The trans-theoretical model for mindful cognitive behavioral therapy a paradigm for systematically advancing evidence-based practice and research

Abstract

Fundamental aspects of contemporary Cognitive Behavioral Therapy (CBT) are linked to ancient philosophies like Stoicism and Buddhism and have evolved through three generational “waves” that can be traced to the early development of behaviorism. These “waves” are often referred to as Behavioral Therapy, Cognitive Therapy, and Mindful Cognitive Behavioral Therapy (MCBT). As the second wave transitioned into the third wave, prominent theorists rebranded principles and practices that were central to traditional CBT. This has generated confusion and miscommunication among researchers, therapists, and the public, which has hampered progress toward the widespread practice of effective, evidence-based treatment. Because no single branded theory is flexible enough to apply to the broad range of clients a typical practitioner serves, many psychotherapists resort to an “eclectic” approach. While combining elements from different protocols can be effective, this approach sacrifices the structure provided by the CBT theoretical paradigm and therefore lacks the integrity of evidence-based practice. To address these challenges, this paper proposes an organizing framework called the Trans-Theoretical Model for Mindful Cognitive Behavioral Therapy (TM-MCBT). This model provides three crucial benefits: 1) a flexible and scientifically-grounded structure within which psychotherapists can choose the most relevant evidence-based interventions for their clients; 2) clarity to researchers as they attempt to establish what is happening, when it is happening, and how often; and 3) a common lexicon that enables providers, their clients, researchers, and the general public to continue to integrate the collective wisdom of the ages within contemporary evidence-based practices.