CBT waves through the lens of Complex Systems Theory: A tentative way toward integration and sustainability

Abstract

IntroductionIn the last 15 years, several new waves have been described within CBT. At the same time, two constraints seem to define the role of psychotherapy: an integrative theoretical trend; an increasing incidence of chronic psychiatric disorders and psychiatric morbidity in chronic conditions.ObjectivesWe discuss the viability of a Complex Systems Theory perspective in fostering the theoretical integration of the new wave of CBT and in promoting the healthcare sustainability in facing with chronicity.AimsThe aims of the present study are to:– frame a few recurrent and relevant theoretical dimensions in psychotherapy;– outline a preliminary cost-effectiveness analysis of a Complex Systems Theory approach to psychiatric chronicity.MethodsWe performed a non-systematic review and a meta-synthesis of selected references (identified through a citation analysis per single reference and per single scholar) of the new wave of CBT. We especially focused on theoretical handbooks, meta-analyses and reviews, clinical trials.ResultsComplex Systems Theory describes an approach to theoretical and operational models based on adaptability, interdependency and self-organization. In defining a few integrative trends in psychotherapy, we highlighted the focus on:– interpretation of events vs. events per se;– processes vs. contents;– transdiagnostic vs. pathologized models.Furthermore, we framed economic, organizational, and educational implications of such an approach in promoting the adaptability of psychotherapy-as-a-system in dealing with the so-called double crisis of welfare state: continuous cutbacks in response to recession; longer-term pressures on health and social care.ConclusionsDespite further studies are needed, we maintain that psychiatry may benefit from a Complex Systems Theory perspective.Disclosure of interestThe author has not supplied his/her declaration of competing interest.