R4第7回医科研セミナークラブ

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Psychotherapy is an evolving field, as befits any evidence-based
discipline. The empirically best supported approach in psychotherapy
is cognitive behavioral therapy or "CBT". Nearly 20 years ago, in
2004, I declared in my Presidential address article for the
Association for Behavioral and Cognitive Therapy (ABCT) that a "third
wave" of CBT had arrived, emerging from both the behavioral and
cognitive wings of CBT, that was carrying this tradition into deeper
clinical waters based on present attention to processes of acceptance,
mindfulness, and values.
At the time, some argued that there was no such wave — but in
hindsight today almost all agree that such a change was occurring.
Today, almost all appear to agree that the 3rd wave of CBT brought
with it a number of useful ideas and methods. In this talk, I will
argue that an even more disruptive change is now upon us in the form
of a shift away from "protocols for disorders" and toward a focus on
the idiographic analysis of biopsychosocial processes of change, and
treatment elements that move them. I will argue that the work on
Acceptance and Commitment Therapy or "ACT" is an example of this
process-based approach but that the underlying ACT model needs to
expand to make room for what the evidence now suggests is a broader
set of processes important to clinical change. CBT is in a position to
become far more dominant clinically and culturally if a process-based
approach is vigorously and rigorously adopted, and pursued in an
idionomic fashion. The implications of that statement will be explored
in this talk.

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