What are 'third-wave' CBT approaches and in what ways do they extend classic CBT?

• A. ACT, DBT, MBCT; emphasize acceptance, mindfulness, values, and context rather than only changing thoughts, expanding the therapeutic toolkit.
• B. They simply add more homework without changing therapeutic goals.
• C. They discard behavioral techniques in favor of talk therapy only.
• D. They rely exclusively on pharmacotherapy to achieve change.

Answer: (B)

Third-wave CBT approaches expand what counts as change in therapy by shifting from trying to directly alter the content of thoughts to changing the relationship we have with our thoughts, feelings, and life context. They bring in acceptance, mindfulness, values, and contextual awareness to help people act in ways that are meaningful, even in the presence of difficult thoughts or emotions. The best example group includes ACT, DBT, and MBCT, which illustrate this shift: ACT emphasizes psychological flexibility, defusion from thoughts, acceptance, present-mocused awareness, and committed action toward personal values; DBT adds skills for emotion regulation, distress tolerance, and interpersonal effectiveness through mindfulness; MBCT combines mindfulness practices with cognitive strategies to prevent relapse. This extends classic CBT by retaining rigorous behavioral components like exposure and skills training while broadening the mechanisms of change to how one relates to thoughts and experiences, not just how one changes their thoughts. The idea that they simply add more homework, discard behavioral techniques, or rely exclusively on pharmacotherapy doesn’t fit these approaches, which integrate new processes with existing behavioral methods and emphasize affective and contextual change.