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 predominantly philosophical perspective to a much more empirical approach, thus developing behavioral therapies (first generation therapies) or cognitive-behavioral therapies (second generation).
However, this trend is going down; being the contextual therapies, or third generation therapies, increasingly common in clinical practice. The different types of contextual therapy are based on the philosophical current of Functional Contextualism, whose basis is based on the results of research in the laboratory; and has applications in any area of human life.
- Related article: "The 10 most effective types of psychological therapy"
What is Contextual Therapy?
As already pointed out, contextual therapies are called Functional Contextualism. From this perspective, the person and their behavior are studied within their context and not in isolation.
Further, these therapies give special importance to the patient's verbal behavior and the values that it possesses . That is, what the patient says to himself and to others directly influences his behavior and daily functioning.
Types of Contextual Therapy
Despite not being the only, there are four models of contextual therapies that stand out from the others. But all with a common goal: to alleviate the patient's mitigation through the development of much more effective, extensive and elastic behavior patterns.
Mindfulness has already been established as a reference therapy within contextual models. Although there is no specific word to refer to Mindfulness, the closest translation would be Full Mindfulness or Full Consciousness, among others.
Although as a rule, we think we have control of our attention and our thoughts, the reality is that we are constantly dealing with intrusive thoughts about the past or the future, or registering only a small part of what happens to us in the present .
This practice allows you to explore what is happening while it is happening . Accepting the experience as it is, whether it is positive or negative and accepting that it is part of our way through life. This avoids the suffering caused by trying to make that unpleasant disappear.
Although Mindfulness is linked to many aspects of a more traditional psychology, such as exposure and self-regulation, it offers a degree of innovation within its own technique:
Focus on the present moment
It is about the patient focusing his attention and feeling things as they happen, without exercising any kind of control over them. The benefit of this technique lies in the possibility of living a moment completely.
Unlike the usual procedure in psychology, the radical acceptance is that the patient focuses on their experiences without making any kind of assessment and accepting themselves as natural.
Choice of experiences
Although it may seem that mindfulness preaches to live personal experiences passively, this is not the case. People actively choose what goals and experiences of their life to be involved with.
The acceptance of our experiences implies a renunciation of direct control of these . It seeks that the person experience their feelings and emotions as they happen. It is not about controlling the discomfort, fear, sadness, etc., but to experience them as such. This point is opposed to the traditional procedures of psychology that 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, becoming aware of their reality and consciously working the challenges that life poses, such as stress, pain, the disease, etc.
2. Dialectical Behavioral Therapy (TDC)
Dialectical behavioral therapy focuses on the learning of psychosocial skills . This combines several cognitive-behavioral techniques for emotional regulation with some of the typical concepts of contextual therapies, such as the acceptance and fullness of consciousness or tolerance to anguish and stressful events.
In the TDC, the professional accepts and validates the patient's feelings. But, at the same time, it makes him aware that some of these feelings he experiences are maladaptive. Next, the therapist signals to the patient alternative behaviors that will lead to more pleasant feelings.
It is a reference therapy in the treatment of borderline personality disorder (BPD), as well as in patients with symptoms and behaviors characteristic 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 attend to sensations, thoughts, feelings, etc., together with the commitment to carry out actions coherent with personal values.
The ACT is based on the theory that psychological problems are based on language , making inevitable the thoughts and sensations that can be lived as annoying. Through techniques such as metaphors, paradoxes and experimental exercises, the patient learns to connect with these thoughts or sensations, recontextualizing them and giving light to what really matters in his life. To do so, acquire the commitment with the necessary changes that must be carried out.
In addition, acceptance and commitment therapy is linked to strategies to improve psychological flexibility, that is, the ability of the person to be present and adapt to the situations that arise; thus avoiding the psychological suffering produced by constantly avoiding contact with negative thoughts, emotions or memories.
4. Functional analytic psychotherapy (FAP)
In addition to being considered a contextual or third generation therapy, it is also part of the movement called Clinical Behavior Analysis. What differentiates it from the other therapies of this wave is the use of the therapeutic relationship as a way to promote change in the patient's behavior.
This therapy uses what the patient does and says during the therapeutic session , or what are called clinically relevant behaviors. These behaviors include thoughts, perceptions, feelings, etc., which should be attempted to occur within the treatment session in order to work with them.
Another category is the improvements in behavior that occur during these sessions and that must be reinforced by the therapist. The objective of this type of therapy is to get the patient to perform interpretations of their own behavior and its causes from the analytical-functional perspective.
For this the therapist uses five strategies:
- Identification of clinically significant behaviors that occur during therapy sessions
- Construction of a contextual therapy that promotes the appearance of conflicting behaviors, to allow the positive development of the patient
- Positive reinforcement of patient improvements
- Detection of aspects of patient behavior that are reinforcing for this
- Favored the development of skills and functional analysis of the relationship between their behaviors and other elements