The empirical status of the "new wave" of cognitive behavioral therapy

In the paper

“This results in a theoretical discrepancy between ACT and CBT, whereby the focus in ACT is to identify and alter the function of the cognition, rather than both the content and function as in CBT.”

What the sources say

• Partly supported

  The ACT theoretical roots section (p. 5) supports focusing on the functions of cognitions rather than primarily on their content. The discussion of traditional CBT (p. 3) describes direct cognitive change and attention to patterns of thought, but does not establish that CBT focuses on both content and function as the claim says. (LLM, conf=0.82)

  cites [1] Hayes, 2006, Acceptance and commitment therapy: model, processes, and outcomes, Behav Res Ther sourceExperimental — accuracy not yet measured

In the paper

“mindfulness-based interventions have also been applied as an acute treatment for a variety of psychiatric disorders including generalized anxiety disorder [43, 44], panic disorder [45–47], social anxiety disorder [48, 49], and depression [50–53]”

What the sources say

• ?Not checked — no full text of the sourcecites [43] Craigie, 2008, Mindfulness-based cognitive therapy for generalized anxiety disorder: a preliminary evaluation, Behav Cogn Psychother source
• ?Not checked — no full text of the sourcecites [44] Evans, 2008, Mindfulness-based cognitive therapy for generalized anxiety disorder, J Anxiety Disord source
• ?Not checked — no full text of the sourcecites [45] Kabat-Zinn, 1992, Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders, Am J Psychiatry source
• Partly supported

  The Assessments section describes an eight-week MBCT program for patients with panic disorder or generalized anxiety disorder, supporting its application as a treatment for those conditions. The Subjects section says participants had received more than six months of pharmacotherapy and that their acute symptoms had stabilized before MBCT began; this study therefore does not support calling it an acute treatment. (LLM, conf=0.84)

  cites [46] Kim, 2009, Effectiveness of mindfulness-based cognitive therapy as an adjuvant to pharmacotherapy in patients with panic disorder or generalized anxiety disorder, Depress Anxiety sourceExperimental — accuracy not yet measured
• ?Not checked — no full text of the sourcecites [47] Lee, 2007, Effectiveness of a meditation-based stress management program as an adjunct to pharmacotherapy in patients with anxiety disorder, J Psychosom Res source
• ?Not checked — no full text of the sourcecites [48] Bögels, 2006, Mindfulness and task concentration training for social phobia: a pilot study, J Cogn Psychother source
• ?Not checked — no full text of the sourcecites [49] Koszycki, 2007, Randomized trial of a meditation-based stress reduction program and cognitive behavior therapy in generalized social anxiety disorder, Behav Res Ther source

In the paper

“These techniques are believed to work by increasing one’s psychological flexibility, which refers to the ability to adopt an awareness of the present moment while concurrently adapting this awareness in light of meeting valued goals [1].”

What the sources say

• Supported

  The “Six core processes of ACT” section (p. 7) says ACT aims to increase psychological flexibility, defined as contacting the present moment fully and changing or persisting in behavior when doing so serves valued ends. This supports the citing sentence’s account of how ACT techniques are believed to work. (LLM, conf=0.92)

  cites [1] Hayes, 2006, Acceptance and commitment therapy: model, processes, and outcomes, Behav Res Ther source

In the paper

“cognitive change can occur through means other than explicitly challenging maladaptive cognitions; cognitions can mediate treatment change even when cognitions are not explicitly addressed in treatment.”

What the sources say

• Supported

  The review states that exposure without explicit cognitive intervention produces cognitive changes and that its effects are mediated through changes in cognitions (passages 1 and 4; section and page not provided). It also says repeated exposure changes harm expectancy with or without explicit cognitive strategies (passage 6). (LLM, conf=0.92)

  cites [23] Hofmann, 2008, Cognitive processes during fear acquisition and extinction in animals and humans: implications for exposure therapy of anxiety disorders, Clin Psychol Rev source

In the paper

“Specifically, ACT views cognitions as a form of behavior, which is “a term for all forms of psychological activity, both public and private, including cognition” [1, p. 2].”

