Cognitive therapy is a type of psychotherapy that suggests that people’s feelings and behaviors are affected by the way they organize ideas and beliefs through a framework of interpretation of reality, and by their analysis in terms of meaning.
Now, within this premise there is a lot of room to develop different therapeutic strategies, and integrative cognitive models of thinking for the treatment of mental disorders have greatly advanced since their creation. Over the past 20 years, it has become clear that therapeutic models cannot remain static. People require treatments that respond to the new demands of society; therefore, context-specific therapies are necessary.
Within this scenario, contextual therapies -or third generation- offer a new perspective on the representation and treatment of mental disorders, or rather, psychological problems in general. In this article we analyze in detail contextual therapy, its origins and main types.
Contextual therapies, also called third generation, examine people’s behavior in the context in which they find themselves rather than separating themselves from it. This means examining what a person values, what they say and how they say it, and also includes analyzing each person’s verbal behavior when interacting with others.
By understanding how context affects behavior, psychotherapists can better predict patient behavior and provide more effective treatment therapies.
Contextual therapy seeks an understanding of the meaning behind people’s emotions, actions and thoughts, including context as a parameter. It also studies the evolution of behavior with interaction.
Third generation therapies provide a new perspective for understanding psychological disorders and their treatment. Some authors claim that these therapies are direct descendants of BF Skinner’s radical behaviorism, according to which human behavior does not respond directly to the stimulus-response association, but rather The origin of all behavior is found in the effect that the acts have on the subject himself and this includes the notion of context.
However, agreeing with this statement would be too reductionist because it would imply that the postulates of third generation therapies are the same as those of Skinner. On the other hand, it is more accurate to say that contextual therapies derive from Skinner’s ideas, although they present certain important divergences.
Third generation therapies include findings from basic science, which have demonstrated results in the psychotherapeutic field, in order to determine the effect of the context and its elements on behavior. Psychotherapeutic interventions examine the differences between “reality” and “the reality constructed” by each person. Therapies that include this approach are part of a new way of thinking and allow considering many other therapeutic lines other than the classic ones.
Contextual therapy It has a great philosophical load – Focuses heavily on themes such as justice, forgiveness, morality, and ethics. It also includes healing across generations, reconciliation and recognition. The objective of contextual therapy is to reconcile these aspects that are in dissonance and direct them towards a cure, either for the emotional pain they cause, or to improve the patient’s relationship with others and the world around them.
The term “contextual” refers to all the people and things involved in the process. In addition to the patient, these include all relevant parties and their interactions. Four aspects of contextual interaction are considered in therapy: facts, individual psychology, behavioral interactions, and relationship-related ethical considerations.
There are many exponents of contextual or third generation therapies, but below we present the most widespread. The main therapeutic models include:
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The origins of contextual therapy
In order to provide a scientific and objective solution to mental disorders, psychotherapy appeared based on the positivist logical model. This treatment method aimed to cure mental disorders by applying the scientific method.
This way of understanding mental problems breaks with the accepted idea – until then – that these were formed only in the minds of “sick” individuals. Psychology begins to be interested not only in the individual, but also in the relational, including the context. The work of Martin Buber – which inspired the greatest advances in this belief system – introduced into the field of philosophy the idea that reality is made up of relationships.
Due to the growing belief in the relational nature of life, in the 1950s, a series of joint therapies with psychotic children were initiated with the participation of close family. Before this, individual therapies were common. However, its limits had already been recognized, particularly in psychotic patients.
In 1957, the Philadelphia Psychiatric Institute launched a research project on family therapies led by Boszormenyi-Nagy and her team. Boszormenyi-Nagy is considered the father of contextual therapy. His work emphasizes the essential union of generations, the processes of the psyche and interpersonal relationships.
The main contextual therapies
Contextual or third generation therapy is the most common form of applied therapy. Their science-based knowledge applies to almost every aspect of life. There are many types of models; Below we collect the main exponents, due to their effectiveness and their widespread application within the therapeutic community.
1. Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT) It is the most widespread model within relational examples. It is a form of intervention that seeks to define the person’s personal values and accept events. This approach is supported by extensive philosophical theory that serves as the basis for this type of psychotherapy and its theoretical framework.
Humans have the ability to be aware of our thoughts, emotions, memories and images in the present moment. From acceptance in the present moment, we can decide to act in accordance with our values. Recognizing capacity and choosing to act in the now are the goals of acceptance and commitment therapy. By submitting to our values and accepting what happens to us, acceptance and commitment therapy allows us to increase our psychological flexibility. This includes engaging in or stopping actions that are uncomfortable without additional stress.
In acceptance and commitment therapy language plays a fundamental role. Most psychological problems originate in language, this approach uses it to recontextualize events, and to understand the meaning and reason of patients’ lives. It seeks to discover what each individual considers important and encourage commitments to the necessary behavioral changes.
In summary, acceptance and commitment therapy suggests accepting the circumstances of the human condition and connecting with the present moment. Through this, we can take actions that lead us to a better life in a way that satisfies us.
2. Dialectical Behavior Therapy (DBT)
Dialectical-behavioral therapy’s main objective is to reduce patients’ self-destructive thoughts and behaviors, AND was developed to primarily treat borderline personality disorder. This method teaches psychosocial skills and uses elements of cognitive behavioral theory to relieve emotional pain, perform reality checks, and maintain mindfulness, while promoting tolerance.
Dialectical-behavioral therapies have been shown to be the most effective treatment for chronic patients with suicidal thoughts, mood disorders, drug addicts, and victims of abuse.
3. Functional analytical psychotherapy (FAP)
Functional analytical psychotherapy focuses on the psychotherapeutic relationship. Within the clinical context, this therapy focuses on the patient’s relationship with their therapist and the learning opportunities that arise within the sessions. Where behavioral progress related to the patient’s problem is identified along with clinical variables related to their individual relationship with the problem.
Within the framework of this therapy model, changing certain behaviors depends on the close relationship created between patient and therapist. This link also allows patients to increase or decrease their behaviors over the course of treatment.
4. Mindfulness-based therapy
The concept of witnessing the present moment It is at the center of one of the most widespread recent therapies. Mindfulness is about becoming a simple spectator of what happens, accepting and not trying to control events.
The theory suggests that we need to radically accept the present moment. It emphasizes that we must actively select our experiences, even if they are unsatisfactory or painful, this allows us to operate in the here and now. It also helps us prevent thoughts about the past or future from taking over us and our minds so we can decide in the current moment.
Related article: “What is Mindfulness? The 7 answers to your questions”
