By Sara Barbeito, director of the Official Master's Degree in Third Generation Therapies at UNIR
The uproar that was generated in the 1950s when Eysenck indicated that there was insufficient evidence regarding the efficacy of psychotherapy is widely known, on the grounds that the percentage of improvements was similar with and without treatment.
This fact produced a great stir and has survived to this day, producing a growing interest in deepening the efficacy of different psychotherapeutic strategies and orientations..
Since then, psychotherapy has evolved in different models and formats, always trying to show the efficacy sustained in each of its aspects..
Around the 40% of the world's population will have a mental disorder in their lifetime and only one in three of them will receive psychological treatment (Wittchen et al., 2010; Smith et al., 2011). Specifically in Spain, 9% of the population has at least one mental disorder and 15% will manifest it throughout their lives (Haro et al., 2006).
Therefore, the evolution of care demands, as well as the evolution of society, demand effective interventions that also take into account not only the symptom but also the context in which it develops.
In the field of psychological intervention, Third Generation Therapies (Hayes., 2004), are currently the therapies most used by mental health professionals, both in the public and private context, worldwide, by the demonstrated effectiveness of the same.
In the 90s, the third generation of behavioral therapy appeared, which is a continuation of behaviorism and cognitive behavioral therapy.
However, they include a differentiating element with respect to their predecessors, attention to the context, being the nucleus to understand the events, that is, they not only take into account the symptom or difficulty or the behavior, but also address it in a way integral, approaching the person and his context and the function of the same.
In this type of psychotherapy, it is about understanding what happens, through the context where it occurs, its life history and the interpretation that the person makes of its reality. Being its core principle to stop fighting the symptoms, focusing on realizing a reorientation in the life of the person.
In addition, they are therapies with wide acceptance by the population, facilitating the care and commitment of patients with them..
Representatives of this type of therapy are Haynes (Acceptance and Commitment Therapy) and Lineham (Dialectical Behavioral Therapy), Kabat-Zinn (Mindfulness), Shapiro (EMDR), Bateman and Fonagy (Mentalization-Based Psychotherapy), and Ryle ( Cognitive Analytic Therapy), among others.
Third generation therapies do not try to eliminate the above, but to add, better understand psychological functioning of the person and include a variety of models, techniques and treatments that reinforce the capacity of the professional.
At present they are recommended in different strict guidelines and as first line treatment by various reference organizations (WHO).
Thus, important data are being obtained on its efficacy in different mental disorders and difficulties, such as personality disorders (O'Connell et al., 2014), eating disorders (Linardon et al., 2017), anxiety (Cavanagh et al., 2014). al., 2014), depression (Hunot et al., 2013)), psychosis (Louise et al., 2017), post-traumatic stress disorder (Cusack et al., 2016), marital difficulties (Beach et al., 1998), among others (pain, cancer, cardiovascular disorders ...), being applied to different age groups with good results, even preventively.
Therefore, the currently available evidence allows consider third generation psychotherapies as effective therapies (Kahl et al., 2012) and with good acceptance and adherence by patients (O Connor et al., 2018). Being effective, protocolized, manualized, of a fixed duration, well accepted by patients and, therefore, suitable for numerous disorders and difficulties.
Therefore, third generation therapies, can constitute an adequate tool for the demands made by society as well as by mental health professionals.
Bibliographic references
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Cavanagh, K., Strauss, C., Forder, L., & Jones, F. (2014). Can mindfulness and acceptance be learned by self-help?: A systematic review and meta-analysis of mindfulness and acceptance-based self-help interventions. Clinical Psychology Review, 34 (2), 118-129.
Cusack K, Jonas DE, Forneris CA, Wines C, Sonis J, Middleton JC, Feltner C, Brownley KA, Olmsted KR, Greenblatt A, Weil A, Gaynes BN. Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta -analysis. Clin Psychol Rev. 2016 Feb; 43: 128-41. doi: 10.1016 / j.cpr.2015.10.003. Epub 2015 Nov 2. Review. PMID: 26574151.
Hayes, S. C., Masuda, A., Bissett, R., Luoma, J., & Guerrero, L. F. (2004) .DBT, FAP, and ACT: Howempirically oriented are the new behavior therapy technologies? Behavior Therapy, 35 (1), 35-54.
Hunot, V., Moore, T. H., Caldwell, D. M., Furukawa, T. A., Davies, P., Jones, H., ... Churchill, R. (2013). "Third wave" cognitive and behavioral therapies versus other psychological therapies for depression. Cochrane Database of Systematic Reviews.
Kahl KG, Winter L, Schweiger U. The third wave of cognitive behavioral therapies: what is new and what is effective? Curr Opin Psychiatry. 2012 Nov; 25 (6): 522-8. doi: 10.1097 / YCO.0b013e328358e531. Review.PMID: 22992547
Linardon J, Fairburn CG, Fitzsimmons-Craft EE, Wilfley DE, Brennan L. The empirical status of the third-wave behavior therapies for the treatment of eating disorders: A systematic review. Clin Psychol Rev. 2017 Dec; 58: 125-140. doi: 10.1016 / j.cpr.2017.10.005. Epub 2017 Oct 23. Review. PMID: 29089145.
Louise S, Fitzpatrick M, Strauss C, Rossell SL, Thomas N. Mindfulness- and acceptance-based interventions for psychosis: Our current understanding and a meta-analysis. Schizophr Res. 2018 Feb; 192: 57-63. doi: 10.1016 / j.schres.2017.05.023. Epub 2017 May 23. Review. PMID: 28545945
O'Connor M, Munnelly A, Whelan R, McHugh L. The Efficacy and Acceptability of Third-Wave Behavioral and Cognitive eHealth Treatments: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Behav Ther. 2018 May; 49 (3): 459-475. doi: 10.1016 / j.beth.2017.07.007. Epub 2017 Jul 27. PMID: 29704973
O'Connell B, Dowling M. Dialectical behavior therapy (DBT) in the treatment of borderline personality disorder. J Psychiatr Ment Health Nurs. 2014 Aug; 21 (6): 518-25. doi: 10.1111 / jpm.12116. Epub 2013 Nov 5.
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