In the 21st century, the clinician is confronted with a plethora of choices when it comes to therapeutic modalities or orientations. While traditional CBT remains the dominant modality in clinical training programs, a range of variations have emerged over recent years. These ‘new wave’ procedures are based on alternative ways of dealing with maladaptive thoughts and behaviours. For example, while traditional CBT has tended to promote a direct attack on unhelpful thoughts and beliefs, many ‘new wave’ procedures adopt metacognitive or diffusion strategies for dealing with this material. Mindfulness-based CBT, ACT, and Schema-focused therapy have had extensive coverage in continuing education programs and workshops over recent years. It is also clear that increasing numbers of community-based programs are including strategies from these therapeutic orientations. But what is the state of the evidence for these approaches to helping people change? In what disorders is their evidence-base strong, and how does it compare to the evidence-base for traditional CBT treatment procedures?

The workshop reviews the evidence for the different psychotherapeutic orientations currently on offer across the range of mental health problems. First, it provides a critical evaluation of some of the assumptions of the various therapeutic modalities. Second, it provides the clinician with an overview of how to assess clinical trials evidence in psychotherapy. Third, it provides detailed analyses of the current evidence-base for the various therapy ‘brands’ across the anxiety disorders, depression, personality disorders and related areas. Fourth, it demonstrates how a thorough understanding of the theoretical underpinnings of each disorder can be used to produce programs that combine ‘new wave’ and traditional procedures in psychotherapy.

This workshop begins with a thorough critique of the working assumptions of the cognitive account of emotion as it is typically applied to cognitive therapy. While CBT is increasingly accepted as the treatment of choice for most sufferers of the emotional disorders, many of the assumptions of contemporary Cognitive Therapy will be shown to be fundamentally flawed. For example, the notion that individuals can readily identify ‘hot cognitions’ that are claimed to play a causal role in driving emotion is disputed by a range of laboratory findings across the last 70 years. Cognitive Therapy, as it is most typically practiced, rests on the spurious claim that humans can easily introspect and identify these causal thoughts, beliefs and attitudes. This has led to the use of overly simplified ‘thought records’ as the central tool in the cognitive therapist’s weaponry. CT delivered in this way is inadequate, since it will regularly fail to identify a range of contributing factors and biased reasoning styles in any given case.

Participants in the workshop will be instructed in the use of more complex materials and methods for the identification of causal cognitive structures involved in negative emotion. The workshop will focus on the use of thirty-two worksheets, each designed for a different and specific purpose in the identification and challenging of unhelpful thoughts. Actual case examples will be used to guide participants through the use of these worksheets.