United we stand: emphasizing commonalities across cognitive-behavioral therapies.
United we stand: emphasizing commonalities across cognitive-behavioral therapies.
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DOI：
10.1016/j.beth.2013.02.004
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发表时间：
2013-06
期刊：
影响因子：
3.7
通讯作者：
Gross JJ
中科院分区：
文献类型：
--
作者：
Mennin DS;Ellard KK;Fresco DM;Gross JJ
认知行为疗法（CBT）在减轻与精神障碍相关的痛苦方面有着丰富的历史。最近，有了令人兴奋的新发展，包括多组分方法，结合替代疗法（如冥想），有针对性和成本效益的技术，以及综合生物和行为框架。这些领域范围的变化导致一些人强调CBT变体之间的差异。在这里，我们提请注意认知行为疗法的共性，包括共同的目标、改变原则和治疗过程。具体来说，我们提供了一个框架来研究常见的CBT特征，强调行为适应是一个统一的目标和三个核心变化原则，即：(1)情境参与促进适应性想象和制定新体验；(2)注意变化促进注意的适应性维持、转移和扩展；(3)认知改变，促进对事件的适应性视角，从而改变言语意义。此外，我们认为，特定的干预成分，包括行为暴露/激活、注意力训练、接受/容忍、去中心化/融合和认知重构，可能会在不同的治疗方案中或多或少地得到强调，但从根本上讲，它们仍然是跨方法存在的共同治疗过程，并且最好通过它们与这些核心CBT改变原则的关系来理解。最后，我们提出了研究独特和共同特征的共享方法和设计框架，以便在日益扩大、多模式和跨学科的干预科学中推进CBT的统一和强有力的声音。
Cognitive behavioral therapy (CBT) has a rich history of alleviating the suffering associated with mental disorders. Recently, there have been exciting new developments, including multi-component approaches, incorporated alternative therapies (e.g., meditation), targeted and cost-effective technologies, and integrated biological and behavioral frameworks. These field-wide changes have led some to emphasize the differences among variants of CBT. Here, we draw attention to commonalities across cognitive-behavioral therapies, including shared goals, change principles, and therapeutic processes. Specifically, we offer a framework for examining common CBT characteristics that emphasizes behavioral adaptation as a unifying goal and three core change principles, namely (1) context engagement to promote adaptive imagining and enacting of new experiences; (2) attention change to promote adaptive sustaining, shifting, and broadening of attention; and (3) cognitive change to promote adaptive perspective taking on events so as to alter verbal meanings. Further, we argue that specific intervention components including behavioral exposure/activation, attention training, acceptance/tolerance, decentering/defusion, and cognitive reframing may be emphasized to a greater or lesser degree by different treatment packages but are still fundamentally common therapeutic processes that are present across approaches and are best understood by their relationships to these core CBT change principles. We conclude by arguing for shared methodological and design frameworks for investigating unique and common characteristics to advance a unified and strong voice for CBT in a widening, increasingly multimodal and interdisciplinary, intervention science.