Here are some useful definitions and descriptions for education on important mental health practices in this clinic.
Acceptance and Commitment Therapy (“ACT”)
ACT is an evidence-based, flexible, modular therapy. ACT aims to balance valued aims with the experience and demands of the world around us. Its interventions question assumptions about health, normality, and the self. In doing so, it helps people manage life’s ups and downs flexibly, and maintain a focus on what is important.
ACT focuses on 6 core dimensions of flexibility: acceptance, presence, cognitive defusion (awareness and acceptance of thoughts), self-as-context, committed action, and values.
Cognitive Behavioral Therapy (“CBT”)
CBT is an evidence-based family of therapies, encompassing over 100 years of research. The early emphasis on observable behavior gave way to the cognitive revolution in the 1960s. While cognitive approaches remain core for many practitioners, mindfulness and acceptance-based approaches began to gain in prominence in the 1980s. Cognitive Behavioral Therapy is rooted in behaviorism and learning theory. CBT emphasizes the interaction between self and one’s environment (human and otherwise) through thoughts, emotions, behaviors, and sensations.
There are hundreds of CBT manuals out there. It can be very cumbersome and confusing, for practitioners and participants alike. Efforts have been made to synthesize factors into one modular, all-encompassing CBT manual, such as the Unified Protocol.
Recovery Model
The Recovery Model comes out of a movement from service participants in mental healthcare. It has aimed to build a better balance of power, greater autonomy, and a more positive focus to treatment. While there is, by design, no ‘right’ model for recovery, many services now hold core recovery principles at heart. These include self-determination, strengths-based, non-linear, and hope. While they may seem obvious at first glance, holding to these principles can be essential when so much focus is on problems and struggles.
Shared Decision Making
Shared Decision Making is a bit more complicated than it sounds. It is more than just cooperating in making decisions about treatment: it is also a process of shifting power to the service participant so that control stays with the participant. Shared decision making follows three steps: 1) introducing choice talk; 2) options talk; and 3) decision talk. This process allows for getting on the same page about what is the purpose of this decision, what are the risks and benefits of each option, and recognition that decisions are flexible and should be adjusted based on outcome feedback.
You are a “Participant”?
What’s in a name? Patient, Client, Consumer, Service User…. People who engage in psychotherapy have been called lots of things over the years. Over time, as psychologists have gained a more comprehensive understanding of what therapy should be, word use has shifted. Nowadays, there are many options out there. You can tell a lot about what type of therapy you will receive by what word clinicians use. Some focus on the medical, expert model and use “patient.” Some want to keep the expert element while generalizing away from medicine, and use “client.” Others focus on the professional, capitalistic exchange taking place, and use “consumer” or “service user.”
All of these have common assumptions of hierarchy and one-directionality. Expert giver, lay receiver. Passively receiving a service. This is not true. You are not purchasing furniture. While I am an expert on psychological science, you are the expert on you, and on your community. And for the therapy to be helpful, both people (all, when in group therapy) should be active contributors (see my upcoming blog post on the myths around finding a therapist). Psychological research has had a parallel journey from “research subject” (passive) to “research participant” (active), and some therapists have begun to borrow this term.