Praxical.Psych
Unit 14 of 20

Third-wave therapies

Change the relationship to experience rather than its content.

Chapter 11Beyond the standard syllabus

What you should be able to do afterwards

  • 1Explain psychological flexibility and its six processes
  • 2Explain the dialectic of acceptance and change
  • 3Describe decentring and the differential activation hypothesis
  • 4Explain why shame requires something other than cognitive restructuring

The reading

The common move across the third wave is to stop trying to change the content of internal experience and to change the person’s relationship to it. ACT reached that conclusion from relational frame theory; MBCT from process research on rumination; DBT from the observation that pure change-focused behaviour therapy drove suicidal patients out of treatment; CFT from patients who could produce a rational alternative in a contemptuous inner voice and derive nothing from it.

What belongs to this unit

Questions to take away

For a seminar, a supervisor, or an argument with yourself.

  1. 1Is the third wave a genuine departure from cognitive therapy or a rebranding? Argue both sides with evidence.
  2. 2When does acceptance become acquiescence to conditions that ought to change?
  3. 3DBT works, and so do MBT and TFP, using incompatible techniques. What follows?

Your notes

Saved in this browser only. Export from Progress.
Educational use only

Praxical.Psych is a teaching tool. It is not medical, clinical, psychological or legal advice, not a diagnosis, not treatment, not supervision, and not a credential. Nothing here creates a clinician–patient or solicitor–client relationship. Every patient, case, transcript and simulated session is fictional. Clinical and legal requirements vary by jurisdiction and change over time — verify anything that bears on a real decision against your own regulator, statute and current professional guidance, and consult a qualified professional.

Do not enter real patient information. If you or someone else is in crisis: US & Canada 988 · UK & Ireland 116 123 · Australia 13 11 14 · elsewhere findahelpline.com · immediate danger, your local emergency number.

Full disclaimerScope, method & limitsEthics & lawYour data

Praxical.Psych · © 2026 Moonlit Social Labs. All rights reserved.

Before you begin

What Praxical.Psych is, and is not

Praxical.Psych is an educational tool. It teaches the theory, evidence base and clinical method of psychotherapy at the level of an advanced survey course, and it lets you rehearse a complete session in a simulator.

It is not medical, clinical, psychological or legal advice. It cannot diagnose or treat anyone, and it does not state the law where you practise — requirements differ by jurisdiction and change. Nothing here creates a clinician–patient or solicitor–client relationship.

  • Every patient, transcript and case in this app is fictional — a composite written for teaching. None depicts a real person.
  • Praxical.Psych is not therapy, not a substitute for supervision, and not a credential. Competence to practise comes from training, supervised hours and licensure.
  • Scores from the instruments here are for learning how they behave. They are not a diagnosis and not a risk assessment, and must not inform a decision about a real person.
  • Do not enter real patient information. Everything you type stays in this browser, but that is not the same as a compliant clinical record system.
If you are in crisis

In the US and Canada, call or text 988. In the UK and Ireland, call 116 123 (Samaritans). Elsewhere, find a local line at findahelpline.com. In immediate danger, use your local emergency number.

Read the full disclaimer