Throughout the history of psychology, therapies have evolved from a predominantly philosophical perspective to a much more empirical approach, thus developing behavioral (first generation therapies) or cognitive-behavioral (second generation) therapies.

However, this trend is downwards; contextual therapies, or third generation therapies, are increasingly common in clinical practice. The different types of contextual therapy are based on the philosophical current of Functional Contextualism, which is based on the results of research in the laboratory; and has applications in any area of human life.

What is Context Therapy?

As noted above, contextual therapies are named after Functional Contextualism. From this perspective, the person and his behavior are studied within their context and not in isolation.

Furthermore, these therapies give special importance to the verbal behaviour of the patient and the values he or she possesses . In other words, what the patient says to himself and to others directly influences his behaviour and his daily functioning.

Types of Contextual Therapy

Although they are not the only ones, there are four models of contextual therapies that stand out from the others. But all of them have a common goal: to alleviate patient mitigation through the development of much more effective, extensive and elastic behavior patterns.

1. Mindfulness

Mindfulness has already become a reference therapy within the contextual models. Although there is no specific word to refer to Mindfulness, the most accurate translation would be Full Attention or Full Consciousness, among others.

Although as a rule, we think we are in control of our attention and thoughts, the reality is that we are constantly attending to intrusive thoughts about the past or future, or recording only a small part of what is happening 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 passage through life. In this way we avoid the suffering caused by trying to make that unpleasant thing disappear.

Although Mindfulness links 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 exerting any control over them. The benefit of this technique lies in the possibility of living a moment in a complete way.

Radical acceptance

Unlike the usual procedure in psychology, radical acceptance aims at having the patient focus on his or her experiences without making any kind of assessment and accepting them as natural.

Choice of experiences

Although mindfulness may seem to preach about living personal experiences passively, this is not so. People actively choose which goals and experiences in their life to be involved in.

Control

The acceptance of our experiences implies a renunciation of direct control over them . The aim is for the person to experience his/her feelings and emotions as they happen. It is not a matter of controlling discomfort, fear, sadness, etc., but of experiencing 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 at the present moment, becoming aware of their reality and consciously working through the challenges that life presents, such as stress, pain, illness, etc.

2. Dialectical Behavioral Therapy (DBT)

Dialectical behavior therapy focuses on learning psychosocial skills . It combines various cognitive-behavioral techniques for emotional regulation with some of the concepts typical of contextual therapies, such as acceptance and fullness of consciousness or tolerance to distress and stressful events.

In DBT, the practitioner accepts and validates the patient’s feelings, but at the same time, makes him/her aware that some of these feelings he/she experiences are maladaptive. The therapist then points the patient to 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 who present symptoms and behaviors of mood disorders.

Acceptance and Commitment Therapy (ACT)

Acceptance and commitment therapy is a type of intervention that employs acceptance, understood as the ability to attend to feelings, thoughts, sentiments, etc., coupled with the commitment to carry out actions consistent 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 experienced 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. In this way, they acquire the commitment with the necessary changes that they must carry out.

In addition, acceptance and commitment therapy is linked to strategies to improve psychological flexibility, i.e. the person’s ability to be present and adapt to the situations presented to them; thus avoiding the psychological suffering produced by constantly avoiding contact with negative thoughts, emotions or memories.

4. Functional Analytical Psychotherapy (FAP)

Besides being considered a contextual or third generation therapy, it is also part of the movement called Clinical Behavior Analysis. What differentiates it from other therapies in this wave is the use of the therapeutic relationship as a way of promoting change in the patient’s behaviour.

This therapy uses what the patient does and says during the therapy session , or what are called clinically relevant behaviours. These behaviours include thoughts, perceptions, feelings, etc., which should be made to occur within the treatment session in order to work with them.

Another category is improvements in behavior that occur during such sessions and should be reinforced by the therapist. The aim of this type of therapy is to get the patient to make interpretations of their own behaviour and its causes from the analytical-functional perspective.

The therapist uses five strategies to do this:

  • Identification of clinically significant behaviors that occur during therapy sessions
  • Construction of a therapeutic context that favours the appearance of conflictive behaviours, to allow the positive development of the patient
  • Positive reinforcement of patient’s improvements
  • Detection of the aspects of the patient’s behaviour that are reinforcing for the patient
  • Fostering skill development and functional analysis of the relationship between their behaviors and other elements