What the sources say

• Supported

  In “How behavior therapy weakened its link to basic principles” (p. 2), the paper explicitly defines behavior to include all psychological activity, including cognition. That directly supports the paraphrase and the quoted definition. (LLM, conf=0.95)

  cites [1] Hayes, 2006, Acceptance and commitment therapy: model, processes, and outcomes, Behav Res Ther source

In the paper

“Furthermore, the 13 ACT studies included in this review differed greatly with regard to the type of comparison group used—whether it was a control group (i.e., treatment as usual) or an active treatment (e.g., cognitive therapy). The studies also varied widely in the disorders that were treated, ranging from math anxiety and depression to epilepsy, diabetes, and psychosis.”

What the sources say

• ?Not checked — no full text of the sourcecites [3] Öst, 2008, Efficacy of the third wave of behavioral therapies: a systematic review and meta-analysis, Behav Res Ther source

In the paper

“These findings, however, are tempered by additional results showing that the methodological rigor of the third-wave RCTs was significantly less stringent than the CBT studies, based on several sample, design, and therapist characteristics, such as representativeness of the sample, reliability of the diagnosis, therapist adherence and competence, and handling of attrition. This remained true even”

What the sources say

• ?Not checked — no full text of the sourcecites [3] Öst, 2008, Efficacy of the third wave of behavioral therapies: a systematic review and meta-analysis, Behav Res Ther source

In the paper

“CBT should be thought of as a family of interventions rather than as one single treatment.”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [10] Hofmann SG, Asmundson GJ. The science of cognitive behavioral therapy. Behav Ther, in press.
• ?Not checked — no full text of the sourcecites [11] Ellis, 1980, Rational-emotive therapy and cognitive behavior therapy: similarities and differences, Cognit Ther Res source

In the paper

“Beck’s content-specificity hypothesis states that each emotional disorder can be characterized by cognitive content specific to that disorder [18].”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [18] Beck, 1976

In the paper

“a major similarity across protocols is the assumption that maladaptive cognitions are causally linked to emotional distress, and therefore, by modifying cognitions emotional distress and maladaptive behaviors will decrease.”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [10] Hofmann SG, Asmundson GJ. The science of cognitive behavioral therapy. Behav Ther, in press.
• ?Not checked — no full text of the sourcecites [11] Ellis, 1980, Rational-emotive therapy and cognitive behavior therapy: similarities and differences, Cognit Ther Res source

In the paper

“However, these differences are not irreconcilable in requiring a separate classification of “new wave” treatments.”

In the paper

“the researchers responsible for developing DBT and MCT posit that their treatments are not part of the “third wave” movement, but rather are firmly grounded in the traditional CBT approach.”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites personal communication, August 23, 2007
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites personal communication, August 28, 2007

In the paper

“Although these studies strongly suggest that changes in cognitions mediate treatment change, future studies that employ strict statistical tests are needed to conclusively demonstrate mediation.”

In the paper

“In this way, the target of change in CBT is often (but not exclusively) the content of such cognitions.”

In the paper

“Mindfulness-based interventions are believed to counter experiential avoidance strategies that maintain and exacerbate emotional disorders”

What the sources say

• ?Not checked — no full text of the sourcecites [31] Bishop, 2004, Mindfulness: a proposed operational definition, Clin Psychol source

In the paper

“CBT is a family of interventions that attempts to modify maladaptive cognitions in order to improve a patient’s emotion regulation, goal setting, and ability to make more adaptive appraisals of social situations.”

In the paper

“Although ACT and CBT differ fundamentally in terms of their theoretical underpinnings, they share many similarities with regard to technique.”

In the paper

“In contrast, mindfulness-based treatments and ACT focus on the function of thoughts and promote emotion regulation strategies that counter experiential avoidance.”

In the paper

“Another therapy that extends from the CBT framework while integrating mindfulness-based techniques is DBT, a form of therapy that is typically used to treat borderline personality disorder [56].”

What the sources say

• ?Not checked — no full text of the sourcecites [56] Linehan, 1991, Cognitive-behavioral treatment of chronically suicidal borderline patients, Arch Gen Psychiatry source

In the paper

“The basic premise of CBT is that cognitions play an important role in the maintenance of an emotional disorder, primarily through its causal influence on one’s emotions and behaviors.”

