The SMARTER-life-GROWTH approach to wellbeing and happiness is a third wave integrative Cognitive Behavioral Therapy (i-CBT) approach. As such, the approach utilises a transdiagnostic, solution-focused understanding that can be applied across many coaching, positive and clinical situations to a range of problems. As no single modality covers the plethora of human experiences, the SMARTER-life-GROWTH approach integrates several well established psychological principles into a coherent framework (e.g. CAT, CBT, DBT, MANTRA, RO-DBT & Schema). By integrating several approaches into a coherent whole, a clinician can collaboratively create the best fit between the person and their difficulty from a range of options. Such integrative approaches are more flexible and personalised because they adapt to fit the person instead of trying to fit the person to the model. Preliminary findings and avenues for further research will be discussed within the framework of the MARIA (Mindful Awareness, Reflection, Insight and Action) acronym. Finally, the advantages of adopting both top-down (insight) and bottom-up (skills) based approaches to complex cases such as eating disorders will be discussed.

1. SMARTER-life-GROWTH
An integrative Cognitive Behavioural approach
2nd Positive Psychology in Practice
24th - 25th October 2019
Utrecht, Netherlands
Pat Gwyer PhD, D.ClinPsych, MSc
Specialist in Adult Mental Health
Clinical Director of Dandelion Healthcare
SMARTER-life-GROWTH

2. Introduction
• Why do we need third wave integrative Cognitive Behavioral (i-CBT) approachs?
• Problem: No single modality covers the plethora of human experiences.
• Solution: Integrate several well established psychological principles into a coherent
framework.
• Problem: People are complex wholes not isolated parts.
• Solution: A transdiagnostic, solution-focused approach applicable across situations to a
range of problems.
SMARTER-life-GROWTH

3. How this is achieved?
• Collaborative fit between the person and their difficulty from a range of options.
• Flexible and personalised (fit the person not the model or manual).
• Apply a top-down (insight) and bottom-up (skills) approach.
• Key concepts MARIA ROARS to BRIM with Serenity AND IMPROVRE to RAISe to her best
possible self
SMARTER-life-GROWTH

4. SMARTER-life-GROWTH
The whole remains in the background providing
the context for the parts.
Emotions
Actions
Thoughts
Body
sensations
Anticipation of
Outcomes
(Future)
Current
experience
(Present)
Past experiences
Interpretations
of experiences
Creation, Utilization, Depletion of
Biological, Psychological, Social, Spiritual
Resource Capital
Mindful
Awareness
Reflection
Insight
Action
The area of intervention (the part) moves to the
foreground and is the focus of current attention.
The other parts create the background (the
whole) to the part.
The reciprocal connection between the parts,
mean that change in one, leads to change in
others.
The constructive nature of memory means that
past, current and future experiences alter
recollection. The event is fixed but the meaning,
recollection and impact is flexible. Meaning and
emotional impact of experiences can alter.

5. SMARTER-life-GROWTH
Emotions
Actions
Thoughts
Body
sensations
Anticipation of
Outcomes
(Future)
Current
experience
(Present)
Past experiences
Interpretations
of experiences
Creation, Utilization, Depletion of
Biological, Psychological, Social, Spiritual
Resource Capital
Mindful
Awareness
Reflection
Insight
Action
Insight based
(top down)
Skills based
(bottom up)

6. MARIA ROARS
• Mindful Awareness, Reflection, Insight and Action (MAIRA).
• Responsibility, Openness, Accountability, self-Respect, Strengths focus (ROARS).
SMARTER-life-GROWTH

7. to BRIM with Serenity
• Mindful Awareness, Reflection, Insight and Action (MAIRA).
• Responsibility, Openness, Accountability, self-Respect, Strengths focus (ROARS).
• Breathing, Relaxation, Imagery, Mindfulness (BRIM)
• Self soothing (Serenity)
SMARTER-life-GROWTH

8. AND IMPROVE
• Acceptance, Never giving up, Distraction (AND)
• Invest in yourself, find Meaning, follow Passions, be Resilient and Open to experiences,
stick to your Values and Engage in what you do (IMPROVE)
SMARTER-life-GROWTH

