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Beyond linear mediation: Toward a dynamic network approach to study treatment processes
Open accessAbstract
Few clinical scientists would disagree that more research is needed on the underlying mechanisms and processes of change in psychological therapies. In the dominant current approach, processes of change are studied through mediation. The study of mediation has been largely structured around a distinction between moderation and mediation first popularized by Baron and Kenny's (1986) seminal article, which is based on a nomothetic and cross-sectional framework. In this article, we argue that this approach is unable to adequately address change processes in psychological therapies, because it falsely assumes that treatment change is a linear, unidirectional, pauci-variate process and that the statistical assumptions are met to study processes of change in an individual using a nomothetic approach. In contrast, we propose that treatment is a dynamic process involving numerous variables that may form bi-directional and complex relationships that differ between individuals. Such relationships can best be studied using an individual dynamic network approach connected to nomothetic generalization methods that are based on a firm idiographic foundation. We argue that our proposal is available, viable, and can readily be integrated into existing research strategies. We further argue that adopting an individual dynamic network approach combined with experimental analyses will accelerate the study of treatment change processes, which is necessary as the field of evidence-based care moves toward a process-based model. We encourage future research to gather empirical evidence to examine this approach.
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“Modeling downstream mechanisms will likely require complex approaches such as network analytic frameworks”
From Measuring the active elements of cognitive-behavioral therapies (2023) · cites this paper as Hofmann et al., 2020
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“The second important component of PBT is the personalization of treatment based on (a) information about the individual network of the problem and (b) matching interventions based on their effective components to the central node of the network [10].”
From Process-based therapy vs. routine-CBT for difficult-to-treat mood and anxiety disorders: study protocol for a randomized controlled trial (2024) · cites this paper as [10]
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In the citing paper
“both outcomes and processes of therapeutic change are likely to be different from person to person (Hofmann et al., 2020;Vlaeyen et al., 2020).”
From Acceptance and Commitment Therapy for women living with Vulvodynia: A single-case experimental design study of a treatment delivered online (2022) · cites this paper as Hofmann et al., 2020
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In the citing paper
“Linear mediation models, as employed in our study, may not be suitable to capture the complexity of therapeutic processes”
From Transdiagnostic Processes as Mediators of Change in an Internet-Delivered Intervention Based on the Unified Protocol (2022) · cites this paper as Hofmann et al., 2020
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In the citing paper
“the relationship between outcome and mediator are dynamic, bidirectional, and non-linear (Hofmann etal., 2020)”
From Transdiagnostic Processes as Mediators of Change in an Internet-Delivered Intervention Based on the Unified Protocol (2022) · cites this paper as Hofmann et al., 2020
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In the citing paper
“If only studies of mediation within randomized controlled trials are examined, more than 1,000 significant findings can be identified, encompassing more than 100 processes of change 71 .”
From “Third-wave” cognitive and behavioral therapies and the emergence of a process-based approach to intervention in psychiatry (2021) · cites this paper as [71]
Experimental — accuracy not yet measuredIn the citing paper
“Mediators often form bi-directional and complex relationships that differ between individuals (Hofmann, Curtiss, & Hayes, 2020).”
