The Most Important Skill Set in Mental Health

Nicole Avagliano/Pexels

Source: Nicole Avagliano/Pexels

Why does psychotherapy work? Until relatively recently, many scientists studying ways to improve mental and behavioral health delayed answering that question. and when you find it works, you can ask why.

This is not an unreasonable strategy, but thousands of studies have been conducted over decades and the list of interventions continues to grow. Many of them may look different, but they actually work by the same process or mechanism. Methods proliferated because they didn’t require knowledge. Sometimes very outlandish theories were put forward by treatment proponents, and as long as the end result was superior to the control condition, the method was on those lists — encouraging proponents to claim that their theory was correct. I did.

perhaps. maybe not. I can’t say anything about the results. The question “why” must be answered.

Statistical methods of identifying important pathways of change—that is, of answering the “why” question—have become increasingly popular in psychotherapy research. The best known and most widely used method is called “mediation analysis”. Mediation applies if a) the treatment modifies the short-term process more than the control condition, b) the process is associated with outcomes in both groups, and that ‘a to b’ This is when the effect of treatment on outcome is greatly reduced by drawing out pathways to This is not a perfect way to start, but it is a place to start and the body of research in the field is now large enough to do a comprehensive tally. (Stéphane Hoffmann of the Catholic University of Australia, Joe Siarocchi of the Catholic University of Australia, and our colleagues Baljinder Sadra and Fred Chin) and I have reviewed successful studies conducted on randomized psychosocial interventions. I decided to look at all the mediation studies. Controlled trials for mental health outcomes.

We didn’t know what we were in for.

It turned out to be a huge undertaking, requiring the work of nearly 50 people over the next four years. I jokingly called it the “Death Star Project” because, like the space station in the Star Wars movies, the project is huge, takes a long time to build, and has a huge impact on how we think about psychotherapy. because I wanted it.

Each of the 54.633 studies was evaluated twice to check whether the analysis was performed properly. At first, it appeared that just over 1,000 of these were being performed, but as we continued to dig, more decreased (e.g., setting aside studies where one outcome mediates another). was). For the core findings, we focused on process measurements that were replicated at least once in the database. In the end, 281 distinct findings were obtained using 73 different scales. Finally, a few weeks ago, his results in one of the biggest reviews I’ve ever attempted were published in the prestigious journal Behavior Research and Therapy.

As you can imagine, there are many paths to change, not just one. Each supports people in different ways in different situations. But the surprising finding is that one set of skills proved to be far more generally effective than the others. Found more often than self-esteem. Support from a friend, family member, or therapist. And even if you have negative, dysfunctional thoughts. The most common pathways of change were psychological flexibility and mindfulness skills. This small set of processes, using our rigorous criteria for successful mediation analysis, accounts for about 45% of everything we know about why treatments work. Adding concepts very similar to psychological flexibility and mindfulness (such as self-compassion, behavioral activation, and anxiety sensitivity) spiked nearly 55% of all successful mediation outcomes.

The 3 Pillars of Psychological Flexibility

It is now possible to say with certainty that psychological flexibility is the most commonly established and important skill for mental health and emotional well-being. Whether you are suffering from physical distress. Psychological flexibility can help you deal with these issues effectively and move your life in a meaningful direction.

So what does this skill mean? Think of it as three skills rolled into one.

Awareness of Pillar 1

The first pillar of psychological flexibility is awareness. This means being aware of what is happening in the moment. What thoughts appear? What emotions? And what other sensations can you notice in your body? It also means being aware of these things from your more mental part – being aware of your witness or sense of self. .

The “now” cannot be experienced with words alone. It’s the difference between talking about the flavor of an orange and actually tasting it. The latter is much richer than the former. Awareness is about being here now, not being “trapped” in your own head. It also requires the ability to intentionally direct, spread, and focus different aspects of the experience.

And all of that is from the part of you that connects you to others in your consciousness.

Pillar 2 Openness

The second pillar of psychological flexibility is openness. This means accepting difficult thoughts and painful emotions as they are before moving forward towards the life you want to live. This part is counter-intuitive and often difficult to understand. Because people tend to seek therapy precisely to get rid of their negative thoughts and feelings. In general, the more you try to get rid of pain, the more it dominates your life. Instead, openness is about dropping your internal battles and letting your thoughts and feelings go without them having to control you. Ironically, with that open attitude, thoughts and feelings often shift in a more positive direction.

Pillar 3 Worthwhile Engagement

The third and final pillar of psychological flexibility is valued engagement. This means knowing what is important to you and taking steps in that direction. It involves getting in touch with your goals (the goals you want to reach or achieve) and your values ​​(the personal qualities you choose to manifest and guide, regardless of any particular outcome). These matters should be freely chosen, not forced on others or unconsciously customary. But if you identify what’s important, you can take action to build sustainable habits and give your life meaning.


Psychological flexibility is the most important skill for mental health and emotional well-being. Her first two pillars create a practical approach to mindfulness skills. Inextricably linked to other processes of change, psychological flexibility and mindfulness are the minimal skill sets that work best in most areas.

And now we know most of the answers to the question, “Why does therapy work?” Often it works to establish greater awareness, openness, and value-based engagement in life.

When you’re feeling frustrated at work, you can notice the frustration, let it go, and take steps to complete the assignment. When you’re fighting with your spouse, you can acknowledge the pain, embrace it as a learning opportunity, and make plans to move forward stronger together. Psychological flexibility allows you to stop fighting yourself and turn your life in a meaningful direction. You can access it here now. Like any skill, the more you practice, the better.

The history of science and human development shows that if we have a clear goal, we can learn how to make it work as a human community. Psychological flexibility and mindfulness are not the only processes important in creating mental health, but they are the most commonly important ones.

It gives us all goals for change.

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