Process-Based CBT for Anxiety

Stefan G. Hofmann is Professor of Psychology at Boston University and one of the foremost experts in CBT, especially anxiety disorders. For most of his career, he has been developing and testing treatment protocols for anxiety disorders, especially social anxiety disorder and generalized anxiety disorder. Stefan has written many clinician guides and has given many workshops to clinicians around the world, some in his role as a Beck trainer. Dissatisfied with the progress in field and the limitations of our current approach to treatment, he started re-examining some very basic assumptions about the contemporary approach toward improving mental health. This has led to a close collaboration with Steve Hayes. The approach he, Steve, and his colleagues developed applies to all aspects of the human experience. However, and in order to keep the discussion focused and concrete, this workshop will primarily focus on issues related to anxiety problems.

Process-Based Cognitive Behavioral Therapy (PB-CBT) is an alternative to the contemporary approach. It is a radical departure from the latent disease model of the DSM and the absurd proliferation of the protocols-for-syndrome approach. Instead, PB-CBT focuses on how to best target and change core biopsychosocial processes in a specific situation for given goals with a given client. This approach recognizes that psychotherapy typically involves non-linear (rather than linear), bidirectional (rather than unidirectional), and dynamic changes of many (rather than only a few) interconnected variables. Effective therapy changes the entire system toward a stable and adaptive state. For therapy to be most effective, we, therefore, need to embrace a systematic, assessment-guided, and theory-based approach to understand the relationships of the various problems of a given client. Functional analysis, the foundation of behavior therapy, provides the basis to understand these relationships. PB-CBT acknowledges the complexity, inter-relatedness, and multidimensional levels of problems in a given client. This workshop will illustrate how PB-CBT is used to target key treatment processes by combining functional analysis with a dynamic and person-specific network approach. To illustrate the unique features of the treatment, two common anxiety-related problems are discussed in detail: social anxiety and generalized anxiety. To illustrate the unique features, the contemporary approach will be juxtaposed with PB-CBT to target specific processes in a specific client.