From A process-based approach to psychological diagnosis and treatment:The conceptual and treatment utility of an extended evolutionary meta model (2020) · cites this paper as Hofmann, Curtiss, & Hayes, 2020
In the citing paper
“A similar lack of progress has been noted for behavioural markers in guiding and individualizing behavioural treatments such as psychotherapy.33”
From Precision clinical trials: a framework for getting to precision medicine for neurobehavioural disorders (2021) · cites this paper as [33]
In the citing paper
“However, neurobehavioural treatment response may not obey a dose–response curve; it could evolve in complex, nonlinear ways both acutely and in the longer term, as patients’ needs, preferences, psychosocial context and neurobiology change over time.33”
From Precision clinical trials: a framework for getting to precision medicine for neurobehavioural disorders (2021) · cites this paper as [33]
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“New statistical methods allow researchers to model the temporal dynamics of illness at an individual level.33,48,49”
From Precision clinical trials: a framework for getting to precision medicine for neurobehavioural disorders (2021) · cites this paper as [33]
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Citations
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- Hayes, 2020, Creating an alternative to syndromal diagnosis: Needed features of processes of change and the models that organize them. Chapter to appear in
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Sorted by citations
Hayes, S. C., & Hofmann, S. G. (2021) · World Psychiatry · doi:10.1002/wps.20884 · Cited by 260
Self-citationHayes, S. C., Ciarrochi, J., Hofmann, S. G., Chin, F., & Sahdra, B. (2022) · Behaviour Research and Therapy · doi:10.1016/j.brat.2022.104155 · Cited by 234
Self-citationHayes, S. C., Hofmann, S. G., & Ciarrochi, J. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101908 · Cited by 227
Self-citationPutting the “mental” back in “mental disorders”: a perspective from research on fear and anxiety
Taschereau‐Dumouchel, V., Michel, M., Lau, H. C., Hofmann, S. G., & LeDoux, J. E. (2022) · Molecular Psychiatry · doi:10.1038/s41380-021-01395-5 · Cited by 200
Self-citationStudying Behaviour Change Mechanisms under Complexity
Heino, M. T. J., Knittle, K. P., Noone, C., Hasselman, F., & Hankonen, N. E. (2021) · Behavioral Sciences · doi:10.3390/bs11050077 · Cited by 161
“Of particular importance to human behaviour change, however, is that the accuracy of mediation analysis depends on four key assumptions [13]: (1) The number of variables involved is small, and dynamics can be meaningfully assessed with only a few time points; (2) The process of change is the same for all individuals,…”
BackgroundInvestigating the feasibility of idiographic network models.
Mansueto, A. C., Wiers, R. W., van Weert, J. C. M., Schouten, B. C., & Epskamp, S. (2023) · Psychological Methods · doi:10.1037/met0000466 · Cited by 147
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McCracken, L. M., Yu, L., & Vowles, K. E. (2022) · BMJ · doi:10.1136/bmj-2021-057212 · Cited by 123
Domhardt, M., Steubl, L., Boettcher, J., Buntrock, C., Karyotaki, E., Ebert, D. D., Cuijpers, P., & Baumeister, H. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101953 · Cited by 106
Individual differences in computational psychiatry: A review of current challenges
Karvelis, P., Paulus, M. P., & Diaconescu, A. O. (2023) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2023.105137 · Cited by 122
“It is interesting to note that many ideas central to this review happen to mirror recent trends in clinical psychology (Hayes et al., 2022, 2019; Wright and Woods, 2020; Hofmann et al., 2020; Hofmann and Hayes, 2019).”
McCracken, L. M. (2023) · European Journal of Pain · doi:10.1002/ejp.2091 · Cited by 81
“In fact, processes of change are probably, as previously mentioned, nonlinear, bidirectional and highly individual (Hofmann et al., 2020).”
InfluentialEarly warning signals and critical transitions in psychopathology: challenges and recommendations
Helmich, M. A., Olthof, M., Oldehinkel, A. J., Wichers, M., Bringmann, L. F., & Smit, A. C. (2021) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2021.02.008 · Cited by 85
Ciarrochi, J., Sahdra, B., Hofmann, S. G., & Hayes, S. C. (2022) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2022.02.001 · Cited by 77
“…say, self-report items that would be tested in high-density longitudinal idiographic networks of processes of change that target common outcomes (Hofmann, Curtiss, & Hayes, 2020), retaining items that appear frequently and prominently in clinical work both before and after intervention when…”
Self-citationAcceptance and Commitment Therapy Processes and Mediation: Challenges and How to Address Them
Arch, J. J., Fishbein, J. N., Finkelstein, L. B., & Luoma, J. B. (2023) · Behavior Therapy · doi:10.1016/j.beth.2022.07.005 · Cited by 72
Irwin, M. R., Olmstead, R., Bjurström, M. F., Finan, P. H., & Smith, M. T. (2022) · Pain · doi:10.1097/j.pain.0000000000002811 · Cited by 87
“1) was used.(16,18,19,53) The hypothesized double mediation model was tested (ie, Model 6),(17) in which the effect of FA on hPTH was mediated by the loss of N3 sleep and increase in cellular inflammation as temporally ordered and shown in the hypothesized pathway (Fig.”
