The most important skill set in mental health


Nicole Avagliano/Pexles

Source: Nicole Avagliano/Pexles

Why does it? Psychotherapy job? Until relatively recently, many scientists studied methods to improve mental and behavioral health and delayed answering that question. Instead, they argued, it is better to first ask if the method works, and after we know it works, we can ask why.

It’s not an unreasonable strategy, but over the decades thousands of studies have produced an ever-expanding list of interventions, many of which may seem different but work through the same processes or mechanisms. Lists of “evidence-based treatment methods” maintained by scientific bodies or government agencies do not require any knowledge of change processes, so methods have proliferated. Sometimes the most unusual theories were presented by medical advocates and the methods entered those lists as long as the bottom line results were better than the control condition – encouraging advocates to claim that their theories were correct.

Maybe. Probably not. Results alone cannot tell you. You have to answer the question “why”.

Gradually, statistical methods that identify important pathways of change – that answer the question of why – have become more common in psychotherapy research. The most well-known and widely used method is called “Mediation Analysis”. Mediation occurs when a) the treatment alters a process in the near future relative to the control condition, b) when this process is associated with outcomes in both groups, and deriving the “from a to” path significantly reduces the treatment effect. It’s not a perfect method, but it’s a place to start, and the body of research in that area is now good enough to make a generalization. Five years ago, my colleagues (Stefan Hoffman, then at Boston University, Joe Ciarrochi at the Australian Catholic University, and our partners Baljinder Sahdra and Fred Chin) and I decided to look at all the successful mediation studies on any psychological intervention that happened. A controlled trial targeting mental health outcomes.

We have no idea what we are.

Over the next four years, it became a massive endeavor that employed about 50 people. We jokingly “DeathStar projectBecause, like the space station in the Star Wars movies, the project was huge, took forever to build, and (we hoped) would have a huge impact on how we think about psychotherapy.

54.633 studies were each graded twice to see if the analyzes were done correctly. At first, more than 1,000 of these appeared to be in the running, but many fell away as we dug deeper (eg, we left out studies where one result mediated another). We focused on process steps that were repeated at least once in our database to obtain the main findings. We ended up with 281 clear findings using 73 different parameters. Finally, a few weeks ago, the results of one of the biggest reviews I’ve ever seen of an experiment appeared in the popular Behavior Research and Therapy.

As you can imagine, there is not only one way to change, but many; Each supports people in different ways. A surprising finding, however, was that a single set of skills proved more effective than anything else. found more frequently than self confidence; support from friends, family or your therapist; And whether or not you have negative, dysfunctional thoughts. The most common way of change is your psychological flexibility and Mentality skills. Using the criteria for effective mediation analysis, this small set of processes accounts for about 45% of what we know about why therapy works. When concepts closely related to psychological efficiency and insight are added (e.g., self-compassion, behavioral activation, Anxiety sensitivity) rose to about 55% of all successful mediations.

The three pillars of psychological flexibility

What we can now say with certainty is that psychological flexibility is the single most commonly-based skill essential to your mental health and emotional well-being. If you suffer from depression, Depression, Addiction, or other mental stress; Psychological agility helps you deal with these issues effectively and move your life in a meaningful direction.

So what does this skill entail? It’s best to think of it as three skills together.

Pillar #1 Awareness

The first pillar of psychological flexibility is awareness. This means noticing what is happening in the moment: what thoughts are appearing? Which feelings? And what other sensations can you notice in your body? It also means to understand these things more Spiritual Part of you – your witness or sense of understanding.

“Now” cannot be practiced with words alone – it must be practiced with attention. It’s the difference between talking about the flavor of an orange and actually tasting the fruit. The latter is much richer than the former. Rather than “holding” it in your own head, awareness is about being here and now. And even more, it increases the ability to intentionally direct, expand, or focus on different aspects of your experience.

And all that from the part of you that consciously connects you to others.

Pillar #2 Openness

The second pillar of psychological flexibility is openness. This means allowing difficult thoughts and painful feelings – just as they are, before you move on to a life without them that you necessarily want to change in any way, shape or form. People actually seek therapy to get rid of their negative thoughts and feelings. Unfortunately, the mind doesn’t work that way. In general, the more you try to avoid pain, the more it controls your life. Rather, openness is letting go of the internal struggle, allowing thoughts and feelings to be—thoughts and feelings don’t need to control you. Interestingly, in that open position, thoughts and feelings often change in a positive direction.

Pillar #3 Value engagement

The third and final pillar of psychological flexibility is value engagement. This means knowing what is important to you and taking steps in that direction. It involves communicating with you Goals – the goals you want to achieve or achieve – and your values ​​- the personal qualities you choose to display and lead regardless of the specific outcome. These matters should be chosen freely rather than being coerced by others or followed in a way that is free from conventional thinking. But if you get clarity about what’s important, you can take action to build lasting habits that help you focus more on what gives your life meaning.


Psychological flexibility is the single most important skill for your mental health and emotional well-being. The first two pillars of thinking skills create a work approach. In close proximity to other change processes, psychological flexibility and mindfulness are the smallest skill sets that do best in most areas.

And now, “Why does therapy work?” We know one main part of the answer to the question. It often works because it fosters greater awareness, clarity, and values-based engagement in life.

When you’re frustrated at work, you can notice your frustration, let it happen, and still take steps to complete your work. When you fight with your spouse, you can accept the pain, accept it as a learning opportunity, and together build a plan to move forward. Psychological flexibility empowers you to stop fighting yourself and move your life in a meaningful direction. It is accessible to you here and now. And like any other skill, the more you practice, the better you get at it.

The history of science and human development shows that when we have a clear goal, we can learn how to move as a human society. Psychological flexibility and mental health are not the only necessary processes to create, but they are the most common.

That gives us all a target for change.


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