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Learning Process-Based Therapy: A Skills Training Manual for Targeting the Core Processes of Psychological Change in Clinical Practice
Step-by-step guidance for implementing process-based therapy in practice Evidence-based mental health treatments—including cognitive behavioral therapy (CBT)—have long been defined in terms of scientifically validated protocols focused on syndromes. This is rapidly changing. A process focus is now emerging for evidence-based therapies, as the era of “protocols for syndromes,” passes away. This groundbreaking book offers concrete strategies for adopting a process-based approach in your clinical practice, and provides step-by-step guidance for formulating effective treatment plans. Written by renowned psychologists Steven C. Hayes and Stefan G. Hofmann, this manual will show you how to utilize the core competencies of process-based therapy (PBT) in a way that honors the behavioral, cognitive, and acceptance and mindfulness wings of CBT and builds bridges to other models. In the book, you’ll find a comprehensive road map to the theoretical foundations of PBT, as well as techniques for creating customized treatments that address the unique needs of each client—leading to better therapeutic outcomes.
Whether you’re a clinician or student of the behavioral sciences, this book has everything you need to understand and implement PBT in your work.
Whether you’re a clinician or student of the behavioral sciences, this book has everything you need to understand and implement PBT in your work.
- GenresPsychologyNonfiction
240 pages, Paperback
Published December 1, 2021
42 people are currently reading
160 people want to read
About the author
Stefan G. Hofmann
54 books19 followersDr. Stefan G. Hofmann is a professor in the clinical program, where he directs the Psychotherapy and Emotion Research Laboratory at the Center for Anxiety and Related Disorders. His main research questions include the following:
Why are psychological treatments, such as cognitive-behavioral therapy, effective for anxiety disorders? What is the mechanism of treatment change, and what are the active ingredients? How can these treatments be improved further?
How can we translate knowledge from basic neuroscience into clinical techniques to enhance therapies for anxiety disorders?
What are the culture-specific expressions of mental disorders, and how can psychological treatments be made more culturally sensitive in order to enhance their efficacy, dissemination, and acceptability?
What are the effects of emotion regulation strategies on anxiety and subjective well-being?
What is the psychopathology of Social Anxiety Disorder? Are there any meaningful subgroups?
His research focuses on the mechanism of treatment change, translating discoveries from neuroscience into clinical applications, emotions, and cultural expressions of psychopathology. He is former president of the Association for Behavioral and Cognitive Therapies, and the International Association for Cognitive Psychotherapy. He is also editor in chief of Cognitive Therapy and Research and is Associate Editor of Clinical Psychological Science. For his most recent books see https://www.amazon.com/Stefan-Hofmann...
Website
http://www.bostonanxiety.org/
http://www.gatestudy.org/home.html
Interests
Social Anxiety Disorder
Psychophysiology of Emotion
Translational Research
Why are psychological treatments, such as cognitive-behavioral therapy, effective for anxiety disorders? What is the mechanism of treatment change, and what are the active ingredients? How can these treatments be improved further?
How can we translate knowledge from basic neuroscience into clinical techniques to enhance therapies for anxiety disorders?
What are the culture-specific expressions of mental disorders, and how can psychological treatments be made more culturally sensitive in order to enhance their efficacy, dissemination, and acceptability?
What are the effects of emotion regulation strategies on anxiety and subjective well-being?
What is the psychopathology of Social Anxiety Disorder? Are there any meaningful subgroups?
His research focuses on the mechanism of treatment change, translating discoveries from neuroscience into clinical applications, emotions, and cultural expressions of psychopathology. He is former president of the Association for Behavioral and Cognitive Therapies, and the International Association for Cognitive Psychotherapy. He is also editor in chief of Cognitive Therapy and Research and is Associate Editor of Clinical Psychological Science. For his most recent books see https://www.amazon.com/Stefan-Hofmann...
Website
http://www.bostonanxiety.org/
http://www.gatestudy.org/home.html
Interests
Social Anxiety Disorder
Psychophysiology of Emotion
Translational Research
Ratings & Reviews
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Community Reviews
Displaying 1 - 9 of 9 reviews
December 5, 2021
The future of psychotherapy has arrived!