MethodA cultural-ecosocial systems view for psychiatry
Gómez-Carrillo, A., & Kirmayer, L. J. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1031390 · Cited by 90
“In clinical settings, nonlinear dynamics are commonly observed and putative explanations in terms of loops could be tested by interventions that target specific parameters (188, 189).”
BackgroundPsychological Flexibility, Chronic Pain, and Health
McCracken, L. M. (2023) · Annual Review of Psychology · doi:10.1146/annurev-psych-020223-124335 · Cited by 89
Roberts, C., Sahakian, B. J., & Robbins, T. W. (2020) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.09.001 · Cited by 63
Sanford, B. T., Ciarrochi, J., Hofmann, S. G., Chin, F. T., Gates, K. M., & Hayes, S. C. (2022) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2022.05.006 · Cited by 62
“…approach to study treatment change processes based on only one or a few variables that are assumed to form linear and unidirectional relationships with the dependent and independent variables is highly problematic both from a conceptual and methodological approach (Hofmann, Curtiss, & Hayes, 2020).”
Self-citationMeasuring the active elements of cognitive-behavioral therapies
Cohen, Z. D., Barnes-Horowitz, N. M., Forbes, C. N., & Craske, M. G. (2023) · Behaviour Research and Therapy · doi:10.1016/j.brat.2023.104364 · Cited by 58
Ong, C. W., Ciarrochi, J., Hofmann, S. G., Karekla, M., & Hayes, S. C. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100734 · Cited by 51
Self-citationCarhart-Harris, R. L., Wagner, A. C., Agrawal, M., Kettner, H., Rosenbaum, J. F., Gazzaley, A., Nutt, D. J., & Erritzoe, D. (2022) · Journal of Psychopharmacology · doi:10.1177/02698811211008567 · Cited by 51
“Idiographic high-frequency time-series data collected through such methods (e.g. daily smartphonebased assessments) could enable more ecologically valid and nuanced modelling of change than conventional study designs (Hofmann et al., 2020).”
BackgroundDo we need a novel framework for classifying psychopathology? A discussion paper
Rief, W., Hofmann, S. G., Berg, M., Forbes, M. K., Pizzagalli, D. A., Zimmermann, J., Fried, E. I., & Reed, G. M. (2023) · Clinical Psychology in Europe · doi:10.32872/cpe.11699 · Cited by 56
“Furthermore, the impact of therapy cannot reasonably be reduced to just one or a few mediators and moderators, nor by assuming that these variables are independent or that they form simple unidirec tional, linear relationships (Hofmann et al., 2020).”
BackgroundSelf-citationDomhardt, M., Engler, S., Nowak, H., Lutsch, A., Baumel, A., & Baumeister, H. (2021) · Journal of Medical Internet Research · doi:10.2196/29742 · Cited by 41
“Furthermore, future studies should resort to more sophisticated and current methods of mediation analysis (eg, Grimm et al [88] and Hofmann et al [89]), ideally capable of clarifying temporal precedence and illustrating the actual pattern of change [24].”
Process-based therapy: A personalized approach to treatment
Moskow, D. M., Ong, C. W., Hayes, S. C., & Hofmann, S. G. (2023) · Journal of Experimental Psychopathology · doi:10.1177/20438087231152848 · Cited by 45
“Hofmann et al. (2020) discussed transitioning from mediators and moderators to treatment or therapeutic processes, which PBT emphasizes.”
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Self-citationLenze, E. J., Nicol, G. E., Barbour, D. L., Kannampallil, T., Wong, A. W. K., Piccirillo, J., Drysdale, A. T., Sylvester, C. M., Haddad, R., Miller, J. P., et al. (2021) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.200042 · Cited by 43
A Personalised Approach to Identifying Important Determinants of Well-being
Ciarrochi, J., Sahdra, B. K., Hayes, S. C., Hofmann, S. G., Sanford, B., Stanton, C. E., Yap, K., Fraser, M. I., Gates, K. M., & Gloster, A. T. (2024) · Cognitive Therapy and Research · doi:10.1007/s10608-024-10486-w · Cited by 45
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“Major challenges do need to be solved, such as the refinement of a dynamically sensible view of mediation (Hofmann et al., 2020) that can be applied idiographically (Hayes et al.”
