Many psychological therapies help clients to direct and sustain their awareness onto specific aspects of their problems to promote change. Yet, no theory-driven measure exists that can code moment-by-moment changes in awareness during a therapy session. It is known that awareness plays a crucial role in the process of change, but little is known about the underlying core processes. Perceptual Control Theory (PCT) offers a scientific explanation of psychological distress as loss of control and describes the role of awareness in processes responsible for restoring control by resolving any internal conflict. The Depth and Duration of Awareness Coding Scheme (D-DACS) was previously developed to capture the person’s current focus of awareness and its duration on the areas that from a PCT point of view are desirable in order to facilitate effective psychological change. The current research applies D-DACS to code three publicly available Method of Levels (MOL) therapy sessions delivered by an expert therapist and presents a visual representation of the client’s presumed attention in these sessions. The results showed that an average of 61.65% of the client’s attention was focused on the D-DACS areas, which is higher than the previous studies involving novel therapists. The produced visual representation of the clients’ presumed attention helps to examine the utility of this new coding scheme and further examine the validity of the underlying theory. Such work might help in examining effectiveness of therapy in meeting the underlying theoretical foundations of change. However, limitations and areas for improvement are also evident.Key learning aims (1)To provide a rationale for the use of observer-rated measures of within-session processes involved in therapeutic change.(2)To describe the desired focus of the client’s awareness in order to facilitate effective psychological change as described by Perceptual Control Theory.(3)To use an earlier validated scheme to code the depth and duration of awareness of three clients in best practice videos of Method of Levels psychotherapy.(4)To present and test the feasibility of a visual representation of moment-to-moment changes in a client’s awareness in a therapy session.

Sleep problems are common with nearly one in three people reporting disturbed sleep. In line with guidelines, most people experiencing poor sleep in the United Kingdom are referred for cognitive and behavioral treatment approaches. A large proportion of these clients are seen by Psychological Well-being Practitioners (PWPs) delivering low-intensity therapy within Improving Access to Psychological Therapies (IAPT) services. The training of PWPs in the treatment of sleep problems is limited to sleep hygiene psychoeducation. The role that sleep hygiene psychoeducation plays in improving sleep quality is unclear, especially if used as a stand-alone intervention. The article introduces method of levels (MOL) as an alternative approach explaining sleep problems by transdiagnostic mechanisms. Two clinical cases are presented to demonstrate how MOL was implemented to support clients with the perceived sleep issue. This article adds to growing evidence that a transdiagnostic approach to helping people experiencing psychological distress is needed.

There are many different approaches to psychotherapy. Research indicates comparable effectiveness of various therapies, despite having different theoretical assumptions and using different therapeutic methods. In recent years, many researchers have attempted to understand such results by investigating specific and common factors in psychotherapy. It has been suggested that further developments in the field should aim to investigate factors underlying mental health problems and the principles informing the process of change in psychotherapy. In the current article, we will present perceptual control theory as a scientifically grounded approach that integrates theory and practice. Transdiagnostic principles explain the sources of emotional distress and the process of psychological change in psychotherapy. The main aim of the article is to introduce method of levels therapy, which has been created as a direct application of perceptual control theory principles. Description of the process of therapy is accompanied by clinical examples.