Method of levels

The method of levels (MOL) is a cognitive approach to psychotherapy (or an approach to cognitive behavioral therapy) based on perceptual control theory (PCT). Using MOL, the therapist aims to help the patient shift his or her awareness to higher levels of perception in order to resolve conflicts and allow reorganization to take place.[1]

Background

Psychotherapy has generally focused on pathology, although there have been exceptions such as Carl Rogers' emphasis on the actualizing tendency. PCT contributes a useful perspective on psychological disorders by providing a model of satisfactory psychological functioning as successful control. Dysfunction then is understood as disruption of successful control, and distress as the experience that results from a person's inability to control important experiences.[2] No attempt is made to treat the symptoms of distress as though they were in themselves the problem. The PCT perspective is that restoring the ability to control eliminates the source of distress. Internal conflict has the effect of denying control to both systems that are in conflict with each other. Conflict is usually transitory. When conflict becomes chronic, then symptoms of psychological disorder may appear.

Method

The core process is to redirect attention to the higher level control systems by recognizing "background thoughts", bringing them into the foreground, and then being alert for more background thoughts while the new foreground thoughts are explored. When the level-climbing process reaches an end state without encountering any conflicts, the need for therapy may have ended. When, however, this "up-a-level" process bogs down, a conflict has probably surfaced, and the exploration can be turned to finding the systems responsible for generating the conflict—and away from a preoccupation with the symptoms and efforts immediately associated with the conflict.

Results of evaluation studies

A randomised controlled trial in subjects with first-episode psychosis demonstrated that the retention in the trial at final follow-up was 97%, suggesting a successful feasibility outcome. The feedback provided by participants delivered initial evidence of the intervention for this population.[3][4] The approach may also be effective in the treatment of sleep disorders[5] and suicidality.[6]

See also

References
  1. Mansell, Carey & Tai 2012
  2. Mansell 2005; Carey 2006
  3. Griffiths, R; Mansell, W; Carey, TA; Edge, D; Emsley, R; Tai, SJ (September 2018). "Method of levels therapy for first-episode psychosis: rationale, design and baseline data for the feasibility randomised controlled Next Level study". BJPsych Open. 4 (5): 339–345. doi:10.1192/bjo.2018.44. PMC 6094182. PMID 30140445.
  4. Griffiths, R; Mansell, W; Carey, TA; Edge, D; Emsley, R; Tai, SJ (October 2019). "Method of levels therapy for first-episode psychosis: The feasibility randomized controlled Next Level trial". Journal of Clinical Psychology. 75 (10): 1756–1769. doi:10.1002/jclp.22820. PMID 31240723. S2CID 191638657.
  5. Grzegrzolka, J; McEvoy, P; Mansell, W (1 May 2019). "Use of the Method of Levels Therapy as a Low-Intensity Intervention to Work With People Experiencing Sleep Difficulties". Journal of Cognitive Psychotherapy. 33 (2): 140–156. doi:10.1891/0889-8391.33.2.140. PMID 32746389. S2CID 150433287.
  6. Macintyre, VG; Mansell, W; Pratt, D; Tai, SJ (2021). "The Psychological Pathway to Suicide Attempts: A Strategy of Control Without Awareness". Frontiers in Psychology. 12: 588683. doi:10.3389/fpsyg.2021.588683. PMC 8012495. PMID 33815194.

Further reading
  • Carey, Timothy A (2006). The method of levels: how to do psychotherapy without getting in the way. Hayward, CA: Living Control Systems Publishing. ISBN 9780974015545. OCLC 63193390.
  • Mansell, Warren (June 2005). "Control theory and psychopathology: an integrative approach". Psychology and Psychotherapy: Theory, Research and Practice. 78 (2): 141–178. doi:10.1348/147608304X21400. PMID 16004696.
  • Mansell, Warren; Carey, Timothy A; Tai, Sara (2012). A transdiagnostic approach to CBT using method of levels therapy: distinctive features. The CBT distinctive features series. Milton Park, Abingdon, Oxon; New York: Routledge. doi:10.4324/9780203081334. ISBN 9780415507639. OCLC 774499959.
  • Carey, Timothy A.; Mansell, Warren; Tai, Sara (2015). Principles-based counselling and psychotherapy: a method of levels approach. London; New York: Routledge. doi:10.4324/9781315695778. ISBN 9780415738774. OCLC 898113412.
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