tCBT Special Issue - CBT in a Time of Climate and Biodiversity Crises

The climate and ecological crises pose a threat to humanity, and to ecosystems. The United Nations has declared that ‘Climate Change is the defining crisis of our time, but we are far from powerless to act.’ There is undisputed evidence for climate change and its physical and mental health consequences.

Feeling overwhelmed by climate change and distressing eco-emotions is increasingly common and has been described as eco-anxiety or eco-distress. Practitioners working with eco-distress need to recognise that it is a non-pathological, understandable response to our reality, and as such, they may be similarly affected.

Being a practitioner in a time of climate and ecological breakdown therefore poses unique challenges. Cognitive Behavioural Psychotherapy and Science have important contributions to make to meet these challenges, with its expertise in research and evidence based therapy.

This special issue orients the reader to the implications planetary crises have for mental health and how we can respond. It explores how adapting our existing tools, and developing transdiagnostic approaches can empower people to turn towards the truth and distress of climate change, to find meaning and connection, and support a just transition to a safer world. We hope it will inspire more engagement, action and advances in theoretical and empirical work.

Podcast episode: In the most recent episode of the BABCP podcast Let's Talk about CBT - Research Matters, managing editor Steph Curnow interviews Liz Marks about the special issue on climate change in the Cognitive Behaviour Therapist. Listen here.

Editorial
Liz Marks and Mandy Cole

Read the pre-print of the Editorial to this special issue here.

My climate journey: One cognitive-behavioural psychotherapist’s account and a commentary linking to the scientific and practice literature
Claire Willsher and Mark Freeston

Abstract: Climate change distress is a challenge to people seeking help, and to those providing help. Those providing help are working in a new area of clinical practice where little is known, but they may also be experiencing climate change distress. The aim of this article is to highlight the personal and professional implications of the unfolding climate crisis and how we might better understand and support those with understandable, yet intense, emotional reactions to the climate crisis. This article consists of a first-person narrative by the first author, and a commentary on the narrative based on the psychology of climate change literature by the second author. We have worked independently on the narrative and commentary; each is responsible for their own contribution. The narrative highlights the first author’s personal experience of moving from denial to facing the truth of the climate crisis and the impact on professional practice. The commentary by the second author found that literature is scarce, but more familiar areas of practice may help to understand and respond to climate change distress. Practitioners face a situation where they may experience similar emotions to their clients, analogous to the shared threat of the pandemic. Awareness of the crisis is daunting, but therapy, self-reflection and action can help hold our emotions and support our clients. The evidence is limited but experience of the pandemic suggests that CBT can respond, adapt, innovate, and even revolutionise mental healthcare. These two perspectives suggest, despite the challenges, there may be reasons for hope.

Environmental-identity-based Therapies for Climate Distress: Applying Cognitive Behavioral Approaches
Thomas Doherty, Salvia Artman, Jesse Homan, Jennifer Keluskar and Kristi E. White

Abstract: This paper describes an interdisciplinary integration of the concept of environmental identity into cognitive behavioural approaches to facilitate psychotherapy interventions for climate distress. Environmental identity encompasses one’s sense of self in relation to the natural world and other species, and is an important sub-identity analogous to gender, sexual and other forms of self and social identity recognized in psychotherapy. We provide a background on the construct of environmental identity as developed in social and environmental psychology and share culturally responsive methods for mental health practitioners and the public to evoke and explore their own environmental identity. We then discuss steps to create environmental identity-based therapy interventions using cognitive and behavioural approaches for climate distress. We highlight the potential for acceptance and commitment therapy to foster mindfulness and values-based action, dialectical behaviour therapy to support emotional regulation, and radically open dialectical behaviour therapy to mitigate perfectionism and over-controlled coping styles. We also describe a composite case study of environmental identity-based cognitive behavioural therapy for an LGBTQ+ client.

‘The Work That Reconnects’: a groupwork methodology for enhancing adaptive responses to the climate and ecological crisis
Rosie Jones and Chris Johnstone

Abstract: The dominant economic, political and sociocultural system is leading the Earth towards climate and ecological breakdown (IPCC, 2023) as well as causing adverse mental, physical and social health consequences (Eisenberg-Guyot and Prins, 2022). To address these inter-related crises there is an urgent need for cultural evolution to life-sustaining ways of living and organising human life (Brooks et al., 2018). This requires concurrent psychological and ideological shifts and psychological contexts of support, in which people can explore their relationship with, and response to, the planetary predicament and the roles they would like to play in its transformation. The Work That Reconnects (WTR) (Macy and Brown, 2014) is a groupwork methodology developed to address this need. It consists of a set of philosophical and psychological teachings and experiential practices drawn from deep ecology, living systems thinking, Buddhism, and indigenous, spiritual and other wisdom traditions. It originated outside the field of CBT and psychotherapy, within activist movements, within which it is an increasingly well-known methodology for psychological support. The WTR has many characteristics which align with cognitive behavioural approaches with regard to processes, techniques and mechanisms of change. The WTR has, as yet, received minimal scientific research attention. The aim of this paper is to raise awareness of the methodology within the cognitive behavioural field, introducing philosophies, concepts, and techniques that may be of utility to CBT practitioners and will stimulate research and evaluation of a methodology with potential to address psychological needs at this time.