Process-Based Therapy (PBT) is it!
PBT is not (yet another) proprietary model of psychotherapy.
PBT is a revolutionary new methodology.
For a great primer on the methods and philosophy of PBT, read:
Process-Based CBT: The Science and Core Clinical Competencies of Cognitive Behavioral Therapy by Steven C. Hayes, Stefan Hofmann.
Read my review of it here:
https://www.goodreads.com/review/show...
Rather than creating a therapeutic model to treat a DSM diagnosis. PBT seeks to identify the active processes of change contained within the various models and schools therapy, and pair them with the processes of suffering that underly the diagnostic categories and syndromes of so-called mental health ‘disorders’.
“What treatment, by whom, is most effective for this individual with that specific problem, under which set of circumstances, and how does it come about?”
- Gordon Paul
This is the central tenet of PBT.
Although this may sound innocuous.
It’s not.
It’s nothing short of a revolution.
Along with tearing down the boundaries between the varieties of proprietary psychotherapy models.
PBT additionally intends to upend the medical model of psychiatric diagnosis typified in the diagnostic and statistical manual (DSM)
For an excellent primer to the process based transdiagnostic method, read:
Beyond the DSM: Toward a Process-Based Alternative for Diagnosis and Mental Health Treatment by Steven C. Hayes, Stefan Hofmann
You can read my review of it here:
https://www.goodreads.com/review/show...
As if all of that isn’t enough.
PBT integrates (r)evolutionary theory into its methodology in a way that evolutionary psychology has hitherto failed.
For (yet another) excellent primer to the the evolutionary approach to functional/contextual psychotherapy read:
Evolution and Contextual Behavioral Science: An Integrated Framework for Understanding, Predicting, and Influencing Human Behavior by Steven C. Hayes, David Sloan Wilson.
You can read my review of it here:
https://www.goodreads.com/review/show...
Learning Process Based Therapy is a practical application of PBT to clincial practice.
And it legit ROCKS!
This is a must read.
Ignore it and become irrelevant.
5/5 stars ⭐️
Process-Based Therapy (PBT) is it!
PBT is not (yet another) proprietary model of psychotherapy.
PBT is a revolutionary new methodology.
For a great primer on the methods and philosophy of PBT, read:
Process-Based CBT: The Science and Core Clinical Competencies of Cognitive Behavioral Therapy by Steven C. Hayes, Stefan Hofmann.
Read my review of it here:
https://www.goodreads.com/review/show...
Rather than creating a therapeutic model to treat a DSM diagnosis. PBT seeks to identify the active processes of change contained within the various models and schools therapy, and pair them with the processes of suffering that underly the diagnostic categories and syndromes of so-called mental health ‘disorders’.
“What treatment, by whom, is most effective for this individual with that specific problem, under which set of circumstances, and how does it come about?”
- Gordon Paul
This is the central tenet of PBT.
Although this may sound innocuous.
It’s not.
It’s nothing short of a revolution.
Along with tearing down the boundaries between the varieties of proprietary psychotherapy models.
PBT additionally intends to upend the medical model of psychiatric diagnosis typified in the diagnostic and statistical manual (DSM)
For an excellent primer to the process based transdiagnostic method, read:
Beyond the DSM: Toward a Process-Based Alternative for Diagnosis and Mental Health Treatment by Steven C. Hayes, Stefan Hofmann
You can read my review of it here:
https://www.goodreads.com/review/show...
As if all of that isn’t enough.
PBT integrates (r)evolutionary theory into its methodology in a way that evolutionary psychology has hitherto failed.
For (yet another) excellent primer to the the evolutionary approach to functional/contextual psychotherapy read:
Evolution and Contextual Behavioral Science: An Integrated Framework for Understanding, Predicting, and Influencing Human Behavior by Steven C. Hayes, David Sloan Wilson.
You can read my review of it here:
https://www.goodreads.com/review/show...
Learning Process Based Therapy is a practical application of PBT to clincial practice.
