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Psychotherapy has always been confronted by the dilemma of whether clients should change (how the feel, their thoughts, circumstances etc) or whether they should accept them. In many ways this dilemma is reflected in the difference between 2nd and 3rd Wave CBT but whatever way you work it often involves ethical decisions and in many ways makes therapy a political choice.
For instance, is the decision to teach mindfulness (acceptance strategy) OK when the cause of the problem lies with the organisation the person works for. Is acceptance a strategy for putting up with circumstances which should change and which should be our real focus. Equally how do we respond when a clients feelings and beliefs following complex trauma seem an inevitable consequence of that trauma. Is it really realistic or acceptable to help the client change those thoughts and beliefs.
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