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Beyond the DSM: Toward a Process-Based Alternative for Diagnosis and Mental Health Treatment
As a mental health clinician, you know that every client is unique, and a client’s symptoms are the result of a complex combination of psychological, environmental, genetic, and neural factors. However, the de facto DSM model poses considerable constraints on how you can treat clients—often resulting in a one-size-fits-all diagnosis. This important volume challenges the assumptions and approach made by the DSM, and provides a vision and plan for an evidence-based, process-based approach to individualized care. With contributions from renowned experts in the field—including Steven C. Hayes, Stefan G. Hofmann, Joseph Ciarrochi, Matthew McKay, Uma Vaidyanathan, Sarah Morris, David Sommers, J. Scott Fraser, and many more—this groundbreaking book will show you a new way to recognize the complexity of human suffering and human prosperity. You’ll find solid tips for treating a wide variety of psychological issues in a more flexible way. And, finally, you’ll come away with a greater understanding of the “processes of change,” and how to build a solid foundation for an alternative to syndromal diagnosis. The future of mental health treatment is process-based. Whether you’re a clinician, researcher, student, instructor, or other professional working in the mental health field, this breakthrough volume offers everything you need to understand process-based treatment and create a more customized and effective approach to treating clients.
304 pages, Paperback
Published October 1, 2020
13 people are currently reading
230 people want to read
About the author
Steven C. Hayes
116 books405 followersSteven C. Hayes, PhD, is Nevada Foundation Professor in the department of psychology at the University of Nevada. An author of thirty-four books and more than 470 scientific articles, he has shown in his research how language and thought leads to human suffering, and cofounded ACT, a powerful therapy method that is useful in a wide variety of areas. Hayes has been president of several scientific societies and has received several national awards, including the Lifetime Achievement Award from the Association for Behavioral and Cognitive Therapy.
He runs the leading Ph.D program in Behavior Analysis, and coined the term Clinical Behavior Analysis. He is known for devising a behavior analysis of human language and cognition called Relational Frame Theory, and its clinical application to various psychological difficulties, such as anxiety.
Hayes has been President of Division 25 of the American Psychological Association, of the American Association of Applied and Preventive Psychology, the Association for Advancement of Behavior Therapy (now known as the Association for Behavioral and Cognitive Therapies), and the Association for Contextual Behavioral Science. He was the first Secretary-Treasurer of the American Psychological Society (now known as the Association for Psychological Science), which he helped form.
Hayes' work is somewhat controversial, particularly with his coined term "Relational Frame Theory" to describe stimulus equivalent research in relation to an elaborate form of B.F. Skinner's Verbal Behavior (also referred to as verbal operants).
An author of 38 books and 550 articles, in 1992 he was listed by the Institute for Scientific Information as the 30th "highest impact" psychologist in the world during 1986-1990 based on the citation impact of his writings during that period.
According to Time columnist John Cloud, "Steven Hayes is at the top of his field. A past president of the distinguished Association for Behavioral and Cognitive Therapies, he has written or co-written some 300 peer-reviewed articles and 27 books. Few psychologists are so well published".
He runs the leading Ph.D program in Behavior Analysis, and coined the term Clinical Behavior Analysis. He is known for devising a behavior analysis of human language and cognition called Relational Frame Theory, and its clinical application to various psychological difficulties, such as anxiety.
Hayes has been President of Division 25 of the American Psychological Association, of the American Association of Applied and Preventive Psychology, the Association for Advancement of Behavior Therapy (now known as the Association for Behavioral and Cognitive Therapies), and the Association for Contextual Behavioral Science. He was the first Secretary-Treasurer of the American Psychological Society (now known as the Association for Psychological Science), which he helped form.
Hayes' work is somewhat controversial, particularly with his coined term "Relational Frame Theory" to describe stimulus equivalent research in relation to an elaborate form of B.F. Skinner's Verbal Behavior (also referred to as verbal operants).
An author of 38 books and 550 articles, in 1992 he was listed by the Institute for Scientific Information as the 30th "highest impact" psychologist in the world during 1986-1990 based on the citation impact of his writings during that period.
According to Time columnist John Cloud, "Steven Hayes is at the top of his field. A past president of the distinguished Association for Behavioral and Cognitive Therapies, he has written or co-written some 300 peer-reviewed articles and 27 books. Few psychologists are so well published".
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December 18, 2021
Thomas Kuhn coined the term paradigm to describe how a regime of scientific understanding is born, then begins to creak under the strain of contradictory data, and eventually fails, giving way to a new, more advanced, more powerful paradigm.
