At a Glance
A comparison of key elements and differences of FPS therapeutic models
Table 1: Acceptance and Commitment Therapy / Cognitive-Behaviour Therapy / Dialectical Behaviour Therapy
Table 2: Eye Movement Desensitisation & Reprocessing / Interpersonal Therapy / Motivational Interviewing
Table 3: Narrative Therapy / Social Skills Training / Solution-Focused Brief Therapy
Table 1
| Criterion | Acceptance and Commitment Therapy | Cognitive-Behaviour Therapy | Dialectical Behaviour Therapy |
|---|---|---|---|
| Overview | Helps people acknowledge and accept their thoughts and feelings while committing to behaviours guided by their personal values | Aims to change maladaptive thoughts that impact on behaviour and emotional and physiological responses | Uses a variety of skills-based approaches to manage painful emotions. |
| Unique Differences | Does not try to modify maladaptive thoughts and schemas | Maladaptive behaviour is learnt so can be changed through education | Accepts and validates person’s emotions, thoughts and behaviours while promoting change |
| Theoretical Basis | Relational frame theory and functional contextualism | Behaviour (conditioning and operant) and cognitive learning theories – impact of cognition on behaviour | Biosocial theory, behaviour theory and dialectics |
| Social Work Context | Empowering through self-resilience and self-care. Non-judgemental acceptance of experiences | Empowerment, self-determination, recognising maladaptive thoughts as product of ecological systems | Person-in-environment used to acknowledge invalidating environments and relevant interventions |
| Key Methods | Mindfulness, acceptance of thoughts and feelings, establish values, commit to action | Cognitive restructuring, behaviour modification, exposure therapy and skills training | Skills training, mindfulness, distress tolerance, emotion regulation and coaching |
| Practitioner’s Role | To be a guide towards psychological flexibility | Collaborator, educator, coordinator of activities | At times confrontational, coordinator of procedures, assessments, techniques and strategies |
| Person’s Role | To be committed to action | Collaborator, active participant setting agenda, completing homework, learning skills | Active participant, learning skills, attending individual and group meetings |
| Applications | Anxiety, depression, BPD, panic, obsessions/compulsions, pain, psychosis, AOD, bulimia, body dysmorphia | Anxiety, depression, AOD, eating disorders, PTSD, OCD and BPD | Anxiety, depression, addiction, eating disorders, PTSD, BPD, FDV, self-harm, mood disorders |
| Expected Outcomes | Reduction in emotional reactions, increase in ‘workable’ actions and positive value-orientated changes to behaviour | Improved emotional regulation, more adaptive and realistic thinking patterns, and enhanced behavioural coping skills | Increase in skills to manage negative emotions, tolerate distress, improved interpersonal relationships |
| Advantages | Clear framework and supporting resources | Highly structured, goal orientated, provides empowering skills/tools | For groups of people and those difficult to treat |
| Limitations | Complex and requires keeping up to date with theory and skills | Reliant on motivation, cognitive ability of person, ingrained behaviour could be resistant | Highly structured, prescribed interventions, practitioner training, requiring high level of commitment by the person |
Table 2
| Criterion | Eye Movement Desensitisation & Reprocessing | Interpersonal Therapy | Motivational Interviewing |
|---|---|---|---|
| Overview | Reduces the psychological and physiological impact of traumatic memories by changing how they are stored in the brain | Aims to alleviate psychological distress by improving a person’s effectiveness in social and relational roles | Guides a person through process of change, by prompting them to take responsibility for change decisions |
| Unique Differences | Requires the person to use directed eye movements while holding traumatic memories in mind to reduce their impact | Is present-focused on relationships, rather than dealing with schema, thoughts or unconscious processes | Uses skilful person-centred techniques to evoke intrinsic motivations |
| Theoretical Basis | Adaptive information processing model and behaviour, cognitive and psychodynamic theories | Interpersonal theory, social theory and attachment theory | Person-centred model and transtheoretical model of change |
| Social Work Context | Strengths-based, person-centred and trauma informed with emphasis on the therapeutic relationship | Strengths-based focus on protective factors, social supports, considers person-in-environment, social systems | Strengths-based, person-centred, empowering and greater sense of agency |
| Key Methods | Identify traumatic memory and negative cognition, bilateral stimulation with positive cognition | Link mood and life events, identify maladaptive communications, explore alternatives, practical reinforcement | Engaging through active listening, setting goals, guiding towards commitment and action, developing self-efficacy and adaptive abilities |