Self-citationClinical psychology is an applied evolutionary science
Hayes, S. C., Hofmann, S. G., & Wilson, D. S. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101892 · Cited by 50
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Hayes, S. C., Hofmann, S. G., & Ciarrochi, J. (2023) · Behavior Therapy · doi:10.1016/j.beth.2023.07.011 · Cited by 37
Self-citationImplications of the Network Theory for the Treatment of Mental Disorders
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“…building upon temporal dependence required in traditional mediation analysis (i.e., linear and unidirectional Wu & Zumbo, 2008), researchers can examine dynamic psychological processes by simultaneously considering bidirectional/reciprocal relationships between constructs (Hofmann et al., 2020).”
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Self-citationBeyond acceptance and commitment therapy: Process-based therapy
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Psychological flexibility and cognitive-affective processes in young adults’ daily lives
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“Correlations among items exhibit a range from moderately to large 67 , thus reinforcing the hypothesis of interconnected psychological processes 50 .”
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“In addition to symptoms, it might be beneficial to also include hypothesized treatment processes as variables in the network in order to improve understanding of the treatments’ working mechanisms (Hofmann et al., 2020).”
InfluentialAsher, M., Hofmann, S. G., & Aderka, I. M. (2021) · Behavior Therapy · doi:10.1016/j.beth.2020.04.001 · Cited by 27
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A Network Control Theory of Dynamic Systems Approach to Personalize Therapy
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“…agreement on the need to increase research on the mechanisms of change in psychological interventions (Kazdin 2009; Nielsen et al. 2018), statistical approaches to analyze those mechanisms, like traditional mediation analyses, may fail to uncover their complex dynamics (Hofmann et al. 2020).”
BackgroundLuoma, J. B., Shahar, B., Lear, M. K., Pilecki, B. C., & Wagner, A. (2021) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.2824 · Cited by 29
“Processes of change can be studied at many levels of analysis, ranging from molecular, neuro- logical, psychological or even sociological levels (Hofmann et al., 2020).”
BackgroundIrie, T., Shinkawa, H., Tanaka, M., & Yokomitsu, K. (2022) · Current Psychology · doi:10.1007/s12144-022-03157-0 · Cited by 29
“It has been pointed out that clarifying the details of the relationship between symptoms and related factors using network analysis can contribute to an improved treatment process and, in turn, maximizing the effectiveness of the treatment (Hofmann et al., 2020).”
BackgroundParental stress and child mental health: a network analysis of Romanian parents
Poetar, C.-R., Dobrean, A., Florean, I. S., & Predescu, E. (2022) · Current Psychology · doi:10.1007/s12144-022-03520-1 · Cited by 32
“, 2022) may surpass existing gaps in evidence-based treatment access and will allow us to investigate treatment processes (Hofmann et al., 2020).”
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Bergmann, N., Hahn, E., Hahne, I., Zierhut, M., Ta, T. M. T., Bajbouj, M., Pijnenborg, G. H. M., & Böge, K. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.708808 · Cited by 23
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Self-citationMechanisms of change in acceptance and commitment therapy for primary headaches
Vasiliou, V. S., Karademas, E. C., Christou, Y., Papacostas, S., & Karekla, M. (2022) · European Journal of Pain · doi:10.1002/ejp.1851 · Cited by 21
“Also, idiographic dynamic network approaches have recently been proposed (Hofmann et al., 2020) and need to be developed and investigated in future studies.”
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A Review of Transdiagnostic Mechanisms in Cognitive Behavior Therapy
Southward, M. W., Kushner, M. L., Terrill, D. R., & Sauer-Zavala, S. E. (2024) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2024.02.003 · Cited by 29
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“comparisons in subgroups, is novel in pain research, paving avenues for more advanced process research on how fear-related processes and pain mutually influence one another and both become overgeneralized [74].”
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A process-based approach to transtheoretical clinical research and training
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“…psychotherapeutic schools, and because of its roots in the knowledge on evolutionary science (Badcock, 2012) applied to the individual in all of its socially-situated complexity (Hofmann, Curtiss, & Hayes, 2020; Hofmann, Curtiss, & McNally, 2016; see Ong et al., 2022 for a recent case description).”
