인지행동치료의 제 3 동향 = The Third Wave of Cognitive-Behavioral Therapy

다국어 초록 (Multilingual Abstract)

Recently, a third wave of cognitive-behavioral therapies has emerged, emphasizing acceptance of private experiences. This approaches focus on changing individual's relationship to the thoughts and feelings, rather than attempting to modify their content. The change of the context is focused, that is acceptance of private experiences. For the acceptance of private experiences, the principle of Oriental mindfulness is usually applied. Acceptance involves an active process of thinking thoughts as thoughts, feeling feelings as feelings, the shift in cognitive set known as decentering, and allows choices and committed action. The purpose of this study is to review and introduce the new wave. In this article, the background and current development of the third wave of cognitive-behavioral therapies are explored. And the foundation of the theory, therapeutic techniques and outcomes of empirical studies of Acceptance-Commitment Therapy, one of the primary exemples of this third wave, is reviewed. Finally, the implications of this evolutionary wave and the necessity of further research, program development, and application in Korea is discussed.

국문 초록 (Abstract)

근래 인지행동치료의 전통 내에서 심리적 수용에 역점을 두는 치료법들이 출현하면서 제 3의 흐름을 형성하고 있다. 이 접근들에서는 생각이나 감정과 같은 사적 경험(private experience)의 내용을 바꾸기보다 그에 대한 관계를 변화시키는 데에 역점을 둔다. 즉, 경험의 수용이라는 맥락의 변화를 강조하는데, 이를 위해 동양심리학의 알아차림(mindfulness) 원리를 흔히 활용한다. 심리적 수용의 촉진을 통해 생각을 생각으로, 감정을 감정으로 자각하여 탈중심화(decentering) 되고 선택한 행동에 전념하도록 돕는다. 본 연구의 목적은 인지행동치료 내의 새로운 흐름을 고찰하고 개관하는 것이다. 본고에서는 인지행동치료의 제 3 동향이 출현하게 된 배경과 전개 과정을 검토하고, 그 중심부에서 활발히 발전하고 있는 수용-전념치료(Acceptance-Commitment Therapy)의 이론적 기초와 치료기법 및 경험연구 결과들을 살펴보았다. 끝으로, 인지행동치료의 새로운 흐름이 지니는 시사점과 국내에서 연구개발 되고 활용될 필요성에 대하여 논의하였다.

참고문헌 (Reference)

1 "명상과 자기치유 [Full catastrophe living The program of the Stress Reduction Clinic at the University of Massachusetts Medical Center] 원전은 1990에 출판" 1998

2 "공상집착 그리고 상담 상담접근의 한 모형 상담 및 심리치료" 1-17, 2001

3 "promising new treatment for couple discord Journal of Consulting and Clinical Psychology" Prince 351-355, 2000

4 "and the types of psychological acceptance Content and context in psychotherapy" Context Press 13-32, 1994

5 "Vipassana meditation as a treatment for alcohol and drug use disorders" Guilford Press 261-287, 2004

6 "The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patient:A randomized controlled trial" 70 : 1129-1139, 2002

7 "The suicidal patient: Principles of assessment, treatment and case management." American Psychiatric Press 1995

8 "The role of acceptance and job control in mental health , job satisfaction, and work performance." 1057-1067, 2003

9 "The relationship between cognition and emotion The mind-in-place in mood disorders Science and practice of cognitive behaviour therapy" Oxford University Press 67-93, 1997

10 "The only way out is through:emotional processing and recovery after a depressing life event" 36 : 361-384, 1998

11 "The impact of acceptance versus control rationales on pain tolerance" 33-47, 1999

12 "The effects of acceptance versus control contexts on avoidance of panic-related symptoms" 293-312, 2003

13 "The central dialectic in psychotherapy Content and context in psychotherapy" Context Press 73-86, 1994

14 "The act of acceptance Content and context in psychotherapy" Context Press 37-50, 1994

15 "Relational frame theory: A précis." Plenum Press 2001

16 "Reconciliable differences." Guilford Press 2000

17 "Process and outcome in psychotherapy Handbook of psychotherapy and behavior change" 311-383, 1986

18 "Prevention of relapse/recurrence in major depression by mindful-based cognitive therapy" 615-623, 2000

19 "On second thought:Where the action in in cognitive therapy for depression" 13 : 441-457, 1989

