What are "Third Wave" Therapies?

by Andrea M. Darcy
Reviewed by Dr Sheri Jacobson

Much like science and philosophy tend to change across time, psychotherapy is a body of knowledge that evolves. The more we learn about human nature, and the more we study how current therapies do or don’t help with common issues, the more new ways of working with clients arise.

And now talk therapy has advanced into what are called ‘third wave CBT therapies’.

A brief history of psychotherapy

The history of psychotherapy is complicated, with some forms of talk therapy developing at the same time as others, thus influencing each other. So there can be a lot of overlap.

Modern Western talk therapy is seen as starting with Freud and psychoanalysis, which led to the psychodynamic movement. Psychodynamic therapies are based on an 'illness' model, looking for what is wrong with you by looking at your past and your thinking.

After the psychodynamic movement came 'behaviourism', which stopped looking at thinking and memories and focused on behaviours.

From there two other movements developed more or less at the same time, the existential and 'humanistic' movement, and the 'cognitive' movement. They both focus on a warmer, more open client/therapist relationship, and are more interested in the inner resources of the client than seeing them as 'ill', or a 'patient'.

Then came 'cognitive behavioural' therapies that seek to find provable and practical ways to improve wellbeing, by looking at how our thinking and behaviours both influence us. And within cognitive behavioural therapies there have been different stages, or 'waves'.

Third wave cognitive behavioural therapies

The first wave of cognitive behavioural therapies is just the earlier behavioural therapy, with its focus on changing behaviours. The second wave refers to when it was decided to also look at thoughts and beliefs and how they integrate with behaviours. CBT therapy is part of this second wave, with its focus on recognising and changing the cycle of thoughts, feelings and behaviours that can lead to depression and anxiety.

But third wave therapies move the focus away from trying to forcefully change our thoughts and behaviours, a content based approach, and looks more at the context and processes of our thinking and acting.

The third wave approach

A third wave therapy might see you approaching things with questions such as:

  • Are you resisting and judging your thoughts and your life, or accepting them?
  • Are you trying to change things you can't, or noticing what you can change and taking action?
  • Do your thoughts and feelings make you feel separate or connected, do you have a sense of spirituality?
  • How do you think about yourself, and how is that influencing you?
  • What motivates and drives you? What does this say about your personal values?
  • How are your personal values influencing your behaviours, and what would aligning yourself more with your values do?

Mindfulness and the third wave

Many third-wave behavioural therapies are influenced by or integrate mindfulness. Mindfulness is the process of bringing our thoughts into the present moment, and cultivating awareness and acceptance of our current feelings and sensations. This allows us to know ourselves better and start to recognise what we value.

Other tools of third wave therapies

As well as mindfulness, third wave tools can look like:

  • acceptance
  • psychological flexibility
  • metacognition (being able to step outside of yourself and 'see' yourself)
  • self-awareness
  • self-compassion
  • spirituality
  • recognising and aligning your values
  • visualisation.

What are the different third-wave therapies?

Third wave therapies include:

What issues could one of these therapies help with?

Third wave therapies can help with a host of issues, such as anxiety, depression, childhood trauma, emotional dysregulation, life change, low self-esteem, and, with therapies like dialectical behaviour therapy (DBT) and schema therapy, borderline personality disorder.

Could a third wave therapy work for me?

So far, research has shown third wave therapies to be as effective, not more, than its more rigorous cousin, CBT. So there is nothing wrong with wanting to stick to CBT. But a third wave therapy might be a better fit if:

  • you have tried mindfulness and enjoyed it and would like to integrate it into your sessions
  • you tried CBT and felt it was useful but that it was a bit too rigid and strict for
  • and want to feel connected to a greater whole
  • you are aware your thoughts and behaviours are an issue but want to change them gently, not forcibly
  • overthinking is your habit and you'd like to move away from it
  • control is an issue for you, and the idea of learning to accept and go more with the 'flow' appeals.

Ready to stop fighting against yourself and sink into who you are and what you are capable of? Book a third wave therapy with a therapist that suits your budget today.

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