And it legit ROCKS!
This is a must read.
Ignore it and become irrelevant.
5/5 stars ⭐️
July 9, 2023
In a nutshell, it's a thoroughly thought-out system of functional analysis. Outside of one, there's a lot to it.
March 15, 2022
This manual is something I carry with me most of the time as a reference. Hofmann, Hayes and Lorscheid were meticulous in how they organized the material and how they communicated the concepts. It's not so much technically sophisticated as it is conceptually sophisticated. But, the authors took time to repeat concepts and themes worth repeating and gave a number of examples, starting with the basic to increasingly more complex. I found it important to take lots of notes all the way, which helps me when I want to reference back to something I want to be clear about. In summary, this is one of the most well organized, well written and well conceived manuals out there. I was always looking for a new way to conceptualize and document more complete and precise functional analyses and treatment plans. This is what I've been looking for.
November 6, 2025
The short version:
Coming from an ACT/third-wave psychotherapy perspective, I found this book was a bit clunky and vague. While I like the idea of visually modeling issues and targeting feedback loops with treatment kernels, I found the discussion of the Extended Evolutionary Meta-Model in relation to the processes of change to be quite cumbersome and unclear.
The longer critique:
The first part of the book focuses on the processes of change- which are basically the 6 parts of the hexaflex in ACT. These made sense until they were put next to Hayes' new Extended Evolutionary Meta-Model (EEMM). The book has an important image of a grid where each of the 6 processes (plus the biophysiological and cultural levels) each have a quadrant with the 4 parts of the EEMM (which are variation, selection, retention, and context). This grid looks cool, but I ended up feeling it was somewhat of a nothing-burger.
Early on, the book has the reader choose an issue they're dealing with and then write out how each of the processes is affected within each aspect of the EEMM as they go through each process. However, the EEMM is very poorly explained, each one getting about a one paragraph definition. The pre-written examples given as a guide also make very little sense with regard to each part of the EEMM. They seem arbitrary and showed me the weakness of this new EEMM.
As I was reading, I began to believe that the EEMM were evolutionary concepts being used metaphorically in a behavioral context. However, when I actually when to a training in Philadelphia that Hayes was leading, I asked him if these were meant to be metaphorical adaptations of evolutionary concepts, and he gave a very strong "no" in response. He believed them to be actual evolutionary concepts at work in our behaviors. He basically explained that he believes that we can behave in ways that create positive evolutionary outcomes and that assessing our issues in this light would help to create evolutionarily-adaptive relationship to our inner life.
As cool as it was to talk to Hayes, I still do not think the EEMM is an accurate way of thinking about change processes (I have no gripes about the 6 given, just the EEMM component). There are certainly evolutionary principles at play in change processes, but I feel that this model is quite forced, it just doesn't fit. This isn't quite how these evolutionary principles play out. For example, the book suggests that "selection" pertains to the reasons we select affect, behavior, etc. But in evolution, selection is about the long-term reasons that traits are retained- namely reproduction and survival. There's no way for an individual to manipulate selection as an evolutionary process that leads to "adaptive" change.
I would have found it more interesting to discuss "core human yearning" which I've heard Hayes mention, as foundations of motivation (something like drives) as opposed to creating the flimsy categories into which we can plug the processes.
My other critique is that the book is clearly not third-wave or ACT specific. This took me an embarrassingly long time to realize (especially given that nothing about ACT is in the title). I have little doubt that this book was largely a diplomatic posturing of Hayes and company to allow their process-based theory access into the greater network of CBT therapists. Because of this, the book never quite says what it really wants to say. Certainly processes are at work and can be addressed even in a CBT context, but the whole idea of change processes also undermines modern CBT as we know it, and sadly this is never suggested in the book.
When I saw him speak in Philly, Hayes was not at all ambiguous about his ambition to tear down the DSM and replace decades of norm-based psychotherapy research with what he calls "idionomic" (within-person changes) research. This is a wonderful mission to be on, but I feel that the EEMM is a false flag in this battle.
