"Enabling Flexible Control" - Warren Mansell's May Davidson Award Lecture - DCP 2011

Dr Warren Mansell, University of Manchester, UK, presents his Award Lecture at the British Psychological Society Division of Clinical Psychology Annual Conference in Birmingham on 1st December 2011. Whilst acknowledging the efficacy of disorder-based cognitive behavioural therapies, he explains the rationale for a transdiagnostic approach to therapy that is a more flexible, efficient and directly linked to theory. He provides evidence that the 15 or more 'transdiagnostic processes' such as worry, thought suppression, experiential avoidance and safety-seeking behaviours are closely correlated, and that their shared properties are more predictive of psychological distress than their unique elements. He proposes that this shared feature is 'inflexible control' - controlling an experience without regard to, or awareness of, the important personal goals that are inhibited by doing so. Putting distinctions between the first, second and third waves of CBT aside, he looks to Perceptual Control Theory (PCT; Powers, Clark & McFarland, 1960; Powers, 1973) for a theoretical framework to inform the understanding of control. He describes the ongoing research in this area, including the evauation Method of Levels therapy (Carey, 2006; Powers, 1973) - a transdiagnostic cognitive therapy aimed at helping people restore flexible control over their lives. A novel hypothesis generated by computer modelling is put forward that the goal conflict caused by inflexible control can manifest itself as (1) lack of control (e.g. uncertainty, worry), (2) escalating effort leading florid loss of control (e.g. panic, mania) and (3) de-escalation of effort leading prolonged loss of purpose (e.g. depression). The evidence for a new CBT called TEAMS - Think Effectively About Mood Swings - is described. This intervention is currently being evaluated for helping people with bipolar disorder. Finally, a range of ongoing research studies involving PCT are summarised. The central messages of the lecture are that control is fundamental to life but typically runs automatically. We notice its importance when conflicts cause reduction in control, and this is exacerbated when people adhere to inflexible attempts to try to regain control. Our interventions therefore need to be flexible to clients' needs, flexible to different presenting problems, and they need to enable flexible control of thinking and goal setting in our clients. For more information about PCT, see www.pctweb.org. For more information on TEAMS, see www.teamstrial.net. Dr Mansell's University of Manchester website is http://www.psych-sci.manchester.ac.uk/staff/131406.

Category:

Science & Technology

Tags:

• Control
• cognitive
• therapy
• cbt
• transdiagnostic
• bipolar
• disorder
• self-regulation
• perceptual
• control
• theory