Interventions for Mental Health Problems
Psychological Distress
When people find themselves struggling, or distressed, or having to exert a great deal of effort to ‘force’ themselves to do simple tasks, control has been disrupted. It is the loss of control not control, therefore, that is the problem when people are psychologically distressed. The main psychological way that control is prevented is through internal conflict according to PCT. Warren Mansell provides an overview of this idea in his 2005 article here.
PCT proposes, therefore, that therapy helps people to restore control (rather than remove it) by resolving conflicts. This is accomplished by helping psychologically distressed people shift their attention away from the symptomatic distress to higher level goals and purposes.
Klaus Grawe, one of the most significant figures in integrative psychotherapy to emerge in recent times, has championed the importance of PCT in his book "Psychological Therapy". He recognises - "Powers was able to adopt a new perspective on mental functioning... considered one of today's leading research trends."
There are many interesting developments in treating mental health problems influenced by PCT, such as exposure therapy, rumination-focused CBT, mindfulness meditation and self-help.
Method of Levels
The therapy developed from PCT that works in this way is called Method of Levels (MOL). The therapist locates and identifies relevant background thoughts and brings them to the foreground for closer inspection. As they are being inspected, background thoughts to these thoughts are sought and so on. By constantly focussing on higher level cognitions the attitudes, beliefs, or values that are generating the conflict will be located. When this occurs new perspectives become possible through reorganization – the trial-and-error process whereby the properties of the control system are altered until error is reduced (see What is PCT?).
There are a whole range of papers on MOL, and two key books written by Tim Carey: “Method of Levels” and “Hold that Thought!”. Many of Tim’s articles on MOL are published in counseling journals, whereas others have been published in journals on Cognitive Behavioural Therapy (CBT). In particular, there is a special issue of the journal, the Cognitive Behaviour Therapist just published online devoted to the application of PCT to CBT.
The empirical evidence for MOL is emerging, alongside a range of evidence from basic science that going 'up levels' of thinking helps to solve problems and improve well-being (e.g. Kross & Ayduk, 2011).
One of the key ways to test PCT in the mental health arena is to build computer models. Here is an example of modelling delusional processes by Tristan Browne. At the University of Manchester we are developing a PCT simulator that allows control hierarchies to be built by anyone, and the process of reorganisation tested systematically.
Could PCT and MOL be the approaches that begin to truly align counsellors, psychotherapists and CBT therapists to deliver effective therapy? Read this article to see...