Why ReWire Was Developed & Why It’s Good

By Dr. Andrew Smith, Clinical Psychologist, Professor, and Pat Tillman Scholar. To learn more about how REWIRE can improve your relationships, download our free guide and checkout the REWIRE app

Over the past 15 years, I’ve been deeply immersed in studying and building psychological and community-level interventions, with a focus on three key areas: (1) social functioning and relationship health, (2) social cohesion and polarization in communities, and (3) how to live a more connected, joyful, and meaningful life. My work has led me to study how individuals—ranging from first responders and veterans to doctors, nurses, and ordinary folks—manage the chronic stress associated with their work. This has included an exploration of how stress and trauma reshape the ways we think about work, survival, and erode deeper connections with one anther. And how this further erodes meaning, beauty, joy, and presence to make life worth living.

Over the last five years, this work has culminated in the development of an intervention I call RE-WIRE, designed to help individuals refocus their meaning and joy on values and relationships. I’ve successfully applied this approach to help hundreds of people, and my hope is to move it out of cloistered and low scalability academic research settings and into the public for broader good.

Today, I’m writing about the context out of which I developed RE-WIRE was developed and what makes it such an effective approach. To provide a clear explanation, I’ll break it down into three parts:

1. The limitations of traditional (second-wave) CBT approaches.
2. How third-wave CBT improves upon these shortcomings.
3. Why RE-WIRE, as a specific form of third-wave CBT, is uniquely designed to harness the power of relationships.

Part 1: The Fundamentals and Failures of Second-Wave CBT

Second-wave CBT, which originated from the work of Aaron Beck in the 1970s and 1980s, quickly became the dominant model in psychotherapy. It revolutionized the field, and emerged in a time that tools and methods for better scientific rigor were available. Gold standards for treatment efficacy such as randomized controlled trials (RCTs) came into being and vogue, and provided opportunities to build rigorous evidence for the effectiveness of psychotherapy—much like pharmaceutical trials for psychiatric medications.

In its simplest form, second-wave CBT is grounded in two core principles:

1. People suffer because their thinking is distorted.
2. Improvement comes from restructuring these distorted thoughts.

Therapists are trained to help clients identify cognitive distortions, such as all-or-nothing thinking, and replace them with more objective, reality-based thoughts. While this approach has provided many positive outcomes, it falls short in several critical areas, especially in the context of trauma treatment, where studies show a high rate of symptom persistence even after therapy.

Problem 1: Waning Effectiveness

Data from meta-analyses show that the positive effects of second-wave CBT have diminished over time, with studies like the Johnsen & Friborg (2015) analysis revealing a regression to the mean in therapeutic outcomes since 1977. Similarly, research by Steenkamp and colleagues (2015; 2020) revealed that up to to two-thirds of patients still had diagnosable conditions after receiving second-wave CBT, suggesting only partial improvements.

Problem 2: Accessibility and Scalability

Second-wave CBT is complicated and deals with very abstract and high minded concepts like “cognition.” It requires highly trained professionals, often with 21-23 years of education and specialized training through doctoral and postdoctoral work, making it difficult for the general public to access. With limited numbers of trained therapists, it’s unrealistic to think this approach is truly scalable to meet the growing mental health needs of the broader population.

Further, even if we had all the demand for rigorously trained therapists met, both the financial cost and time burden to participate in these interventions is not feasible for most people. In other words, these are interventions for wealthy people with the money and time to spend.  

Problem 3: Lack of Authenticity

Traditional CBT places too much emphasis on cognition as the sole change mechanism, creating an imbalance in the therapeutic relationship. The therapist becomes the “expert,” while the patient is viewed as a “novice” in understanding their own life. The therapist is the purveyeor of “objective reality.” This dynamic can be disempowering, leading to resistance or dropout in therapy.

Problem 4: Passivity

By focusing primarily on thought restructuring, second-wave CBT can lead clients into a cycle of “thinking about thinking,” which can be fruitful, but just as often generates more rumination. In today’s world, where overthinking is already rampant, this approach may not be the most effective way to propel people toward actionable improvements.

Part 2: The Evolution of Third-Wave CBT

Third-wave CBT departs from the traditional emphasis on cognitive restructuring and instead focuses on values-based actions and behavior change. Rather than viewing distorted thinking as the primary issue, third-wave approaches emphasize living in alignment with personal values and goals, with therapy acting as a guide to achieving that alignment.

In this model, patients—not therapists—define the targets for change, with the focus on behaviors rather than thoughts. Cognition is acknowledged as important but not the central driver of change. Instead of passively examining thoughts, patients engage in concrete actions aligned with their values, evaluating the success of those actions against personal goals, rather than an external “objective reality” defined by the therapist.

For example, rather than asking, “How did your distorted thinking lead to anger?” a third-wave therapist might ask, “Was your behavior aligned with your values during that conflict? What action could have been more in line with your values next time?”

This shift makes therapy more accessible, authentic, and action-oriented, addressing many of the shortcomings of traditional CBT.

Part 3: Why RE-WIRE is Different

RE-WIRE takes the principles of third-wave CBT and applies them specifically to relationships, which, in my experience, are the core concern for nearly all therapy clients. Relationship issues are not only the most common reason people seek therapy, but they are also one of the most universally supported protective factors in mental and physical health, with strong social ties linked to better outcomes in areas like depression, anxiety, PTSD, and even chronic diseases.

RE-WIRE was designed to fill the gap left by traditional therapies that often focus on individual pathology without explicitly addressing relationships. By focusing on key relationships—whether with a spouse, parent, child, or friend—RE-WIRE helps people reconnect to their values and act in ways that enhance those relationships. The approach is scalable and accessible, offering tools that people can use without requiring years of specialized training.

In a world where social isolation, overwork, and digital dystopia are increasingly the norm, RE-WIRE offers a simple yet profound way to reclaim joy and meaning through improved relationships. This is an alternative to traditional therapy models, and focus on disease.