CBT is already a mature field, often being the approach someone seeking treatment specifically names, and a young enough field to still have many of the first influential thinkers, researchers, and practitioners among us. We are thus blessed with the ability to ask them about themselves and their approach to the problems that confront many of us. Imagine a world where we got to listen to Darwin outside the Royal Society or to the Wright brothers, and you'll get a sense of the important of these sessions, and the treat they are to so many of us.
Meet our CBT Pioneers....
In a discussion in which he lays out various elements that we do, or can, use to help us better address our patients’ needs, Greg Siegle points to neuroscience, mindfulness, dissemination and implementation, as well as brain mechanisms, and manages to make it all visible, understandable, and come to life.
Talking about neuroscience’s role, he says negative emotions are visible, we can see them: he’s watched a 30-second response to a negative word, uttered in a nanosecond; by showing this to our patients, we show them they are not the sole cause of their negative emotions. Ultimately, we might be able to personalize medicine, finding those who are more likely to respond better to CBT or, even better, find ways to prepare those who might not so that they could better benefit. He hopes we can harmonize the language of psychology, as researchers, clinicians and patients, and industry each use different languages. We should aim to build dissemination and implementation into research so our findings can be used. Talking about ABCT, Siegle said the Association kept him touch with what clinicians care about.
Steve Safren recounts his work on “Life Steps,” which promotes adherence to taking HIV medicine. In 1996, medicines were becoming available that changed HIV from a death sentence to something manageable, but the drugs were difficult to take, had huge side effects, and had complex dosages. Life Steps helped people break those complex dosages into manageable steps. He notes that this adherence intervention has since been adapted to other areas, include comorbid depression and other mental health problems. And, he says, it’s become the standard of care for Doctors without Borders in their fights against HIV/AIDS in South Africa.
He thinks that what science shows isn’t always practiced. He notes how, when confronted with severe mental health problems, instead of sequencing various solutions, such as medicines and cognitive-behavioral therapy, which science shows is the most effective approach, practitioners might just throw everything at it at once. He is also looking forward to seeing more studies comparing new technologies to in person treatment, to see which has more success for which clients; and hoping to involve CBT in the medical system more effectively.
Patricia Resick looks to the future, discussing the potential of technology, not only in treatment where remote sessions are being shown to be as effective as in-camera ones, but also in helping train front-line providers, like the social workers who are often the ones administering most of the treatment that people will receive. She thinks courses in CBT, especially basics, diagnosis, and assessment, could supplement the two years in masters-level training that often doesn’t cover enough.
Meet Russell Barkley, who has explored ADHD and its implications for half a century, looking at parental relationships, its effects on executive functioning as well as it long-term health and occupational outcomes. Lately, he’s been studying mortality rates and life expectancy as he has followed ADHD through adulthood, showing it is not only a mental health problem but a health concern as well.
Tom Ollendick talks pediatric anxiety treatments, and especially his early work with one-session treatments that had success rates as high as 75% and long-term success even at 4 years.
One of the foremost experts in hoarding, Gail Steketee reflects on her past and psychology's future. She thinks it essential to find out what works best, for whom, and under what conditions. She believes we need to take advantage of new information available now from our research findings in neuroscience and biology in order to better help people.
Gail thinks that it is important to distinguish when diagnostic categorizing works for us; when the "lumping and splitting we all do as humans is used to best advantage."
One of CBT's recognized experts in depression, Steve Hollon looks at the landscape in clinical practice today, seeing a need for change. He wants us to use what we know works, not what we know best. He lauds those, like Vikram Patel, who is researching ways to increase access to mental health care in less developed countries, exploring new ways of task shifting.
Alan Kazdin recounts how he came to be a psychologist and discusses where his emphasis is now: studying models of treatment delivery with the idea of completely changing who, and how many, can access treatment. He notes that "most people in need of psychological help receive no treatment." This is based on current delivery models. He's hoping to find ways to make delivery scalable and accessible, overcoming the current inherent limits.
Andrew recounts his interesting path from deep South chicken-farming family to Southern California researcher, therapist, and innovator. From "practice dating" and family systems, he's moved to couples' conflict and couples' intervention, studying the push-pull patterns and the roles the partners take. With the late Neil Jacobson, he developed Integrated Couple Behavior Therapy that focuses on understanding broad patterns, causal analysis, and behavioral change and, especially, emotional acceptance.
Esther Deblinger shares her personal and professional journey choosing a career in clinical psychology and focusing her research on helping children and families overcome adversity. Her research in collaboration with colleagues not only led to highly effective evidence-based treatments that are utilized worldwide, but her academic pursuits deepened her understanding of the impact of childhood trauma on her own parents. Her training, research and service efforts continue to be inspired by the resilience she has seen in her parents as well as the many children and families with whom she has worked.
Perhaps most famous for Acceptance and Commitment Therapy, Hayes is equally passionate about social justice and societal concerns and his hope that psychology can leave the protocols behind and focus on the competencies.
When asked about dissemination, he said he hates the word and hates the very idea. We shouldn't be telling, or showing, he says, but, instead, creating a safe space in which we welcome all to talk about their perspectives before talking about ours. At the same time, Hayes relishes the work of Ronan and Klepac's Organizational Task Force and wishes we were banging the drums more loudly about their findings.
Art Nezu and Christine Maguth Nezu
Art and Chris have done outstanding work in developing problem solving approaches and specialty competencies in psychology, as well as promoting multiculturalism and diversity within the field. Listen as they discuss early days in art, theatre, and social activism through their fortune telling for the field.
Listen to Judy Beck as the teacher comes full circle, returning to her roots. It includes fascinating insights, especially a discussion of the principles and fidelity inherent in manuals and the need to conceptualize the patient's individual needs.