Kuhn refered to this as scientific revolution (inline with revolutionary zeitgeist of the 1960s). But the term revolution, could be just as easily swapped with the word evolution, and perhaps become even more powerfully descriptive and predictive.
Just as Kuhn described, there is a (r)evolution well underway in the behavioral sciences, and the field of mental health.
The replication crisis in psychology has shed light on flaws in the philosophical assumptions and methodological standards of psychological measurement and research.
I’m not sure who said it first, but there’s an old chestnut of a phrase that goes: “a statistician drowned in a river that was an average of 3 feet deep”.
Psychological research and the field of psychometrics are drowning in that same proverbial river.
Similarly.
The recent addiction and mental health crisis is shedding an even brighter light on the clear failures of the medical model of diagnosis and mental health care.
DSM5 (The American Bible of mental health diagnosis) and ICD10 (The nearly identical European Bible of mental health diagnosis) are woefully flawed.
Everybody knows it.
And the best anyone can say is “ it’s better than nothing”.
Creating diagnostic categories out of thin air, based on clusters of “symptoms”, without any real understanding of their underlying etiology, is where biomedicine was before germ theory.
And (tragically) that’s pretty close to where the medical model of mental health diagnosis is today.
Furthermore: the big box proprietary “evidence-based” models of psychotherapy purported to be efficacious in the treatment of these diagnostic fictions is way better than nothing, but (shamefully) insufficient to meet the crisis of the day.
What (precisely) does it mean when you say that CBT is an evidenced based treatment for major depressive disorder?
What part of CBT?
Which (actual) aspects of (the arbitrary and fictional diagnostic category known as) major depressive disorder?
The old paradigm is creaking and leaking like the U-boat in Das Boot (perhaps the greatest film of all time) and many of us in the mental health field feel like the anxious paranoid and loathing crew, that can’t help but sense that the vessel we are all in is imploding.
That being said.
The metaphor falls short.
Because unlike the crew of Das Boot.
We have a choice.
We can elect right now to resurface, flip open in the hatch, and enjoy a little fresh air and sunlight.
There is a new land on the horizon, and we don’t have to go down with the ship.
Stepping out of the metaphor.
The new paradigm of mental health diagnosis and psychotherapy has arrived.
The trans-diagnostic method of case conceptualization (represented in this book) intends to identify the “processes of suffering” that underlie contemporary DSM diagnosis.
And.
Process based psychotherapy intends to identify the “processes of change” contained in each of the old “big box” proprietary models psychotherapy.
And match process to process based on the specific needs of the individual you are working with.
Most psychotherapist already work in this way.
Most of us don’t “treat” our clients “diagnosis” with unitary models delivered to fidelity.
Most of us find out what our individual clients are suffering from, and deliver interventions pulled from a variety of psychotherapeutic models.
Many of us feel shame about working “eclectically” because they told us not to do it in therapy school.
But once we are out of school, we all learn very quickly that trying to fit the diversity of human suffering we encounter, into one model or school of psychotherapy and case conceptualization makes jamming a square peg into a round hole seem reasonable in comparison.
For a wonderful introduction to the philosophy and methodology of process-based psychotherapy, check out:
Process-Based CBT: The Science and Core Clinical Competencies of Cognitive Behavioral Therapy By Stephen C Hayes and Stefan G. Hofmann (2018).
Click the link below to read my review:
https://www.goodreads.com/book/show/2...
And for an equally third eye-opening introduction to transdiagnostic case conceptualization.
Read this book.
The new paradigm has arrived.
Here’s your chance to jump in early.
Kuhn refered to this as scientific revolution (inline with revolutionary zeitgeist of the 1960s). But the term revolution, could be just as easily swapped with the word evolution, and perhaps become even more powerfully descriptive and predictive.
Just as Kuhn described, there is a (r)evolution well underway in the behavioral sciences, and the field of mental health.
The replication crisis in psychology has shed light on flaws in the philosophical assumptions and methodological standards of psychological measurement and research.
I’m not sure who said it first, but there’s an old chestnut of a phrase that goes: “a statistician drowned in a river that was an average of 3 feet deep”.
Psychological research and the field of psychometrics are drowning in that same proverbial river.
Similarly.
The recent addiction and mental health crisis is shedding an even brighter light on the clear failures of the medical model of diagnosis and mental health care.
DSM5 (The American Bible of mental health diagnosis) and ICD10 (The nearly identical European Bible of mental health diagnosis) are woefully flawed.
Everybody knows it.
And the best anyone can say is “ it’s better than nothing”.
