CBT & ACT: Help your clients give their thoughts a little space

CBT & ACT: Help your clients give their thoughts a little space

CBT & ACT: Help your clients give their thoughts a little space

One of the major premises of cognitive-behavioral therapy (CBT) is the idea that thoughts affect feelings, and that by changing our interpretations and thoughts about and interpretations of situations or events, we can change our emotional responses. Sometimes this can take the form of challenging the validity or accuracy of thoughts by questioning whether or not they’re true. This process is effective for many people and helps them to recognize that their interpretations, beliefs, and self-talk aren’t accurate or fair to them. By then generating more positive and true statements, they are able to feel differently about their experiences. For example, rather than feeling anxious by focusing on an unlikely worst-case scenario, individuals can acknowledge that the most likely outcome is something they can handle, and their concerns or worries become much more manageable. One of the essential tools for examining and challenging thoughts in cognitive therapy is the thought record. The thought record is used to help individuals see the relationship between their experiences, thoughts, and emotions. It also helps people to identify potential inaccuracies in their thinking, and provide an opportunity to change those thoughts to be more fair.

Despite CBT’s wide acceptance and demonstrated efficacy, for some individuals, the process of challenging their thoughts can feel invalidating. Some people find that they get stuck in what feels like an academic exercise of trying to find evidence for or against their thoughts. More recently, there has been a “third wave” of therapy (such as Acceptance and Commitment Therapy or ACT) which integrates concepts from mindfulness and acceptance to help individuals change their relationship to their thoughts. On first glance, some people (therapists and clients alike) have a difficult time reconciling CBT and acceptance-based approaches, because they appear to be in conflict (one aimed at changing thoughts while the other is focused on accepting them).

CBT & ACT: Integrating Different Approaches

However, both CBT and these newer therapies have the effect of helping people see their thoughts as more like “mental events”, being more objective, and giving their thoughts more space. CBT is more oriented towards challenging the content of the thoughts whereas acceptance- and mindfulness-based therapies are more focused on allowing oneself to co-exist with the thoughts, without necessarily believing or acting on them, or trying to change them. In both cases, the individual is changing their relationship to their thoughts; often this means putting some distance between themselves and their thoughts. One of the difficulties clients often face is taking their thoughts to be the truth and believing them. Often they have the same thoughts over and over, and that repetition makes the thoughts seem all the more true. Whether mindfulness, acceptance, or distancing by challenging a thought’s validity ring most true for your clients, increasing their awareness of their thoughts and emotions will help them to disconnect and de-fuse from those thoughts.

Pacifica is a digital implementation of an integrated approach, which is to say, it includes elements of cognitive-behavioral therapy and mindfulness-based approaches. Pacifica includes several different types of thought records with different foci, some delving more deeply into cognitive distortions, with another more focused on guiding the user to generate alternative thoughts, etc. Additionally, there are guided meditations focused on awareness and acceptance of thoughts and emotions, and psychoeducational content which guides users through the process of using the various tools. Pacifica users are able to select which approaches and tools are most effective for them and which fit their needs and personality best.

"The most effective solution is the one you are willing to implement", ACT or CBT