Coming from an ACT/third-wave psychotherapy perspective, I found this book was a bit clunky and vague. While I like the idea of visually modeling issues and targeting feedback loops with treatment kernels, I found the discussion of the Extended Evolutionary Meta-Model in relation to the processes of change to be quite cumbersome and unclear.
The longer critique:
The first part of the book focuses on the processes of change- which are basically the 6 parts of the hexaflex in ACT. These made sense until they were put next to Hayes' new Extended Evolutionary Meta-Model (EEMM). The book has an important image of a grid where each of the 6 processes (plus the biophysiological and cultural levels) each have a quadrant with the 4 parts of the EEMM (which are variation, selection, retention, and context). This grid looks cool, but I ended up feeling it was somewhat of a nothing-burger.
Early on, the book has the reader choose an issue they're dealing with and then write out how each of the processes is affected within each aspect of the EEMM as they go through each process. However, the EEMM is very poorly explained, each one getting about a one paragraph definition. The pre-written examples given as a guide also make very little sense with regard to each part of the EEMM. They seem arbitrary and showed me the weakness of this new EEMM.
As I was reading, I began to believe that the EEMM were evolutionary concepts being used metaphorically in a behavioral context. However, when I actually when to a training in Philadelphia that Hayes was leading, I asked him if these were meant to be metaphorical adaptations of evolutionary concepts, and he gave a very strong "no" in response. He believed them to be actual evolutionary concepts at work in our behaviors. He basically explained that he believes that we can behave in ways that create positive evolutionary outcomes and that assessing our issues in this light would help to create evolutionarily-adaptive relationship to our inner life.
As cool as it was to talk to Hayes, I still do not think the EEMM is an accurate way of thinking about change processes (I have no gripes about the 6 given, just the EEMM component). There are certainly evolutionary principles at play in change processes, but I feel that this model is quite forced, it just doesn't fit. This isn't quite how these evolutionary principles play out. For example, the book suggests that "selection" pertains to the reasons we select affect, behavior, etc. But in evolution, selection is about the long-term reasons that traits are retained- namely reproduction and survival. There's no way for an individual to manipulate selection as an evolutionary process that leads to "adaptive" change.
I would have found it more interesting to discuss "core human yearning" which I've heard Hayes mention, as foundations of motivation (something like drives) as opposed to creating the flimsy categories into which we can plug the processes.
My other critique is that the book is clearly not third-wave or ACT specific. This took me an embarrassingly long time to realize (especially given that nothing about ACT is in the title). I have little doubt that this book was largely a diplomatic posturing of Hayes and company to allow their process-based theory access into the greater network of CBT therapists. Because of this, the book never quite says what it really wants to say. Certainly processes are at work and can be addressed even in a CBT context, but the whole idea of change processes also undermines modern CBT as we know it, and sadly this is never suggested in the book.
When I saw him speak in Philly, Hayes was not at all ambiguous about his ambition to tear down the DSM and replace decades of norm-based psychotherapy research with what he calls "idionomic" (within-person changes) research. This is a wonderful mission to be on, but I feel that the EEMM is a false flag in this battle.
August 4, 2022
Knyga yra apie procesu grįstą terapiją. Joje kviečiama pereiti prie kito diagnostinio modelio, kuris nėra paremtas sindromais, o daugiau procesais. Į procesą orientuota terapija, nėra kažkokia atskira terapijos rūšis, tai daugiau modelis pagal kurį dirbti ir jį galima pritaikyti bet kuriai terapijos paradigmai.
Sudaromas procesu tinklas, kurie daro įtaką problemai ir tada intervencijos nukreipiamos tiesiogiai į procesus, kurie yra svarbiausi.
Man patiko toks modelis, nes labai logiškas, plius netoli pabėgęs nuo kognityvinės elgesio terapijos esmės. Kadangi jau anksčiau susipažinau su unifikuotu protokolu nerimo sutrikimams gydyti, tai ši forma nebuvo nauja.