Creating diagnostic categories out of thin air, based on clusters of “symptoms”, without any real understanding of their underlying etiology, is where biomedicine was before germ theory.
And (tragically) that’s pretty close to where the medical model of mental health diagnosis is today.
Furthermore: the big box proprietary “evidence-based” models of psychotherapy purported to be efficacious in the treatment of these diagnostic fictions is way better than nothing, but (shamefully) insufficient to meet the crisis of the day.
What (precisely) does it mean when you say that CBT is an evidenced based treatment for major depressive disorder?
What part of CBT?
Which (actual) aspects of (the arbitrary and fictional diagnostic category known as) major depressive disorder?
The old paradigm is creaking and leaking like the U-boat in Das Boot (perhaps the greatest film of all time) and many of us in the mental health field feel like the anxious paranoid and loathing crew, that can’t help but sense that the vessel we are all in is imploding.
That being said.
The metaphor falls short.
Because unlike the crew of Das Boot.
We have a choice.
We can elect right now to resurface, flip open in the hatch, and enjoy a little fresh air and sunlight.
There is a new land on the horizon, and we don’t have to go down with the ship.
Stepping out of the metaphor.
The new paradigm of mental health diagnosis and psychotherapy has arrived.
The trans-diagnostic method of case conceptualization (represented in this book) intends to identify the “processes of suffering” that underlie contemporary DSM diagnosis.
And.
Process based psychotherapy intends to identify the “processes of change” contained in each of the old “big box” proprietary models psychotherapy.
And match process to process based on the specific needs of the individual you are working with.
Most psychotherapist already work in this way.
Most of us don’t “treat” our clients “diagnosis” with unitary models delivered to fidelity.
Most of us find out what our individual clients are suffering from, and deliver interventions pulled from a variety of psychotherapeutic models.
Many of us feel shame about working “eclectically” because they told us not to do it in therapy school.
But once we are out of school, we all learn very quickly that trying to fit the diversity of human suffering we encounter, into one model or school of psychotherapy and case conceptualization makes jamming a square peg into a round hole seem reasonable in comparison.
For a wonderful introduction to the philosophy and methodology of process-based psychotherapy, check out:
Process-Based CBT: The Science and Core Clinical Competencies of Cognitive Behavioral Therapy By Stephen C Hayes and Stefan G. Hofmann (2018).
Click the link below to read my review:
https://www.goodreads.com/book/show/2...
And for an equally third eye-opening introduction to transdiagnostic case conceptualization.
Read this book.
The new paradigm has arrived.
Here’s your chance to jump in early.
February 8, 2021
I decide to trust my gut feeling and give up on this halfway. The language is impossibly obtuse, that I realistically don't see myself finishing it any time soon. The core ideas listed in its table of contents looked interesting, and as someone who likes his counselling/clinical psychology sprinkled with discussions on philosophy of science, this definitely looked very promising. But god I know I am going to have to endure great pain as I see jargon after jargon from vastly different paradigms get used at every sentence. As far as I have read I saw close to nothing to inform a hands-on therapist as well.
I honestly do not dislike Hayes. I am giving this at least a two star because I feel assured Hayes does not make baseless claims, and this book will at the very least serve as a good anchor point for discussions in this area. I have a hunch that this will stay cutting edge for years to come.
I can only see this book working as a textbook for a very specific class dedicated to the idea of 'Beyond DSM', because this is close to being absolutely unreadable otherwise. I dont see how the average academic trying to wrap their head around the controversies of the DSM (whether as an educator or researcher) can leverage this book. The average therapist would probably not last a few sentences.
Maybe I will return when I run out of reading materials or get a dedicated reading group for this. But this book definitely isn't doing it for me now.
I honestly do not dislike Hayes. I am giving this at least a two star because I feel assured Hayes does not make baseless claims, and this book will at the very least serve as a good anchor point for discussions in this area. I have a hunch that this will stay cutting edge for years to come.
I can only see this book working as a textbook for a very specific class dedicated to the idea of 'Beyond DSM', because this is close to being absolutely unreadable otherwise. I dont see how the average academic trying to wrap their head around the controversies of the DSM (whether as an educator or researcher) can leverage this book. The average therapist would probably not last a few sentences.
Maybe I will return when I run out of reading materials or get a dedicated reading group for this. But this book definitely isn't doing it for me now.
July 4, 2025
من ترجمه فارسی کتاب رو خوندم و واقعا به نظرم ترجمهی افتضاحی بود که از نشر ارجمند انتظار نداریم و الا خود کتاب واقعا حرفی برای گفتن داره
Displaying 1 - 3 of 3 reviews