Framing and definition of therapy

The evolution towards the third generation and the contextual approach

Acceptance and Commitment Therapy (ACT) represents a paradigm shift within clinical psychology, placing it in what is known as the "third wave" or third generation of cognitive-behavioral therapies.

To understand its position, it is necessary to review the history: the first generation (behaviorism) focused exclusively on observable behavior change through conditioning and associative learning.

Subsequently, the second generation introduced cognition as a determining factor, assuming that in order to change an emotion or dysfunctional behavior, we must first modify the "erroneous" or distorted thinking that preceded it.

However, ACT and other third-generation therapies propose a radically different approach: they abandon interest in the content of thoughts (whether they are true, false, logical or irrational) to focus exclusively on their function and the context in which they occur.

In this model, a thought is not considered pathological because it is negative or pessimistic.

What determines whether a cognition is problematic is its usefulness or functionality in the person's life.

The therapeutic question ceases to be "Is it true that you are worthless?" and becomes "Does merging with the idea that you are worthless help you build the life you desire?" This approach is called functional contextualism.

It seeks to alter the relationship the individual has with his or her private events (emotions, memories, sensations), rather than attempting to alter the events themselves.

It is assumed that attempting to "fix" thoughts often gives more power and relevance to those same thoughts, creating a vicious cycle of attention and struggle.

Fundamental contrasts with traditional second generation models

The most notable difference with traditional second-generation therapies (such as classical Cognitive Behavioral Therapy or CBT) lies in the distress management strategy.

Classical CBT operates on a "change and control" premise: if you feel anxiety or have catastrophic thoughts, you are taught tools to discuss those thoughts, look for counter-evidence, relax, and reduce the symptom.

Success is often measured by reducing the frequency and intensity of discomfort.

ACT challenges this logic, arguing that mental health is not the absence of symptoms.

For example, imagine a person who avoids going to parties because he or she thinks "I'm boring and no one will want to talk to me."

A traditional therapist might work on cognitive restructuring: look for evidence that the person has been fun in the past, analyze the actual likelihood of being rejected, and try to replace the negative thought with a more realistic one such as "I'm sometimes quiet, but I can be interesting." The goal is to make the person feel better so that he or she can then go to the party.

In contrast, from the ACT perspective, the goal is not to convince the mind that "I am interesting."

The therapist might say, "Your mind is telling you the story that you are boring.

Can you carry that story with you, feel the insecurity it causes you, and still go to the party because connecting with other people is an important value to you?"

Engaged action is encouraged with the symptom, not after the symptom goes away.

Summary

Acceptance and Commitment Therapy is situated in the third generation of cognitive-behavioral therapies, proposing a paradigm shift by abandoning interest in the logical content of thoughts.

This model, called functional contextualism, seeks to alter the individual's relationship with his or her private events rather than modify them, focusing exclusively on the function and context in which they occur.

Unlike traditional "change and control" models, ACT promotes acceptance and value-committed action, inviting the symptom to be carried rather than eliminated.