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What is Third-Wave Therapy and Third-Wave CBT?

by edinburghtherapyservice
10 minutes read

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In the ever-evolving field of mental health, new therapeutic approaches or types are constantly emerging. One of the most noteworthy developments in recent years has been the advent of third-wave therapies. These innovative approaches are changing the way we understand and treat various mental health issues. In this blog post, we will explore what third-wave therapies are, how they differ from traditional therapies, and their potential benefits.

What is a “wave” in psychotherapy?

Before diving into third-wave therapies, it’s essential to understand their place in the broader context of psychotherapy. Psychotherapy has undergone significant transformations over the years, with each “wave” representing a new stage of development.

  • First wave: The first wave of psychotherapy was dominated by psychoanalysis, pioneered by Sigmund Freud. This approach focused on exploring the unconscious mind and the role of childhood experiences in shaping adult behaviour.
  • Second wave: The second wave introduced behaviourism, which emphasised observable behaviours and the use of conditioning techniques to modify them. Cognitive-behavioural therapy (CBT) also emerged during this period, emphasising the role of thoughts in influencing emotions and behaviours.
  • Third wave: The third wave of psychotherapy, which gave rise to third-wave therapies, began in the 1990s. These approaches marked a departure from the more traditional and structured therapies of the past. They are characterised by a focus on mindfulness, acceptance, and the interconnectedness of thoughts, emotions, and behaviours.

Key third-wave approaches

Several therapeutic approaches fall under the umbrella of third-wave therapies, each with its unique principles and techniques. Here are some of the most prominent ones:

  • Acceptance and commitment therapy (ACT): ACT encourages individuals to accept their thoughts and feelings rather than trying to change or suppress them. It promotes mindfulness, values clarification, and committed action as essential components of psychological flexibility.
  • Mindfulness-based stress reduction (MBSR): Developed by Jon Kabat-Zinn, MBSR combines mindfulness meditation and yoga to reduce stress and enhance overall well-being. It has been widely adopted in clinical settings.
  • Compassion-focused therapy (CFT): CFT aims to cultivate self-compassion and address self-criticism. It acknowledges the importance of treating oneself with kindness and understanding, especially when facing difficulties.
  • Metacognitive therapy: Metacognitive Therapy focuses on helping individuals change their thinking processes, specifically targeting maladaptive metacognitions or beliefs about thinking itself. It aims to reduce rumination and improve mental well-being.
  • Dialectical behaviour therapy (DBT): Originally designed to treat borderline personality disorder, DBT integrates cognitive-behavioural techniques with mindfulness and acceptance strategies. It is effective in addressing emotion regulation and interpersonal effectiveness.

CBT vs third-wave therapies

Cognitive-behavioural therapy (CBT) and third-wave therapies are both forms of psychotherapy, but they have distinct differences in their theoretical foundations and therapeutic approaches. Here’s a comparison of the two:


Cognitive-behavioural therapy (CBT)

  • Founding principles: CBT is one of the earliest forms of psychotherapy and is rooted in behaviourism and cognitive psychology. It was developed based on the idea that thoughts, feelings, and behaviours are interconnected, and changing negative thought patterns can lead to behavioural and emotional change.
  • Focus: It primarily targets changing maladaptive thought patterns and behaviours. It often involves identifying and challenging cognitive distortions or “thinking errors” that contribute to emotional distress.
  • Techniques: CBT employs structured techniques, such as thought records and behavioural experiments, to help clients recognize and modify unhelpful thought patterns. It emphasises problem-solving and skill-building.
  • Mindfulness: While some versions of CBT incorporate mindfulness techniques, it’s not a central focus. Traditional CBT tends to prioritise cognitive restructuring and behavioural change over mindfulness and acceptance.


Third-wave therapies

  • Founding principles: Third-wave therapies emerged in response to the perceived limitations of traditional CBT. They incorporate elements from mindfulness-based practices, Eastern philosophies, and other therapeutic traditions. These therapies emphasise acceptance, mindfulness, and values-based living.
  • Focus: They place a strong emphasis on accepting difficult thoughts and emotions rather than trying to change or eliminate them. They promote psychological flexibility, which involves being open to experiences and taking committed actions despite emotional discomfort.
  • Techniques: These therapies incorporate mindfulness and acceptance techniques as core components. Clients learn to observe their thoughts and emotions without judgement, defuse from unhelpful thinking patterns, and align their actions with their values.
  • Mindfulness: Mindfulness is a central focus. Clients are encouraged to develop a mindful awareness of their inner experiences and the present moment.

While both CBT and third-wave therapies aim to alleviate psychological distress, they differ in their underlying philosophies and therapeutic techniques. CBT is more focused on cognitive restructuring and behavioural change, whereas third-wave approaches prioritise acceptance, mindfulness, values-based living, and psychological flexibility. The choice between the two often depends on the individual’s preferences and the nature of their mental health challenges.

Integrating CBT with Third Wave Therapies: A Personalized Approach

Therapists are trained to adapt their therapeutic approach based on the client’s progress and feedback. This flexibility allows for ongoing adjustments to the treatment plan, ensuring that it remains effective and relevant throughout the therapeutic journey. As a result, it’s not uncommon for therapists to combine CBT with third-wave therapies to create a more comprehensive and personalised treatment approach. This blending of therapeutic techniques allows therapists to adapt their interventions to the unique needs and preferences of each client. Some benefits of this combination include:

  • Flexible and personalised treatment: Every person seeking therapy has a unique set of challenges, strengths, and preferences. CBT and third-wave therapies each offer valuable tools and insights. By combining these approaches, therapists can tailor the treatment plan to suit the specific needs of the client.
  • Enhanced mindfulness: Third-wave therapies bring mindfulness to the forefront of treatment. By incorporating mindfulness techniques into a CBT framework, clients can learn to observe their thoughts and emotions more objectively, allowing them to better understand and challenge unhelpful thought patterns.
  • Psychological flexibility: Combining CBT with third-wave therapies can foster psychological flexibility. Clients can learn not only to modify their thought patterns and behaviours but also to respond to challenging situations with greater adaptability and resilience.
  • Holistic well-being: Third-wave therapies often take a holistic approach to mental health, considering the interconnectedness of various aspects of life. This broader perspective can be integrated into CBT to help clients work towards not only symptom reduction but also overall well-being and personal growth.

Combining CBT with third-wave therapies provides therapists with a versatile toolkit to create a more complete and client-centred treatment approach. This integration allows clients to benefit from the strengths of all these approaches, promoting a deeper understanding of their challenges and a more holistic path to personal growth and well-being.

Further reading

Your third-wave therapist in Edinburgh

Edinburgh Therapy Service is a counseling and psychotherapy practice based in Edinburgh. We specialize in a range of therapeutic approaches, including cognitive-behavioral Therapy (CBT) and the third-wave therapies such as acceptance and commitment therapy (ACT), compassion-focused therapy (CFT), and mindfulness-based cognitive therapy (MBCT). Our services extend beyond the borders of Edinburgh, as we offer online therapy to clients worldwide. Contact us today!

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The Edinburgh Therapy Service is a psychotherapy and counseling practice based in Edinburgh, Scotland (United Kingdom). We offer therapy both in-person in Edinburgh and online, available in English and Spanish.

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Contact us for more information or to book your first appointment: [email protected]