Kas nauja, tai autorių noras patikrinti ir įrodymais pagrįsti gydymo intervencijas. Jie yra atlikę didelę metanalizę apie gydymo intervencijas ir atradę kas labiausiai veikia. Faktas, kad daug dalykų yra iš Acceptance and commitment therapy stalčiaus, nes Steen Hayes yra jos kūrėjas. Bet Stefan Hofman yra ket'istas, tai jie ražiai vienas kitą papildo.
Knyga skirta psichikos sveikatos specialistams pirmiausia, bet joje pristatomas modelis puikia tinka ir kitoms specialybėms: koačeriams, darbe su vaikais, sprendžiant sveikatos problemas.
Tuo šis modelis ir universalus, nes jį galima pritaikyti sprendžiant plataus mąsto problemas. Tiesiog ieškoma procesų, kurie palaiko ir daro įtaką problemai labiausiai ir ten yra daromos intervencijos.
Diagnozuoti nebūtina, nes net ir su ta pačia diagnoze esantys žmonės turi skirtingus palaikančius procesus, tad šis modelis yra labai personalizuotas, čia nėra jokio algoritmo. Tiesiog logika.
Sudaromas procesu tinklas, kurie daro įtaką problemai ir tada intervencijos nukreipiamos tiesiogiai į procesus, kurie yra svarbiausi.
Man patiko toks modelis, nes labai logiškas, plius netoli pabėgęs nuo kognityvinės elgesio terapijos esmės. Kadangi jau anksčiau susipažinau su unifikuotu protokolu nerimo sutrikimams gydyti, tai ši forma nebuvo nauja.
Kas nauja, tai autorių noras patikrinti ir įrodymais pagrįsti gydymo intervencijas. Jie yra atlikę didelę metanalizę apie gydymo intervencijas ir atradę kas labiausiai veikia. Faktas, kad daug dalykų yra iš Acceptance and commitment therapy stalčiaus, nes Steen Hayes yra jos kūrėjas. Bet Stefan Hofman yra ket'istas, tai jie ražiai vienas kitą papildo.
Knyga skirta psichikos sveikatos specialistams pirmiausia, bet joje pristatomas modelis puikia tinka ir kitoms specialybėms: koačeriams, darbe su vaikais, sprendžiant sveikatos problemas.
Tuo šis modelis ir universalus, nes jį galima pritaikyti sprendžiant plataus mąsto problemas. Tiesiog ieškoma procesų, kurie palaiko ir daro įtaką problemai labiausiai ir ten yra daromos intervencijos.
Diagnozuoti nebūtina, nes net ir su ta pačia diagnoze esantys žmonės turi skirtingus palaikančius procesus, tad šis modelis yra labai personalizuotas, čia nėra jokio algoritmo. Tiesiog logika.
June 27, 2023
Great book! Views and assesses people from a functional perspective. The way in which the therapy views people should make implicit sense to clinicians, as it gathers most of the data we often gather from thorough clinical intakes. Think of this as a way of succinctly organizing what we've known for years. This approach is part of the new research wave on mental health that'll change the field of psychology for the better.
The other review mentions some excellent books as additional reading. I'd also recommend looking into research written by Ong in the Frontiers of Psychology, and recommend trainings from Div 12 (APA Clinical Psychology) and ABCT to hone your understanding of this fascinating book.
The other review mentions some excellent books as additional reading. I'd also recommend looking into research written by Ong in the Frontiers of Psychology, and recommend trainings from Div 12 (APA Clinical Psychology) and ABCT to hone your understanding of this fascinating book.
December 1, 2022
Very useful for psychotherapists everywhere. The EEMM model, largely described in the book, it is simple, efficient and applicable with clients in a clinical/psychotherapeutic setting. I strongly recommend this book!
June 8, 2022
Phenomenal.
Read
January 6, 2023A useful book. Was not a huge revelation to me. I think if you have a good grasp of ACT, and you think across levels (emotional, self-concept, biological, etc), and you are skeptical of mental disorders as essential categories, this will not feel all that groundbreaking. I am going to hold onto it and return to it in my practice to see if it makes a difference... Willing to have my mind changed and see how I actually use it in practice.
Displaying 1 - 9 of 9 reviews