We have tried to address the most common questions about Process-Based Therapy.
This FAQ is based on Process-based Therapy as understood through the extended evolutionary meta model (EEMM)
- Who owns PBT? Is PBT copyrighted?
PBT is an idea, framework, or approach. It cannot be owned or copyrighted, any more than the English language or mindfulness can be copyrighted. People may use the English language to create unique books and content. This can be copyrighted, but English itself can’t be copyrighted. The same is true for Process-Based Therapy. PBT, as an idea and approach, is freely available to everybody. If someone wants to create a trademark in this area simply to do business, please do not do it using generic terms linked to PBT. The confusion that can result is a grounds for opposing such trademarks and we’d rather you focus on the business you hope to create.
- What is meant by a process?
A process of change is a contextually situated, modifiable behavior or sequence of behaviours that orients the client towards an adaptive outcome. We use the term “behavior” broadly here, to refer to both overt, observable action as well as covert behavior such as thinking, feeling, and attending. Processes of change are also dynamic (they can change slowly or rapidly), progressive (they often need to be ordered for optimal effect), and multilevel (they can be described at the physiological, psychological, and social level).
- Is PBT an alternative to other therapies? Does it compete with other therapies?
Process based therapy based on the EEMM is not an alternative to other therapies. It is an approach to what we even mean by evidence-based therapy or intervention, and a statement of the kind of breadth and depth we expect of intervention models. PBT could be used as a way of understanding any kind of therapy, whether that be Acceptance Commitment Therapy , Cognitive Behavioural Therapy, Gestalt Therapy, Psychodynamic Therapy, Schema Therapy or whatever therapy you use. PBT is based on a meta-model – a model of models – and is intended to provide a common language and set of change processes for understanding any kind of therapy.
You could think of PBT as neutral ground where people from different therapeutic islands can meet. For example, the ACT therapist and the schema therapist can talk about the cool things they do in their interventions, without having to reduce what they do to the other person’s therapeutic terms. Schema folks can talk about schema types without calling it defusion, and ACT folks can talk about defusion without calling it schema modes. The two therapists can meet in the middle and discuss how their different approaches are designed to establish healthY variation in cognition or to select, and retain cognitive features that are useful in given contexts or situations. The psychodynamic therapist and gestalt therapist can both talk about how they help people develop new responses to shame, and so on.
PBT does not compete with other models. It seeks to bring them together.
- Does PBT have an eclectic approach, putting very different therapeutic tools together in a giant “toolbox”?
Process-Based Therapy, as discussed here, is mainly driven by the EEMM and focuses the practitioner on the change processes related to variation, selection and retention and their fit to contextual demands. It also encourages the therapist to think in terms of multiple levels of organization (biophysiological, psychological, sociocultural context) and in terms of six psychological dimensions (cognition, affect, motivation, overt behavior, attention, and self). However, therapeutic approaches can and do make additional theoretical assumptions, over and above what is suggested by the EEMM and evolution. These additional assumptions define what, when, and how often particular interventions are used by a therapy. For example, if a therapeutic theory says automatic negative thoughts cause behaviour, then the therapy focuses on changing the content of thoughts in order to change behaviour. in contrast, if a theory says that negative thoughts, by themselves, do not cause behavior, then the therapy may target things other than cognitive content, such as mindfulness or nonreactivity to thoughts .
Each therapeutic approach has its own philosophy and theoretical orientation, which restrains how processes are implemented and used together.
- Why does the extended evolutionary meta-model (EEMM) not include some important dimensions?
At present, the EEMM includes processes related to cognition, affect, motivation, overt behavior, attention, and self. This is a pragmatic list and not intended to be the “true” list that cuts the world at its joints. There are no hard a fast edges between dimensions. There are endless numbers of possible additional dimensions of course: sensations, memories, dreams, urges, predispositions etc. But we find these usually fit roughly in the EEMM as it is, especially as these dimensions and evolutionary ideas are mixed. For example, memories can be thought of as retention of cognitive and affective content. Urges are motivational but also affective, and so on. But a model with 10 dimensions (etc) will only amplify the “which dimension is THIS?” problem. We are not really defending these dimensions as real. They are useful, not ontological. Our goal is pragmatic and if it is pragmatic to add dimensions, that can be done.
- Why aren’t the biophysiological or sociocultural levels also dimensionalized?
They can be and we ourselves have made preliminary attempts to do so. The data (especially on mediation or specifically on processes of change) is not as voluminous however so we leave that task to our future.