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Book Reviews   |    
Mindfulness and Acceptance: Expanding the Cognitive-Behavioral Tradition
Reviewed by Yad M. Jabbarpour
Psychiatric Services 2006; doi: 10.1176/appi.ps.57.6.894
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edited by Steven C. Hayes, Ph.D., Victoria M. Follette, Ph.D., and Marsha M. Linehan, Ph.D.; New York, Guilford Press, 2005, 319 pages, $36

Dr. Jabbarpour is clinical assistant professor at the University of Virginia School of Medicine and chief of staff at Catawba Hospital near Roanoke, Virginia.

It's time for self-liberation. Expanding a cognitive-behavioral tradition from within the insitution of cognitive-behavioral traditions might sound like a radical cognitive reframing and behavioral intervention for a patient with a fixed practice of thoughts and behaviors, ironically performed by the patient him or herself. The poetic irony continues in that Drs. Steven Hayes, Victoria Follette, and Marsha Linehan, the three editors of Mindfulness and Acceptance, are leaders in their field. All are professors of psychology who bring together the pioneers who are leading the application of mindfulness and acceptance into the domain of behavioral and cognitive therapy. This volume, planned initially during a summer conference in 2002, documents their journey and findings into this new frontier of empirical clinical psychology. If the first wave was behaviorism and the second was cognitive advance, then the "third wave" is a movement into the new worlds of mindfulness, acceptance, dialectics, relationship, values, and spirituality.

The book is a well-organized, visionary, and pragmatic presentation of multiple new concepts, which were originally off limits for traditional, purely cognitive-behavioral therapists. These concepts range from the application of eastern Zen "acceptance" to a value-based approach, asking clients, "What do you really want your life to stand for?" and from a transcendent sense of self to the therapeutic application of Hegel's dialectic. The D in dialectic behavior therapy (DBT) is based on Hegel's philosophic paradigm. The dialectic has foundations in Socrates's and Plato's ideas of transcending the opposition and sublimating the conflict between thesis and antithesis via questioning to develop a synthesis, an emergence of an ever-evolving greater set of truths and for the client an improved life.

Although the initial chapters focus on theory and background, a majority of the chapters thereafter target specific psychopathology, including depression, anxiety, trauma, bulimia nervosa, borderline personality disorder, alcohol and drug use disorders, and couples conflicts. These concepts are operationalized into specific therapeutic technologies, including mindfulness-based cognitive therapy, acceptance and commitment therapy, DBT, and Vipassana meditation. Each author describes the theoretical concepts and their associated clinical approaches with often detailed descriptions of therapeutic strategies, which allows the reader to better understand the therapy. The contributors also compare their models with other theories and cognitive-behavioral strategies.

Although clinical efficacy is discussed and the authors examine future implications for theory, clinical application, and research, the detail varies in regard to the evidence base supporting the treatments. In addition, the volume does not address the overlap of these concepts with other areas of study in mental health, including parallels with psychoanalysis and similarities with wellness, empowerment, and recovery. Attention is primarily focused on adults; more attention could have been devoted to the relevance of mindfulness and acceptance to childhood and adolescent development and to the application of these concepts in pediatric psychotherapy.

Nonetheless, this book is one not only to read but also to keep on the shelf for reopening by psychiatrists, psychologists, social workers, nurses, and other mental health clinicians who treat, teach, and just enjoy a good adventure of expanding the mind.




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