking Perceived Control Self-Efficacy Chronic Pain Treatment Within the CBT Approach Treatment of A Chronic Pain Patient: Ms. M Third Wave Evidence Base for Chronic Pain Treatment Across Waves of Behavior Therapy Challenges in Evaluating Efficacy and Effectiveness of Waves of Behavior Therapy for Chronic Pain For Whom and Under Which Circumstances Are Second Wave Treatments Superior? Future Directions Conclusion References Chronic Pain: Third Wave Case Conceptualizations Pain: An Overview The ‘Waves’ of a Behavioral Approach to Chronic Pain First Wave Second Wave Third Wave ACT Case Conceptualization Conceptual Issues Questionnaire Assessment Case Conceptualization Example Effectiveness and Mechanism Data The ‘Waves’ – Comparisons and Challenges Future Objectives for a Behavioral Approach to Chronic Pain Conclusion References Part V: CBT from International Perspectives The History of Behavior Therapy in Brazil and Its Relationship with the Three Waves Behavior Therapy in Brazil: A Historical Construction Behavior-Analytic Therapy (TAC) and the Third Wave of Behavior Therapy Behavior-Analytic Therapy (TAC): A Brazilian Model Evidence for Behavior-Analytic Therapy (TAC) Conclusion References History of Cognitive and Behavior Therapies in Japan: A Behavior Analytic Perspective Behavior Therapy and Licensing Law for Psychologists in Japan Public Image of Behavior Therapy in Japan: A Cultural Perspective Preference of Assimilation and Accommodation Over Control Japanese Language Unwillingness to Recognize Oneself as a Control Agent Person-Centered Approach and Japanese Culture Dawn of Behavior Therapy in Japan (1950–1980): The First Wave Studies of Nocturnal Enuresis by Kousaku Umezu: The Dawn of Behavior Therapy Research in Japan Translation of the Volume Behaviour Therapy and the Neuroses by Hans Eysenck Establishment of Japanese Association of Behavior Therapy in 1975 Further Development of Behavior Therapy and Division (1980–2001): The Second Wave An Invited Visit of Albert Bandura in 1982: Bridging from Behavioral Theories to Cognitive Theories Establishment of Japanese Association of Behavior Analysis in 1983 Publication of “Cognitive Behavior Therapy” by Yuji Sakano: The Establishment of Cognitive Behavior Therapy in Japan Behavior Therapy’s Identity Crisis in Japan (2001–2020): The Third Wave World Congress of Behavioral and Cognitive Therapies in 2004 Arrival of Mindfulness Revolution: A Role of Japanese Cognitive Behavior Therapy Where Is Behavior Therapy Headed in Japan? Education and Trainings Conclusion References Part VI: Summary and Future Directions The Future of First Wave Behavior Therapies Signs of Professionalization Organizational Infrastructure Credentialing and Legal Regulation Insurance Reimbursement and Billing Codes Practice Some Problems Competing Credentials Corporate Takeover of Behavior Analysis? The Intrusion of Pseudo-scientific and Non-Research-Based Services Summary and Conclusions References The Future of Third Wave Cognitive Behavior Therapies Domain of Third Wave Cognitive Behavior Therapies Changes in What Is Delivered and How The ACT-RFT Relationship Parallel Play Reticulated Model Amicable Separation The Emergence of Process-Based Therapy (PBT) A Confluence of Influences ACT and the Rest of Third Wave Behavior Therapies Contributions of Third Wave Cognitive Behavioral Therapies Challenges That the Third Wave Movement Has Brought to the Field After All, What Is the “Third Wave”? Personal Reflections by Robert D. Zettle Conclusion References Index