Clinical Round Table 4 - Considering Process Based Therapy (PBT) from Varying Perspectives: Back to the Future?

CBT’s journey moved from an idiographic study of behavioral principles to a nomothetic approach that followed a latent disease model, emphasizing the use of diagnosis-specific protocols, and more recently moved back to its roots as an individual approach with models of treatment based on therapeutic change processes and transdiagnostic considerations, rather than specific diagnostic entities. Process based therapy (PBT) is a framework for targeting interventions to meet clients’ needs in which therapists select from a range of evidence-based interventions based on the context and goals of intervention. PBT requires moving clinical questions from, “Which treatments work?” to “How do treatments work?” and “How can that knowledge be applied to this client?” PBT brings existing evidence-based treatments under an umbrella in which the context and function of a given technique in relation to an idiographic understanding of a clients’ psychological issues is of greater importance than the “theoretical” tribe from which it comes. This clinical round table brings together noted clinicians whose approaches to treatment span various CBT models: REBT, mindfulness-based therapies, traditional CBT, and ACT. Dr. Steven Hayes (co-developer of PBT) discusses the evolution of PBT and how it provides a large tent for ACT, traditional CBT, and other evidence-based models and techniques, within a context of an expanded psychological flexibility model. Dr. DiGiuseppe discusses the fit of REBT into a PBT model, emphasizing the historical writings of Albert Ellis along with the practical utility of approaching client suffering with this “big tent” mindset. Dr. Gardner describes the utility of PBT to understand the added value of the specific mechanisms that mindfulness-based interventions bring to an idiographic approach to the reduction of client suffering. 1) Discuss how clinical experiences have informed our theoretical and practical reactions to the PBT approach 2) Assess whether PBT is simply another acronym for ACT 3) Present empirical evidence on the foundations of the PBT model. 4) Describe future treatment research ideas. 5) Illustrate how students/early career practitioners can develop skills to deliver CBT from the perspective of PBT.