| Practitioner’s Role | Facilitator guiding through procedures | Helpful coach, directing discussion, developing supportive resources | Collaborator and guide, in democratic empathetic working alliance |
| Person’s Role | Active participant, accessing traumatic memories and following cues | A patient, who has to do the work | Collaborator, taking responsibility for change |
| Applications | PTSD, vicarious, acute and intergenerational trauma, anxiety, depression, phobias, OCD, panic attacks, eating disorders, body dysmorphia | Major life crises, grief, bereavement, role disputes, role transitions, social isolation | Smoking, drinking, cannabis, gambling; management of chronic health conditions; weight loss, dietary change, physical activity, medication adherence; student behaviour, return to work |
| Expected Outcomes | Improved self-concept, social functioning and reduced depression, anxiety, intrusive PTSD symptoms | Better communication, healthier relationships, improved mood and skills to deal with symptoms | Increased change self-efficacy displayed in language reflecting hope and confidence |
| Advantages | Evidence-based outcomes for PTSD, faster with less drop-out | Time-limited structured intervention, strong evidence base | Evidence-based, brief, variety of settings, flexible delivery |
| Limitations | Highly prescriptive, complex, requires specialised training | Limited application and requires patient selection | Not everyone is ready for change, focuses on conscious decision-making, requires skill |
Table 3
| Criterion | Narrative Therapy | Social Skills Training | Solution-Focused Brief Therapy |
|---|---|---|---|
| Overview | Identifying and analysing the stories that a person tells about themselves with the aim of fostering change by re-authoring their life narratives | Structured interventions aimed at improving the ability of people to interact with others, when they struggle to form interpersonal relationships | Identifies and expands on what is working well in a person’s life and prioritises the times when there was no problem |
| Unique Differences | Separates the person from the problem, gives a powerful sense of agency and addresses injustice and oppression | Breaks down complex learned performance behaviour, that is situational, into components | Highly collaborative, with the person making key decisions, focusing on solutions unique to the person’s lived experience |
| Theoretical Basis | Social constructivism and postmodernism | Behaviour and cognitive theories, social competence and learning theory | Social constructivism and postmodernism |
| Social Work Context | Strengths-based, empowering, positions the person as author, anti-oppressive and reflects respect for persons and social justice | Empowering for people lacking social competence to live independently, collaborative working relationship with shared decision-making | Strengths-based, empowering, person-centred approach that meets people where they are, returns choice to them and acknowledges problems as systemic |
| Key Methods | Stories are identified and examined with distortions challenged and gaps filled in, unique outcomes that don’t match the story are identified to assist re-authoring. | Identify social behaviours required to meet life goals, behaviour rehearsal, modelling, reinforcement, corrective feedback, homework practice in real life | Collegial engagement, identify previous solutions and exceptions, questioning, miracle question, scaling questions, gentle guiding to do more of what is working |
| Practitioner’s Role | Facilitator and collaborator using a range of targeted questions to invite alternative narratives. | Collaborator and trainer, participating in role-plays, modelling, providing feedback and setting homework | Gentle guide, questioner, facilitator, collaborator, in an egalitarian relationship |
| Person’s Role | Author of their own story that reflect preferred identities and values. | Collaborator and student, learning behavioural skills and participating in decision-making | Collaborator, expert on their own lived experience, author of their preferred future |
| Applications | Identity issues, trauma, loss, grief, anxiety, depression, addictions, eating disorders | Autism, schizophrenia, developmental disabilities, psychiatric rehabilitation | Sexual abuse, substance abuse, schizophrenia, also for families, couples, groups, organisations and involuntary settings |
| Expected Outcomes | Powerful sense of agency, renewed meaning, redefined sense of self | Improved social competence leading to greater life-satisfaction and self-efficacy | Healthy changes to thinking, emotions and behaviour to allow for satisfactory function |
| Advantages | Highly empowering and culturally adaptable | Can be practiced by a wide range of people, for individuals or groups, and social skills are a protective factor | Time limited, can be used with other approaches, respects cultural values and differences, anti-oppressive |
| Limitations | Lacking in measurable goals and evidence-base | Requires family or social supports to reinforce learning of skills in social environments | Focusing on solutions could overlook social injustices and miss important information |
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