9. to march to the BEATS of her own drum
• Realistic, Achievable, Ideal, best possible SElf (RAISE)
• Bodily sensations, Emotions, Actions, Thoughts, Social connection
SMARTER-life-GROWTH

10. MAIRA ROARS to BRIM with Serenity AND IMPROVE so she can RAISE up
and march to the BEATS of her own drum she does this through
• SMARTER-life-GROWTH skills
SMARTER-life-GROWTH

11. SMARTER wellbeing and happiness goals are
Specific
Measurable
Achievable
Relevant
Time-framed
Evaluated
Reflected upon
SMARTER-life-GROWTH

12. Making sure you include in your goals …
The things you Love and are passionate about
The things that Interest, motivate and are meaningful to you
Remembering to be Fair, kind and companionate to yourself and others
And to include the things you Enjoy and that give you a sense of connection
SMARTER-life-GROWTH
life wellbeing and happiness goals involve

13. GROWTH promoting wellbeing and happiness goals are
Growth orientated
Realistic
from all the … Options, Obstacles, Opportunities
identify … Ways to achieve the goal
find the Tactics
that make the outcome a Habit
SMARTER-life-GROWTH

14. SMARTER-life-GROWTH is an approach that …
Empowers, facilitates and enables choice by providing skilled alternatives
Our actions and reactions are the conduit between our internal and external worlds
(and the only thing we have control over)
SMARTER-life-GROWTH
Change is within their
their power and
authority
To make change as easy
as possible
By providing the skills
and resources

15. SMARTER-life-GROWTH promotes…
Autonomy, responsibility and choice, but a real choice, not a Hobson’s choice.
Hobson’s choice
A Choice Of Taking What is Available or Nothing At All
It’s only a choice if you have an alternative to choose
People do not chose to be unhappy, self harm, be abused, use substances, suffer and
struggle. This happens because they feel there are no other options available to them other
than those they have. They can not choose what they do not have.
SMARTER-life-GROWTH

16. Viktor E. Frankl
Man's Search For Ultimate Meaning
“The last of the human freedoms: to choose one's attitude in any given set of
circumstances, to choose one's own way. And there were always choices to make.
Every day, every hour, offered the opportunity to make a decision, a decision which
determined whether you would or would not submit to those powers which
threatened to rob you of your very self, your inner freedom; which determined
whether or not you become the plaything to circumstance, renouncing freedom
and dignity...”
SMARTER-life-GROWTH

17. SMARTER-life-GROWTH
Hierarchy of approach
Growth
Stabilisation
Safety and risk reduction

18. Some of the other skills
STOP: Stop, Take three deep breathes, Observe, Problem solve
HALT(s): Hungry / Haggard, Angry/ Anxious, Low in mood / Lonely, Tired (& stressed)
People skills
SOFTEN: Smile, Open, Face forward, Tone, Eye contact, Nod
HEAR: Honesty, Empathy, Acceptance, Respect
DESCRIBE: Describe, Express feeling, State objectives, Compromise, Reinforce, Investigate
possibilities, Body language, Easy & gentle manner
SMARTER-life-GROWTH

19. Mindfulness skills
• Reasonable, Emotional, Wise mind
• Awareness, Reflection, Insight, (wise) Action
• Expansive attention “Landscape painter”
• Constructive attention “Watch maker”
• Bare attention “Bird watcher”
SMARTER-life-GROWTH

20. Two examples of client handouts

21. SMARTER-life-GROWTH
Workbook template

22. 3) The gunpowder
5c) Emotional out of control reaction5a) Emotional over controlled reaction
2) The touch paper
5b) Wise mind response
1) The H.A.L.T vulnerabilities
4) S.T.O.P
Start here
5) Choice
Mindful response
or mindless reaction
A B or C
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23. What the look might look like in session

24. SMARTER-life-GROWTH
Confusion to ….
Clarity ….

25. But we do tidy them up!

26. SMARTER-life-GROWTH