Cognitive-behavioral therapies

Cognitive-Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) has been tested a lot since the 1970s; as of today there are over 500 studies showing it is indeed effective for a wide range of psychological disorders and problems.

Albert Ellis and Aaron Beck were two American psychologists who developed this form of psychotherapy in the 1950s and 60s.  Very different from the psychoanalytical approach that preceded it, CBT is brief (generally 2 to 12 sessions max), focused on the present and very practically oriented toward solving the client’s current problems.

How to change the unhelpful thoughts ?

Treatment is about the understanding that our negative thoughts arouse negative emotions, which in turn cause problem behaviors.  CBT teaches the client how to change his unhelpful thoughts into more positive ones, thereby changing how he feels and then how he acts.

Results are astonishingly rapid and complete, as the research shows and the psychological profession attests.  It is the most listed therapy on the American Psychological Association list of Empirically Validated Treatments, and it is the most recommended psychotherapy by the National Institute of Clinical Excellence (NICE) in the UK.

Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT) was developed in the early 1980s; the American Psychology Association and the Society of Clinical Psychology have both affirmed that ACT has been confirmed empirically as beneficial in the treatment of chronic pain, depression, anxiety, OCD and psychosis.

Usefulness of ACT

Its usefulness (especially in the case of grieving, chronic pain and other life difficulties that call on the ability to accept what cannot be changed) has been demonstrated by over 31 meta-analyses, 202 ACT trials under random controls, as well as narrative and systematic examination peer-assessed and published. 

An approach combining both cognitive and behavioral therapies

Stephen C. Hayes developed ACT in 1982 to create an approach combining both cognitive and behavioral therapies.  ACT’s objective is not to eliminate difficult emotions; rather it is to teach clients to be present for what life offers us and a value-oriented life.  Life’s actions are studied in terms of “workability”, or in accordance with what functions best for each person, to take a step forward toward what each considers important.

ACT increases psychological flexibility, or the ability to live in the present more fully and to change behaviors or persevere.  Therapists and clients work together to established this psychological flexibility through 6 main approaches linked to ACT, including acceptance, the contrary of experiential avoidance; cognitive defusion, in which negative thoughts are observed attentively instead of being avoided or got rid of; chosen values; and committed action.

« The idea of ACT deserve to be taken seriously by the general community and have great potential for developing a truly progressive clinical science to guide clinical practice.” (Kentor, 2013)

Today, ACT seems to be as effective as standard CBT, with certain meta-analyses demonstrating slight difference in favor of ACT and not others (Ruiz, 2012).

A meta-analysis directed by the University of Amsterdam demonstrated the effectiveness of ACT in the treatment of:

  • Anxiety disorders
  • Depression
  • Addictions
  • Somatic disorders