20 "Mood and memory" 36 : 129-148, 1981

21 "Mindfulness-based cognitive therapy for depression A new approach to preventing relapse" Guilford Press 2002

22 "Mindfulness- based cognitive therapy for depression:Replication and exploration of differential relapse prevention effects" 72 : 31-40, 2004

23 "Mindfulness training as a clinical intervention" 125-143, 2003

24 "Metacognitive awareness and prevention of relapse in depression" 275-287, 2002

25 "Metacognition,mindfulness and the modification of mood disorders" 146-155, 1999

26 "Mediator of change in emotion-focused and problem-focused worksite stress management interventions" 5 : 156-163, 2000

27 "How empirically oriented are the new behavior therapy technologies?" 35-54, 2004

28 "How does cognitive therapy prevent relapse in residual depression Evidence from a controlled trial Journal of Consulting and Clinical Psychology" 347-357, 2001

29 "How does cognitive therapy prevent depressive relapse and why should attentional control(mindfulness) training help?" How does cognitive therapy prevent depressive relapse and why should attentional control 25-39, 1995

30 "Group cognitive and contextual therapies in treatment of depression" 45 : 438-445, 1989

31 "Expanding our conceptualization of and treatment for generalized anxiety disorder Integrating mindfulness/ acceptance-based approaches with existing cognitive-behavioral models" 54-68, 2002

32 "Evaluation of inpatient Dialectical-Behavioral Therapy for Borderline Personality Disorder-a prospective study" 875-887, 2003

33 "Emotionally focused therapy for couples" Guilford Press 1988

34 "Emotional processing of fear:Exposure to corrective information" 99 : 20-35, 1986

35 "Emotional avoidance: An experimental tests of individual differences and response suppression during biological challenge" 403-411, 2003

36 "Emotional acceptance in integrative behavioral couple therapy Content and context in psychotherapy" Context Press 109-118, 1994

37 "Emotion regulation in acceptance and commitment therapy" 243-355, 2001

38 "Emotion and two kinds of meaning:cognitive therapy and applied cognitive science" 31 : 339-354, 1993

39 "Content and context in psychotherapy" Context Press 125-142, 1994

40 "Content and context in psychotherapy" Context Press 175-197, 1994

41 "Cognitive-behavior therapy:Reflections on the evolution of a therapeutic orientation" 27 : 53-69, 2003

42 "Cognitive vulnerability to depression" Guilford Press 1998

43 "Cognitive behavioral treatment of chronically parasuicidal borderline patients Archives of General Psychiatry" 1060-1064, 1991

44 "Cognitive behavioral treatment of borderline personality disorder" Guilford Press 1993

45 "Cognitive and behavioral treatment of the personality disordered patient Psychotherapy in managed health care The optimal use of time and resources" In C 1991185-201

46 "Changing conceptions of cognitive behavior modifications:Retrospect and prospect" 61 : 202-204, 1993

47 "Brief ACT treatment of depression" Ltd 35-53, 2002

48 "Applying Empirically Supported Techniques in Your Practice" Inc o'do (o'do): 4-9, 2003

49 "An experiential approach to behavior change" Guilford Press 1999

50 "An appraisal of constructivist therapies" 61 : 221-234, 1993

51 "Acceptance-based psychotherapy in the treatment of an adjusted exhibitionist:A case example" 30 : 149-162, 1999

52 "Acceptance in experiential therapy Content and context in psychotherapy" Context Press 53-67, 1994

53 "Acceptance and commitment therapy(ACT) in panic disorder with agoraphobia: A case study." 120-128, 2000

54 "Acceptance and commitment therapy and the third wave of behaviotr therapy Dutch Journal of Behavior Therapy" in press

55 "Acceptance and commitment therapy and the new behavior therapies." Guilford Press 1-29, 2004

56 "Acceptance and commitment therapy (ACT) vs. systematic desensitization in treatment of mathematics anxiety." 2003

57 "Acceptance and Change in Couple Therapy A Therapist's Guide to Transforming Relationships" 1996

58 "ACT, sexual desire orientation and erectile dysfunction." montessi : 291-320, 2003

59 "ACT for OCD : Abbreviated Treatment Manual." 2004

60 "ACT at work" Ltd 117-139, 2002

61 "A functional dimensional approach to diagnosis and treatment Journal of Consulting and Clinical Psychology" 1152-1168, 1996