In the paper

“the set of techniques used in ACT (known as acceptance, cognitive defusion, being present, self as context, values, and committed action) are intended to target experiential avoidance, which is the reluctance to experience negative emotions, physical sensations, and thoughts [61].”

What the sources say

• ?Not checked — no full text of the sourcecites [61] Hayes, 2004, DBT, FAP and ACT: how empirically oriented are the new behavior therapy technologies?, Behav Ther source

In the paper

“Therefore, ACT is not an extension of the CBT model, but is rather a reformulation of Skinnerian radical behaviorism [61], as it rejects the tripartite model and its basic premise of the causative interplay between cognitions, behaviors, and emotions.”

What the sources say

• ?Not checked — no full text of the sourcecites [61] Hayes, 2004, DBT, FAP and ACT: how empirically oriented are the new behavior therapy technologies?, Behav Ther source

In the paper

“Mindfulness-based treatments emphasize achieving a mental state characterized by present-moment focus and non-judgmental awareness [31–34].”

What the sources say

• ?Not checked — no full text of the sourcecites [31] Bishop, 2004, Mindfulness: a proposed operational definition, Clin Psychol source
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [32] Kabat-Zinn, 2003, Mindfulness-based interventions in context: past, present, and future, Clin Psychol
• ?Not checked — no full text of the sourcecites [33] Melbourne Academic Mindfulness Interest Group, 2006, Mindfulness-based psychotherapies: a review of conceptual foundations, empirical evidence and practical considerations, Aust N Z J Psychiatry source
• ?Not checked — no full text of the sourcecites [34] Teasdale, 2000, Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy, J Consult Clin Psychol source

In the paper

“By employing both mindfulness and cognitive techniques, MBCT encourages patients to increase their awareness of and break free from this self-perpetuating cycle.”

What the sources say

• ?Not checked — no full text of the sourcecites [42] Teasdale, 1988, Cognitive vulnerability to persistent depression, Cogn Emot source

In the paper

“The first meta-analysis [3] included 29 randomized controlled trials (RCTs) in various third wave treatments: 13 in ACT, 13 in DBT, one in Cognitive Behavioral Analysis System of Psychotherapy, and two in Integrative Behavioral Couple Therapy. The results revealed a moderate effect size for the ACT trials (d = 0.68), with a fail-safe analysis indicating that 65 unpublished ACT studies would be re”

What the sources say

• ?Not checked — no full text of the sourcecites [3] Öst, 2008, Efficacy of the third wave of behavioral therapies: a systematic review and meta-analysis, Behav Res Ther source

In the paper

“both ACT and CBT utilize behavioral strategies, such as exposure exercises, problem solving skills, role playing, modelling, and homework, while setting clear and observable goals. In addition, both therapies encourage greater awareness of thoughts, feelings, and sensations without attempting to control or hold onto them. Finally, both approaches target specific concerns and fears, as well as”

In the paper

“The concept of “decentering” is closely related to “distancing” in traditional CBT.”

In the paper

“RFT extends from a philosophical view called functional contextualism [59, 60], which uses a behavioral analytic model to integrate cognition and language.”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [59] Gifford, 1993, Functional contextualism: a pragmatic philosophy for behavioral science
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [60] Pepper, 1942

In the paper

“Although mindfulness-based treatments and CBT interventions are closely related, subtle and important differences exist.”

In the paper

“ACT derives its theoretical basis from Relational Frame Theory (RFT) [58], which is a framework for understanding the relationship between cognition and language.”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [58] Hayes, 2001, Relational frame theory: a post-Skinnerian account of human language and cognition, New York: Kluwer Academic;

In the paper

“CBT tends to promote strong antecedent-focused emotion regulation skills and ACT primarily targets maladaptive response-focused strategies.”

In the paper

“It was initially developed to prevent relapse among patients recovered from depression [5].”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [5] Segal, 2002

In the paper

“In order to answer the important questions about the mechanism of treatment changes, mediational analyses are essential because they cannot be replaced by efficacy studies or component analyses.”