A Transdiagnostic Approach to CBT Using Method of Levels Therapy

The principles and techniques of PCT and MOL are clearly and practically described for clinicians to offer a transdiagnostic CBT that is tailor-made to the goals of each client.

Warren Mansell is a Reader in Psychology, Accredited Cognitive Behavioural Therapist, and Chartered Clinical Psychologist. He has authored over 100 publications on CBT and in 2011 received the May Davidson Award from the British Psychological Society for an outstanding contribution to the field of clinical psychology in the first ten years since qualifying. Timothy A. Carey is the Associate Professor in Mental Health at the Centre for Remote Health in Alice Springs, Australia. He has been using the Method of Levels in a variety of settings for over ten years and has researched and published extensively on its use. Sara J. Tai is a Senior Lecturer in Clinical Psychology at the University of Manchester, Chartered Clinical Psychologist and Accredited Cognitive Behavioural Therapist. She is an experienced researcher, practitioner, trainer and supervisor of Cognitive Behaviour Therapies, including the Method of Levels.

Introduction. Part I: Theory. Thinking styles and behaviours that maintain psychological distress are transdiagnostic. Transdiagnostic processes overlap to form a core process that maintains distress. The phenomenon of control - perception, comparison, and action. The control of perception - not the control of behaviour. The negative feedback loop. Basic causes of the loss of control. Hierarchies of Control - Going up and down levels. Conflict. Reorganisation - a non-linear process of change. Awareness and imagination. Arbitrary (or inflexible) control maintains distress via conflict. Directing awareness to regain flexible control - a common factor of CBT, effective therapy, and natural recovery. Interpersonal control. Circular causality and model building. It's all perception. Part II: Practice. The setting conditions: A problem that the client is willing to talk about. The stance: To enable the client's flexible control as efficiently as possible. Method of Levels goal one: asking about the current problem. Method of Levels goal two: asking about disruptions. Using the past, controlling the present and living for the future. "Green Apples" - Working through problems without disclosure. What to say at the first session. How much treatment and how often to provide it. A focus on distress rather than symptoms. Outcome monitoring. Evaluating your own practice. The therapeutic relationship - liberated exploration. Building MOL into other therapies and therapeutic practices. Utilising control theory in existing CBT. Interventions without talking - testing the controlled variable.