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The Future of Intervention Science: Process-Based Therapy
Open accessAbstract
Clinical science seems to have reached a tipping point. It appears that a new paradigm is beginning to emerge that is questioning the validity and utility of the medical illness model, which assumes that latent disease entities are targeted with specific therapy protocols. A new generation of evidence-based care has begun to move toward process-based therapies to target core mediators and moderators based on testable theories. This could represent a paradigm shift in clinical science with far-reaching implications. Clinical science might see a decline of named therapies defined by set technologies, a decline of broad schools, a rise of testable models, a rise of mediation and moderation studies, the emergence of new forms of diagnosis based on functional analysis, a move from nomothetic to idiographic approaches, and a move toward processes that specify modifiable elements. These changes could integrate or bridge different treatment orientations, settings, and even cultures.
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“traditional approaches evaluating the effectiveness of generic interventions by comparing aggregated group data are limiting as they overlook important information regarding individual differences in training needs and outcomes [69-71].”
From Evaluation of an App-Delivered Psychological Flexibility Skill Training Intervention for Medical Student Burnout and Well-being: Randomized Controlled Trial (2023) · cites this paper as [71]
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“evaluating them separately provides a stronger understanding of intervention methodologies that can address this heterogeneity [70,71].”
From Evaluation of an App-Delivered Psychological Flexibility Skill Training Intervention for Medical Student Burnout and Well-being: Randomized Controlled Trial (2023) · cites this paper as [71]
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“Building matrices of change and change procedures represented a valuable method to ensure our change mechanisms were precisely defined (148) and got effectively linked to therapeutic applications (75).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [75]
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“In doing this, SCEDs provide evidence of the effectiveness of interventions, drawing on substantially fewer participants than nomothetic approaches (such as RCTs) [51,52,53,54,55,56,57,58].”
From Brief and Telehealth Acceptance and Commitment Therapy (ACT) Interventions for Stress in Inflammatory Bowel Disease (IBD): A Series of Single Case Experimental Design (SCED) Studies (2022) · cites this paper as [58]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“This contextual-behavioral approach, as proposed by the latest process-based evolutionary meta-model (Hofmann and Hayes, 2019), allows for the inclusion of social and environmental factors (e.g., school, family, peers), in case conceptualization and therapeutic process.”
From Process of change and efficacy of acceptance and commitment therapy (ACT) for anxiety and depression symptoms in adolescents: A meta-analysis of randomized controlled trials. (2025) · cites this paper as Hofmann and Hayes, 2019
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“Firstly, our intervention directly targets hypothesized change mechanisms instead of specific symptom content and hence follows a current promising paradigm shift in intervention science toward process-based treatments (13, 75, 144).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [75]
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“It has been suggested that researchers consider a more idiographic approach in order to identify underlying processes of clinical change, using high temporal density and contextualized measurement applied at the level of the person (Ciarrochi et al., 2021; Hofmann and Hayes, 2019).”
From Online ACT intervention for fibromyalgia: An exploratory study of feasibility and preliminary effectiveness with smartphone-delivered experiential sampling assessment (2022) · cites this paper as Hofmann and Hayes, 2019
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“The use on an idiographic approach with the time-extensive collection of repeated process and outcome measures provided a wealth of information useful in understanding treatment effects linked to processes of change with a small sample, in line with a process-based therapy (PBT) framework (Hayes and Hofmann, 2018; Hofmann and Hayes, 2019).”
From Online ACT intervention for fibromyalgia: An exploratory study of feasibility and preliminary effectiveness with smartphone-delivered experiential sampling assessment (2022) · cites this paper as Hofmann and Hayes, 2019
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“Processes of change are defined as theory-based, dynamic, progressive, contextually bound, modifiable, and multilevel change mechanisms that occur in predictable, empirically established sequences oriented toward desirable outcomes (Hofmann and Hayes, 2019).”
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Metadata
- Authors
- Hofmann, S. G., & Hayes, S. C.
- Affiliations
- Boston University (US)
- University of Nevada, Reno (US)
- Corresponding author
- Hofmann, Stefan G.
- Venue
- Clinical Psychological Science
- Publisher
- SAGE Publications
- Published
- 2018-05-29
- Volume
- 7
- Issue
- 1
- Pages
- 37-50
- ISSN
- 2167-7026 (ISSN-L)
- 2167-7034
- PMC
- PMC6350520
- OpenAlex
- W2807203549
- Semantic Scholar
- 83e462c52031103055115209eafb3a9b92f622a3
- Cited by
- 888
- References
- 67
- Citations by year
- 2026: 145 · 2025: 114 · 2024: 121 · 2023: 128 · 2022: 134 · 2021: 114 · 2020: 80 · 2019: 39 · 2018: 13
- FWCI
- 72.27
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Psychological Science (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH099021, R34MH099311, U01MH108168)
- National Center for Complementary and Integrative Health (R01AT007257)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Psychology › General Psychology › Academic and Historical Perspectives in Psychology
- Keywords
- process-based therapy, intervention research, evidence-based care, mediating and moderating effects
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