13 Mindfulness and Acceptance in Cognitive Behavior Therapy What’s New? MARVIN R. GOLDFRIED
God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference. Living one day at a time; Enjoying one moment at a time. —Reinhold Niebuhr
Cognitive behavior therapy (CBT) has clearly come a long way since the 1970s, when cognitive constructs began to be introduced into behavior therapy. Most recently, notions such as mindfulness and acceptance have clearly broadened the scope of what we now call “cognitive behavior therapy.” With this added complexity, there has also come controversy and confusion (see Herbert & Forman, in press). I consider it both an honor and a challenge to have been asked to comment on the current state of CBT. Having arrived at Stony Brook as an assistant professor in 1964, I feel it is safe to say that behavior therapy, CBT, and I grew up together professionally. As a participant in, and observer of, the development of the field, I have my own perspective on where we now are in comparison to how we started. Although history has never been my strong suit, I am relying on long-term memory to inform me about where we have come from, along with my knowledge of what is going on clinically and empirically to comment on what is happening now and—far more risky—where I believe we need to go in the future. To provide a context for the contributions to this volume, I begin with a brief history of CBT, followed by another contextual framework based on relevant observations coming from the sociology of science. I then comment on what is new in CBT, particularly as it relates to the role of cognition, behavior, and emotion. I follow this with a commentary on the growing movement to delineate empirically based principles of change 317
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