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Objectives
• Define and review the concepts of contextual cognitive behavioral therapy
• Explore the impact of context on people’s phenomenological reality
• Explore how addiction and mental health issues can be influenced by context
• Explore how acceptance, awareness, mindfulness and psychological flexibility can be used transdiagnostically.

Why Contextual
• Addiction and mental health issues are often intergenerational
• Addiction and Mental Health issues are strongly correlated with:
• Each other
• Adverse childhood experiences (history of and children with)
• Impaired occupational and social functioning
• Health problems
Contextual Approaches
• Encourage mindfulness in the present moment
• Accept each person’s “truth” is constructed from their schema and the resulting interpretation of the current moment
• The goal is to consider the context and function of the past and present issue and empower the person to make a conscious choice toward their valued goals
• Remember that the prefix RE means to do again
• REpeat
• REdo
• REgress
• RElapse
• REaction

Childhood Context and Development
• The family context can be a preventative or risk factor for the development of issues
• Children develop schema about themselves, others and the world through these early interactions
• In later life people continue to develop schema influenced by their past learning.

Caregiver Requirements for Secure Attachment and Healthy Development
• Consistent Age-Appropriate Responsiveness
• Trust
• Autonomy
• Industry
• Identity
• Empathy
• Compassion
• Effective Communication Skills
• Unconditional Love
Core Concepts in Contextual CBT
Mindfulness
• Improves people’s ability to be present in the present
• Shift from automatically reacting to thoughts and feelings based on schema to being aware of ALL experiences in the present to provide more flexibility

Encouraging Acceptance of Internal Experiences
• Accepting thoughts, feelings, sensations without having to act on them
• Radical Acceptance
• Unhooking
• Dialectics
• I can be a good person AND be divorced
• I can be happy AND grieving
• I can stay sober AND be stressed
Acceptance of Internal Experiences
• Accepting thoughts, feelings, sensations without having to act on them
• Distress Tolerance
• ACCEPTS
• Activities
• Contributing
• Comparisons
• Emotions (opposite)
• Push Away
• Thoughts
• Sensations
Focus on Adding vs. Eliminating

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