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The third generation of cognitive behavior therapy (CBT) has been defined this way:

Grounded in an empirical, principle-focused approach, the third wave of behavioral and cognitive therapy is particularly sensitive to the context and functions of psychological phenomena, not just their form, and thus tends to emphasize contextual and experiential change strategies in addition to more direct and didactic ones. These treatments tend to seek the construction of broad, flexible and effective repertoires over an eliminative approach to narrowly defined problems, and to emphasize the relevance of the issues they examine for clinicians as well as clients. The third wave reformulates and synthesizes previous generations of behavioral and cognitive therapy and carries them forward into questions, issues, and domains previously addressed primarily by other traditions, in hopes of improving both understanding and outcomes. (Hayes, 2004)

The most unique characteristic of the third wave interventions is the degree of emphasis on contextual and experiential change strategies, including acceptance, defusion, mindfulness, relationship, values, emotional deepening, contact with the present moment, and the like. The purpose of experiential and contextual strategies of this kind is to rapidly alter the function of problematic psychological events, even if their form or frequency does not change or changes only slowly. Mindfulness-based and acceptance technologies show that focus quite clearly. For example, Segal, Teasdale, and Williams (2004) state: “Unlike CBT, there is little emphasis in MBCT on changing the content of thoughts; rather, the emphasis is on changing awareness of and relationship to thoughts.”

It is worth noting that this step is being taken both by techniques that are quite behavior analytic and thus philosophically contextualistic in their rationalization (e.g., Behavioral Activation, ICBT, DBT, ACT, FAP), and by techniques that are quite cognitive in their rationalization (e.g., MBCT, Metacognition).

This is important, because it means that the mainstream itself is changing and there are new opportunities for connection and communication across old boundaries. In a kind of dialectical synthesis of a previous thesis and antithesis, the new wave therapies seem to be healing old wounds and divisions between behavioral and cognitive perspectives. Evidence for this view can be found in the synergies between technologies across of the spectrum of third wave interventions, and in the ways that each of these new approaches has breadth across these divisions regardless of its home of origin. The third wave interventions are not a rejection of the first and second waves of behavioral and cognitive therapy so much as a transformation of these earlier phases into a new, broader, more interconnected form. Thus, while the implications may be revolutionary, the processes giving rise to these developments are evolutionary – as might be expected in an explicitly empirical tradition.

We invite child pages to be added in any of the methods and approaches that are part of a more contextual approach (simply click the "add child page" link at the bottom of the relevant page). Check out the Fellow Travelers Forum for ongoing discussions.