BackgroundSelf-citationMetacognition as a window into subjective affective experience
Cushing, C. A., Lau, H. C., Hofmann, S. G., LeDoux, J. E., & Taschereau‐Dumouchel, V. (2024) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.13683 · Cited by 21
“Much like anxiety and trauma-related disorders, metacognition is better understood through its variation between individuals 98,99 and as a function of situations.”
BackgroundSelf-citationPredictors of pharmacotherapy outcomes for body dysmorphic disorder: a machine learning approach
Curtiss, J. E., Bernstein, E. E., Wilhelm, S., & Phillips, K. A. (2022) · Psychological Medicine · doi:10.1017/s0033291721005390 · Cited by 18
“…recent initiatives in promoting precision medicine frameworks in psychiatry and clinical psychology (Bernardini et al., 2017; Hayes et al., 2019; Hofmann, Curtiss, & Hayes, 2020), it would be profitable to determine whether machine learning approaches would enhance our ability to predict who…”
Self-citationBlanchard, M. A., & Heeren, A. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-818697-8.00044-3 · Cited by 21
Ong, C. W., Krafft, J., Panoussi, F., Petersen, J. M., Levin, M. E., & Twohig, M. P. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.02.001 · Cited by 16
“Furthermore, larger samples are still needed to gauge generalizability and to power statistical methods capable of modeling the nonlinear and interconnected relationships among variables of interest (Hofmann et al., 2020).”
BackgroundSimpson, A., Beauchamp, M. R., Dimmock, J. A., Willis, C., & Jackson, B. (2025) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2025.102918 · Cited by 23
Cognitive fusion and personality traits in the context of mindfulness: A cross-sectional study
Pux, S., Hahn, E. W., Bergmann, N., Hahne, I., Pauly, L., Ta, T. M. T., Pijenborg, G. H. M., & Böge, K. (2022) · PLoS ONE · doi:10.1371/journal.pone.0273331 · Cited by 18
“Moreover, as this relationship is clearly not explained by a single process, alternatives to traditional mediation analyses, such as dynamic network approaches, as suggested by [70], could prove useful in discerning the processes of change influencing the association between mindfulness and negative affect.”
MethodLiu, C., & Gershon, E. S. (2024) · Translational Psychiatry · doi:10.1038/s41398-024-03195-1 · Cited by 24
Inflammatory Exposure and Depression in Older Adults With Insomnia
Irwin, M. R., Boyle, C. C., Cho, H. J., Piber, D., Sadeghi, N., Castillo, D., Smith, M. T., Eisenberger, N. I., & Olmstead, R. (2025) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2025.1327 · Cited by 19
Hilger, K., & Markett, S. A. (2021) · Network Neuroscience · doi:10.1162/netn_a_00198 · Cited by 14
Raudales, A. M., Kiefer, R., Forkus, S. R., Contractor, A. A., & Weiss, N. H. (2021) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2021.102475 · Cited by 16
Maisto, S. A., Moskal, D., Firkey, M. K., Bergman, B. G., Borsari, B. E., Hallgren, K. A., Houck, J. M., Hurlocker, M. C., Kiluk, B. D., Kuerbis, A., et al. (2024) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.15411 · Cited by 15
Lavefjord, A., Sundström, F. T. A., Buhrman, M., & McCracken, L. M. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.05.005 · Cited by 14
Bohlmeijer, E. T., Frielingsdorf, L., Kraiss, J. T., Meezenbroek, E. D. J., Visser, A., & ten Klooster, P. M. (2023) · Journal of Happiness Studies · doi:10.1007/s10902-023-00640-8 · Cited by 20
“Experience sampling is an emerging research design to study within-person processes in the context of daily life and real-world dynamics (Hofmann et al., 2020; Myin-Germeys et al., 2018).”
BackgroundAn Introduction to Change in Psychotherapy: Moderators, Course of Change, and Change Mechanisms
Antichi, L., & Giannini, M. (2023) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-023-09590-x · Cited by 14
Social anxiety and MDMA-assisted therapy investigation: a novel clinical trial protocol
Lear, M. K., Smith, S. M., Pilecki, B. C., Stauffer, C. S., & Luoma, J. B. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1083354 · Cited by 15
“molecular, neurological, to sociological (50).”
