The 4 types of contextual therapy: what they are and what they are based on

Throughout the history of psychology, therapies have evolved from a primarily philosophical perspective to a much more empirical one, thus developing behavioral (first generation) or cognitive-behavioral (second generation) therapies.

However, this trend is decreasing; being contextual therapies, or third generation therapies, increasingly common in clinical practice. The different types of contextual therapy are based on the philosophical stream of functional contextualism, the basis is based on the results of laboratory research; and has applications in any area of ​​human life.

    What is Contextual Therapy?

    As already noted, contextual therapies get their name from functional contextualism. In this perspective, the person and his behavior are studied in their context and not in isolation.

    Outraged, these therapies place particular emphasis on the patient’s verbal behavior and values.. In other words, what the patient says to himself and to others directly influences his behavior and daily functioning.

    Types of contextual therapy

    While these are not the only ones, there are four models of contextual therapy that stand out from the rest. But all with a common goal: to mitigate the attenuation of patients by developing much more effective, extended and resilient models of behavior.

    1. Mindfulness

    Mindfulness has already been established as the gold standard therapy within contextual models. Although there is no specific word for Mindfulness, the most accurate translation would be Mindfulness or Mindfulness, among others.

    While we generally think we have control over our attention and thoughts, the reality is that we are constantly paying attention to intrusive thoughts about the past or future, or registering only a small portion of what is happening to us. arrives in the world. past. present.

    This practice allows you to explore what is happening while it is happening.. Accept the experience as it is, whether positive or negative, and accept that it is part of our journey in life. It avoids the suffering caused by trying to make the unpleasant go away.

    While mindfulness is linked to many aspects of a more traditional psychology, such as exposure and self-regulation, it offers a certain degree of innovation within its own technique:

    Focus on the present moment

    It is for the patient to focus his attention and put things as they are, without exerting any control over them. The interest of this technique lies in the possibility of experiencing a moment in its own right.

    radical acceptance

    Unlike usual behavior in psychology, radical acceptance is about having the patient focus on their experiences without making any assessments and accepting themselves as natural.

    Choice of experiences

    While it may seem that mindfulness preaches about passively having personal experiences, it is not. People actively choose the goals and life experiences in which to get involved.

    Control

    Acceptance of our experiences implies a relinquishment of their direct control. He seeks to make the person feel his feelings and emotions as they occur. It is not about controlling the discomfort, fear, sadness, etc., but feeling them as such. This point is opposed to traditional procedures in psychology which pursue the elimination of negative thoughts, or the control of anxiety.

    These techniques allow the person to learn to relate directly to everything that is happening in their life in the present moment, to become aware of their reality and to consciously work on the challenges that life presents to them, such as stress. , pain, illness, etc.

    2. Dialectical Behavior Therapy (CDT)

    Dialectical Behavior Therapy Focuses on Learning Psychosocial Skills. This combines various cognitive-behavioral techniques for emotional regulation with some of the concepts typical of contextual therapies, such as acceptance and fullness of consciousness or tolerance to anxiety and stressful events.

    At TDC, the professional accepts and validates the feelings of the patient, but at the same time, it makes him realize that some of these feelings that he experiences are inappropriate. The therapist then instructs the patient on alternative behaviors that will lead to more pleasurable feelings.

    It is a standard therapy in the treatment of borderline personality disorder (BPD), as well as in patients with symptoms and behaviors typical of mood disorders.

    3. Acceptance and Commitment Therapy (ACT)

    Acceptance and Commitment Therapy is a type of intervention that uses acceptance, understood as the ability to respond to sensations, thoughts, feelings, etc., coupled with the commitment to carry out actions in accordance with personal values.

    ACT is based on the theory that psychological problems are based on language, Make inevitable thoughts and feelings that can experience as boring. Through techniques such as metaphors, paradoxes and experimental exercises, the patient learns to connect with these thoughts or sensations, to recontextualize them and to shed light on what really matters in life. Thus, to acquire commitment with the necessary changes that need to effect.

    In addition, acceptance and commitment therapy is linked to strategies to improve psychological flexibility, that is, the person’s ability to be present and to adapt to situations presented to him; thus avoiding the psychological suffering produced by constantly avoiding contact with negative thoughts, emotions or memories.

    4. Functional Analytical Psychotherapy (PAF)

    As well as being considered contextual or third generation therapy, it is also part of the movement called Clinical Behavior Analysis. What sets it apart from other therapies in this wave is the use of the therapeutic relationship as a means to promote behavior change in patients.

    This therapy uses what the patient does and says during the therapy session, Or what are called clinically relevant behaviors. These behaviors include thoughts, perceptions, feelings, etc., which should be looked for during the treatment session in order to work with them.

    Another category concerns the behavioral improvements that take place during these sessions and which need to be reinforced by the therapist. The goal of this type of therapy is to get the patient to interpret his own behavior and its causes from the analytical-functional panorama.

    For this, the therapist uses five strategies:

    • Identification of clinically significant behaviors that take place during therapy sessions
    • Construction of a therapeutic context favoring the appearance of conflicting behaviors, to allow the positive development of the patient
    • Positive reinforcement of patient improvements

    • Detection of aspects of the patient’s behavior that are reinforcing for him
    • Encourage skills development and functional analysis of the relationship between their behaviors and other elements

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