Approaching rTMS With Openness, Awareness, and Engagement in a Combined Acceptance and Commitment Therapy Framework

Recent decades have seen a surge in empirical support for the clinical application of noninvasive neuromodulation technology, such as repetitive transcranial magnetic stimulation (rTMS). The aim of this perspective is to review the emerging research exploring the literature on combined psychotherapy with rTMS.

This article provides a narrative overview of studies combining psychotherapy and rTMS from the perspective of a practicing psychologist in the context of implicated neural networks and an evidenced-based contextual behavioral model of therapy.

It is advanced that the network flexibility and connectivity changes induced by rTMS may facilitate an effective neural context for psychotherapy processes to support meaningful change, providing a synergistic strengthening of psychological and brain network flexibility. More precisely, this clinical perspective considers existing studies that combine psychotherapy techniques with rTMS across diverse clinical populations, within an acceptance and commitment therapy (ACT) framework.

It is argued that rTMS can be applied while concurrently fostering psychological flexibility pillars of openness, awareness, and engagement and applied as a transdiagnostic, process-based intervention in a psychosocial and biophysiological context.