Rizvi, S. L., Ruork, A. K., Yin, Q., Yeager, A. L., Taylor, M. E., & Kleiman, E. M. (2024) · JMIR Mental Health · doi:10.2196/60035 · Cited by 17
“There is also interest in using these technologies to measure dynamic and mechanistic psychotherapy processes, which could replace assessment approaches that have relied on static and infrequent measures [3].”
BackgroundAngerer, F., Mennel, V., Grund, S., Mayer, A., Büscher, R., Sander, L., Cuijpers, P. J., Terhorst, Y., Baumeister, H., & Domhardt, M. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.09.055 · Cited by 17
Rethinking Autism Intervention Science: A Dynamic Perspective
Chen, Y., Duku, E., & Georgiades, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.827406 · Cited by 14
Campoli, J., & Cummings, J. A. (2024) · Journal of Medical Education and Curricular Development · doi:10.1177/23821205231223321 · Cited by 13
“38 – 40 Chaos theory is a useful theoretical framework for understanding health behaviors as it recognizes the complexity of changing such habits.”
BackgroundIrwin, M. R., Boyle, C. C., Cho, H. J., Piber, D., Breen, E. C., Sadeghi, N., Castillo, D., Smith, M. T., Eisenberger, N. I., & Olmstead, R. (2023) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2023.100601 · Cited by 13
“1) (Hayes, 2015; Hayes and Preacher, 2010; Hofmann et al., 2020; Preacher and Hayes, 2004), the hypothesized mediation model is tested(Hayes, 2022), in which the effect of endotoxin on the primary outcome (i.”
BackgroundHeterogeneity in response to treatment across tinnitus phenotypes
Niemann, U., Boecking, B., Brüeggemann, P., Spiliopoulou, M., & Mazurek, B. (2024) · Scientific Reports · doi:10.1038/s41598-024-52651-x · Cited by 12
“Future studies should consider defining phenotypes by grouping psychological maintaining factors associated with tinnitus-related distress 53,54 .”
BackgroundAcceptance as a possible link between past psychedelic experiences and psychological flexibility
Krabbe, A., Sikka, P., & Jylkkä, J. (2024) · Scientific Reports · doi:10.1038/s41598-024-75595-8 · Cited by 15
“Participants were recruited via the online platform Prolific 27 , where they received an anonymous participant ID and were directed to the in-house survey platform “Soile”.”
MethodCurtiss, J. E., Wallace, B., Fisher, L. B., Nyer, M., Jain, F. A., Cusin, C., & Pedrelli, P. (2020) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2020.100040 · Cited by 12
“Such approaches may afford more rigorous methodologies to study change processes in psychological interventions (Hofmann, Hayes, and Curtiss, 2020), and they have been adopted in prior studies.”
BackgroundMethodSelf-citationCurtiss, J. E., Pinaire, M., Fulford, D., McNally, R. J., & Hofmann, S. G. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.07.061 · Cited by 15
“Contemporary theories acknowledge that mental disorders are not static entities that persist over time with uniform structure, but rather dynamic systems with interacting features that vary over time (Hofmann et al., 2020).”
BackgroundSelf-citationPerski, O., Copeland, A., Allen, J., Pavel, M., Rivera, D. E., Hekler, E. B., Hankonen, N. E., & Chevance, G. (2024) · Health Psychology Review · doi:10.1080/17437199.2024.2400977 · Cited by 18
“…‘system-ness’ of many health behaviours (Heino et al., 2021), which cannot be adequately represented using formalisms that have traditionally been used to develop and refine health psychology theories (e.g., applying mediation/moderation techniques to cross-sectional data) (Hofmann et al., 2020).”
Process-Based Cognitive Behavioral Therapy: A Framework for Conceptualization and Treatment
Pavlacic, J. M., & Young, J. N. (2020) · Clinical Case Studies · doi:10.1177/1534650120951858 · Cited by 11
“Examples of how to apply structural models to individual patient presentations are imperative for understanding how biological, psychological, and social processes interact to predict and explain complex human behavior, which ultimately guides the selection of evidence-based procedures for intervention consistent with…”
BackgroundMethodCotton, S., Betts, J. K., Eleftheriadis, D., Filia, K., Seigerman, M., Rayner, V., McKechnie, B., Hulbert, C. A., McCutcheon, L., Jovev, M., et al. (2021) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674211050299 · Cited by 11
“Are different interventions needed for family members compared to other caregivers? We may need to go beyond moderation (and mediation) models to examine complex interpersonal interactions in real time (Hofmann et al., 2020).”