Extreme weather, climate change, climate action and uncertainty distress: an exploratory study using network analysis
Mark Freeston, Letitia Sermin-Reed, Saskia Whittaker, Joanne Worbey and Chloe Jopling

Abstract:
Background: Both extreme weather and climate change have been linked to distress and at times mental health problems. Pro-environmental actions have often been related to higher distress. The uncertainty distress model (Freeston et al., 2020) proposes that in real-world situations, perceptions of threat and uncertainty contribute to distress. The aim of this study is to integrate variables from these two literatures and examine their relationships.
Method: A community sample (n=327) was recruited and completed an online survey. Network analysis was used to analyse the relationships between the variables. Exposure to extreme weather, perceptions of climate change, climate change distress and pro-environmental action were measured along with symptoms of adjustment disorder and post-traumatic stress disorder, and uncertainty intolerance and behaviours.
Results: There was variable exposure to extreme weather, but greater exposure was associated with more severe post-traumatic symptoms. Pro-environmental action was associated with greater severity of adjustment disorder symptoms. The perception that climate change was happening now was linked positively to pro-environmental action and negatively to perceptions of uncertainty about whether climate change was happening.
Discussion: The results replicate several findings from the emerging climate change distress literature and are consistent with some predictions of the uncertainty distress model, but not others. Uncertainty as to whether climate change is happening now may be a less distressing position. Research that simultaneously considers extreme weather and climate change may help understanding the range of complex responses that may arise as the frequency of extreme weather increases and evidence for anthropogenic climate change strengthens.

‘The complete opposite of what you morally believe’: (in)action on climate change by State authorities and powerful bodies drives moral injury and eco-distress in UK young people
Ines Zevallos Labarthe and Elizabeth Marks

Abstract: Young people are increasingly distressed by the climate and ecological crises (eco-distress). This has been associated with the failure of people in power to act appropriately, which may cause moral distress and moral injury. We examined this hypothesis by interviewing 13 young adults (19–25 years) in the UK about their climate concerns and perceptions of how State actors and authorities are responding to climate change. Using reflexive thematic analysis, four themes were developed: (1) Climate change is a wicked problem, (2) Moral distress is associated with witnessing acts of omission and commission, (3) Moral distress drives eco-distress, and (4) Opportunities for moral repair. Climate concerns extended to broader concerns about ecological degradation (eco-distress), linked to feelings of moral distress arising from repeatedly witnessing powerful people failing to act on climate change. Eco-distress was also exacerbated by (a) witnessing others in society failing to take appropriate responsibility, (b) realising the limitations of individual action, and (c) being embedded within a culture where personal contribution to climate change is inescapable. In contrast, eco-distress was lessened by seeing authorities engage with the issues morally, and further mitigated by collective, ethical, pro-environmental action. This adds empirical evidence to support the hypothesis that eco-distress involves moral distress and injury arising when State authorities and other powerful bodies engage in wrongful acts and omissions on climate change. We argue that this is affecting the wellbeing of young people and supports the argument that such wrongful (in)action infringes human rights. Clinical implications are discussed.

What happens in Climate Cafés?: exploring responses to the psychological burdens of climate change in seven UK women
Luis Calabria and Elizabeth Marks

Abstract: As humanity faces a future of rising global temperatures, and associated extreme weather events, distressing emotional responses are understandable, but often silenced. Climate Cafés are unique, dedicated spaces where such responses can be shared and validated with others. Semi-structured interviews were conducted with attendees of Climate Cafés facilitated by the Climate Psychology Alliance (CPA). An initial interview of 45 minutes was followed by a shorter follow-up interview 3 months later. Interpretative phenomenological analysis (IPA) methodology was used with seven female participants. Four superordinate themes were identified: (1) Having a keen awareness of threats to planetary health, (2) Action taken in the face of climate change, (3) Journeying from isolation to connection, and (4) Legacy of Climate Cafés. Participants described positive experiences both during and after the Climate Cafés, particularly having their concerns heard and validated, being with others who share their worldview, and feeling more connected. Attending Climate Cafés appears to offer important support to people experiencing distress related to the climate and ecological emergencies. Findings are discussed in light of the compassion-focused therapy (CFT) ‘Three Systems’ model, which offers a unifying theoretical conceptualisation that could support future development and research in this area.

Compassion-focused approaches to understanding the mental health of climate scientists
Luis Calabria, Charlotte Peters and Marc Williams

Abstract: As we face a future of rising global temperatures, and associated extreme weather events, distressing emotional responses are understandable. Climate scientists comprise a unique group, in that they must regularly confront the reality, and consequences, of climate change. In this paper, we explore how the principles of compassion-focused therapy (CFT) might be applied to comprehend the responses of climate scientists to climate change; by doing so, we aim to gain a deeper understanding of these responses in order to consider fruitful avenues for providing support and investigating this area further. We consider how flows of compassion, and blocks to compassion, might play a role in climate scientists’ experiences. Additionally, we conceptualise a role for compassion towards the wider world and humanity more broadly. Finally, by applying the CFT Three Systems model to current understanding of climate scientists’ emotional experiences, we seek to proffer a potential conceptualisation of them.

Acceptance and commitment therapy as an approach for working with climate distress
Marc O. Williams and Victoria M. Samuel

Abstract: Climate distress describes a complex array of emotional responses to climate change, which may include anxiety, despair, anger and grief. This paper presents a conceptual analysis of how acceptance and commitment therapy (ACT) is relevant to supporting those with climate distress. ACT aims to increase psychological flexibility, consisting of an open and aware orientation to one’s experiences, and an engaged approach to living, guided by personal values. We discuss the pertinence of each of these processes for adapting to the challenging reality of climate change. By embracing climate distress as a natural human experience and promoting value-guided action, ACT offers a promising approach that brings co-benefits to individuals and wider society.