Mindfulness and Acceptance (a review)

Mindfulness and Acceptance: Expanding the Cognitive-Behavioral Tradition, Edited by Steven C. Hayes, Victoria M. Follette, and Marsha M. Linehan Guildford Press, NY

In the past decade or so, CBT in its various guises has begun to move away from its original intellectual roots to integrate ideas that were previously left to other areas of thinking and practice – including mindfulness, acceptance, values, the therapeutic relationship, spirituality, meditation and focusing on the present moment. These ideas tend to emphasise the experiential (‘being’ not ‘doing’), and therefore differ from the behavioural therapy traditions and can struggle to be neatly characterised using traditional distinctions between behaviour therapies and other therapies.

This book is broadly concerned with looking at these new developments, with some emphasis on the inherent tensions of classification that they bring (for example, how do meta-cognitions fit with cognitions?). Leading authors, researchers and clinicians contribute, although largely through the lens of psychological science and research which (mostly) doesn’t make for light reading. Research findings and heavy terminology that goes with it meant it quickly became a desk book rather than a bedside one for me – theoretical models being referred to as ‘technologies’ in the preface warned me early.

Each of the 13 chapters articulates a theoretical model, examines it against others, wraps up recent research findings and looks ahead at the possible implications for future clinical use. The first few chapters look at more general approaches and issues, such as Dialectical Behaviour Therapy: Synthesising Radical Acceptance with Skilful Means (Robins, Schmidt III and Linehan) and Mindfulness-Based Cognitive Therapy: Theoretical Rationale and Empirical Status (Segal, Teasdale and Williams). Later chapters hone in on more specific issues – such as Acceptance, Mindfulness and Trauma (Follette, Palm and Hall), and a fascinating, less well known look at Vipassana Meditation as a Treatment for Alcohol and Drug Use Disorders (Marlatt et al). Two chapters look at aspects of couples work too – an area that mindfulness-based ideas has tackled less in the literature.

The thrust of this volume is an optimistic one – a feeling emerges of an exciting and dynamic future for the CBT traditions, fuelled by these old ideas, newly incorporated. Authors all offer their own reflections on how the field can develop, including sharing their ideas of how clinical applications of their work may expand. Here is a good place to start if you are keen on seeing where CBT thinking may go to – it’s hard to ignore Mindfulness CBT these days at the least.

This first appeared in Private Practice journal.