BackgroundThe Influence of Implicit Theories of Depression on Treatment-Relevant Attitudes
Zimmermann, M., Hmaidan, R., Preiser, B., & Papa, A. (2020) · Cognitive Therapy and Research · doi:10.1007/s10608-020-10120-5 · Cited by 8
Technology-Based Ecological Momentary Assessment in Clinical Psychology
Colombo, D., Suso‐Ribera, C., Fernández‐Álvarez, J., Cipresso, P., García‐Palacios, A., Riva, G., & Botella, C. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-818697-8.00003-0 · Cited by 9
Psychotherapeutic Interventions and Processes
Hofmann, S. G. (2022) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2022.02.001 · Cited by 10
Self-citationRäihä, K., Katajavuori, N., Vehkalahti, K., Huotilainen, M., & Asikainen, H. (2024) · Current Psychology · doi:10.1007/s12144-024-05800-4 · Cited by 14
Milne, L., Ratushniak, A., & Nguyen, H. (2024) · Frontiers in Child and Adolescent Psychiatry · doi:10.3389/frcha.2024.1423451 · Cited by 14
Modeling the onset of a depressive episode: A self-regulation perspective
Strauman, T. J. (2021) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2021.04.003 · Cited by 10
Wirkfaktoren und Veränderungsmechanismen digitaler psychotherapeutischer Interventionen
Domhardt, M., & Baumeister, H. (2021) · Psychotherapeut · doi:10.1007/s00278-021-00525-2 · Cited by 9
Schumacher, L., Burger, J., Echterhoff, J., & Kriston, L. (2022) · doi:10.31234/osf.io/ea7fu · Cited by 9
Validation and Application of Wrist-Worn Wearable Physiological Measures in Psychotherapy
Mink, F., Lutz, W., Rafaeli, E., Hehlmann, M. I., Schwartz, B., & Uhl, J. (2025) · Cognitive Therapy and Research · doi:10.1007/s10608-025-10601-5 · Cited by 7
“Personalized dynamic network models could be utilized to explore these interactions further (e.g., Hofmann et al., 2020; Fisher et al., 2017 ).”
Changing Biased Interpretations in CBT: A Brief History and Overview
Woud, M. L., & Hofmann, S. G. (2023) · CBT: science into practice · doi:10.1007/978-3-031-23650-1_12 · Cited by 11
Self-citationMonteiro, F., Pereira, M., Canavarro, M. C., & Fonseca, A. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.701107 · Cited by 15
“Understanding treatment processes and researching and intervening at such level is essential and has been considered a promising path forward for intervention science (60).”
BackgroundLopes, A. C., Roque, F., Morgado, S., Dinis, C., Herdeiro, M. T., & Morgado, M. (2021) · Behavioral Sciences · doi:10.3390/bs11110153 · Cited by 11
Metadata
- Authors
- Hofmann, S. G., Curtiss, J. E., & Hayes, S. C.
- Affiliations
- Boston University (US)
- University of Nevada, Reno (US)
- Corresponding author
- Hofmann, Stefan G.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2020-03
- Volume
- 76
- Pages
- 101824
- ISSN
- 0272-7358 (ISSN-L)
- PMC
- PMC7137783
- OpenAlex
- W3000381339
- Cited by
- 232
- References
- 110
- Citations by year
- 2026: 25 · 2025: 37 · 2024: 52 · 2023: 31 · 2022: 35 · 2021: 34 · 2020: 18
- FWCI
- 2.32
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Physical Sciences › Mathematics › Statistics and Probability › Advanced Causal Inference Techniques
- Keywords
- treatment process, psychotherapy, mediation analysis, moderation, dynamic network model, individual differences, idiographic approach, mechanistic model, evidence-based care, mechanisms of change
- MeSH terms
- Humans, Psychotherapy
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