In discussing First/Second wave CT an earlier post said "These have very explicitly emphasised the need to change cognitve content in order to change "bad feelings" (e.g the Daily Thought Record has been a central intervention, see Padesky and Greenberger's Mind over Mood for instance)." An important part of the apparent contradiction is the assumption that CT sees explicit efforts to change the content of cognition as a necessary part of treatment. It would be more accurate to say that CT sees interventions directed at changing the content of cognitions as useful in treating many problems, not as being necessary. Those who argue that CT always focuses on changing the content of cognitions misunderstand CT.

It is true that there are a number of problems where CT focuses extensively on changing the content of cognitions. A classic example is in CT for depression where we often spend quite a bit of time modifying the content of automatic thoughts and later work to modify beliefs and assumptions. However, we focus on changing the content of cognitions when treating depression because it works and works well. When treating other problems there often is much less emphasis on generating "rational responses" and much more emphasis on other interventions. For example, in treating phobias there is much more emphasis on in-vivo exposure and much less emphasis on rational responses. A clear example (as noted earlier in this thread) is in treating OCD where it usually turns out that attempts to generate rational responses to obsessions are counter-productive and we emphasize exposure and response prevention.

Some of the approaches that get lumped together as "third wave" approaches are difficult to reconcile with CT. For example, when I've heard Steve Hayes present ACT he's been explicitly anti-CT and he presents ACT as though it's diametrically opposed to CT. Other "third wave" approaches are quite compatible with CT. For example, DBT has some theoretical differences from CT and uses different terminology but there's a great deal of overlap between the interventions used in DBT and the interventions CT uses with borderline personality disorder. MBCT, of course, is a variant of CT which uses "standard" CT interventions such as rational responses in a mindfulness-based framework. Note that MBCT is intended for use when the individual's depression is in remission. I doubt that mindfulness would be a great idea when one is in the midst of a major depression.

If anyone has specific questions about this topic, post them and I'll try to respond. I've got a good deal more to say on this topic but it's late and I need to call it a night.