Process based therapy
Process based therapy is not a replacement for other psychological therapies. It’s a shift in focus. For example, somebody could do psychodynamic therapy, schema based therapy,positive psychology coaching, or cognitive behaviour therapy in a process based way.

An example of a process-based case conceptualization for a single individual
Process based therapy helps us to shift from thinking in terms of evidence based packages to evidence processes inside those packages. So instead of saying this CBT protocol is evidence based and you have to use the whole protocol with every single person, we can identify the evidence based processes within the protocol.
This gives us a lot more flexibility and creativity, because we don’t have to use the whole protocol with every single client, and we can cross therapeutic islands and use techniques from different approaches together, within the same coherent framework. Pretty cool huh?


Process-based therapy seeks to look inside therapeutic block boxes, or protocols, to identify the active processes.
The process based metatheory underpinning process-based therapy is called the extended evolutionary metamodel (EEMM; Hayes, Hofmann, & Ciarrochi, 2020). I know that’s a mouthful, but don’t worry, you can read about it if you’d like to know more. There are follow-up readings below. Here are a couple of important points about the EEMM.
- We can use the EEMM to understand other theories. It’s not restricted to one therapeutic approach. Rather, It’s based on the one theory that every single therapeutic island accepts: evolution. Thus we hope it will allow us to create a shared language that everybody can use, in every therapeutic orientation, to communicate their amazing insights.
- The key drivers of change in this model are: variation, selection, retention, in a particular context. For example, if someone is struggling and seeking help, that means they need a change. You’ll need to support them to try something new (variation). Then they’ll discover if that new behaviour builds value, meaning and health (selection). Finally when they find what works, they need to make sure the new behavior “sticks” (retention). Maybe they’ll develop habits or morning rituals or change their environment so that it’s easier to engage in value consistent behaviour.
Learn more about DNA-V here
DNA-V Process Label | Hexaflex Process Label | Extended evolutionary meta-model | Purpose of intervention |
---|---|---|---|
Discoverer | Committed Action | Overt Behavior | Use trial-and-error learning. Help people to willingly engage in new or nontypical behaviour, to develop their skills and resources, and expand their context. |
Noticer | Present moment awareness; acceptance | Attention Affect Physiological states and responses | Help people notice inner and outer experience and have the capacity to accept rather than or avoid or cling to it. Help people attend to the present context. |
Advisor | Defusion | Cognition | Help people to navigate their context with language and disengage from unhelpful language processes |
Values | Values | Motivation | Create contexts that empower people to clarify what they value, choose value consistent action and sustain action across time and hardship |
Self-view | Self-as-contentSelf-as-process Self-as-context | Self | Help people take perspective on themselves, overcome self-limiting beliefs or categories, view self with compassion, and take actions towards self that are self-enhancing rather than self-destroying. |
Social-View | All six processes at the social level | All six dimensions above at social level | Help people to take perspective on others, to recognize social interdependence and the value of others, and to behave effectively in social situations |
DNA-V Process Label | Hexaflex Process Label |
---|---|
Discoverer | Committed Action |
Noticer | Present moment awareness; acceptance |
Advisor | Defusion |
Values | Values |
Self-view | Self-as-contentSelf-as-process Self-as-context |
Social-View | All six processes at the social level |
Extended evolutionary meta-model | Purpose of intervention |
---|---|
Overt Behavior | Use trial-and-error learning. Help people to willingly engage in new or nontypical behaviour, to develop their skills and resources, and expand their context. |
Attention Affect Physiological states and responses | Help people notice inner and outer experience and have the capacity to accept rather than or avoid or cling to it. Help people attend to the present context. |
Cognition | Help people to navigate their context with language and disengage from unhelpful language processes |
Motivation | Create contexts that empower people to clarify what they value, choose value consistent action and sustain action across time and hardship |
Self | Help people take perspective on themselves, overcome self-limiting beliefs or categories, view self with compassion, and take actions towards self that are self-enhancing rather than self-destroying. |
All six dimensions above at social level | Help people to take perspective on others, to recognize social interdependence and the value of others, and to behave effectively in social situations |
The extended evolutionary meta model doesn’t replace hexaflex or DNA-V. Rather, it let’s us put the two frameworks side-by-side and understand how they relate.
The process-based approach will help you understand what you emphasise in your own practise and what you may want to do more of. It’ll also allow you to explore other therapeutic orientations, knowing that you can always classify the process within that orientation inside the extended evolutionary metamodel. Finally, it gives you flexibility with clients. You can use different processes, in different orderings, with different clients, depending on what they need. For example, with a mandated client you may emphasise value clarification and building a relationship. In contrast if you have a fully engaged client who already has a high level of emotional awareness, but is not engaging in helpful behaviour, you might emphasise activating overt behaviour. In this way, process-based approaches help you personalise your interventions.
Follow this new journey of process based therapy with these follow up readings.