Study type: Cross-sectional clinician survey.
In plain language
Process-based therapy (PBT) aims to match treatment components to a person’s needs and context. For that approach to work in routine care, clinicians need a framework they can understand and use. Ong and colleagues surveyed 150 clinicians about their familiarity with PBT and its organizing framework, the extended evolutionary meta-model (EEMM). After a brief introduction, participants used the EEMM to classify treatment components and offered feedback.
Just over half of respondents had heard of PBT, while fewer than half had heard of the EEMM. Nevertheless, clinicians often agreed on the main dimension or level associated with a treatment component. Agreement became less consistent when components could serve several functions. Respondents also identified aspects of functioning, particularly interpersonal relationships, that needed to be more visible in the framework.
The study suggests that the EEMM can provide a shared language for organizing therapeutic methods, while showing where explanation and training need improvement. It also highlights the importance of developing process-based assessment and case conceptualization alongside intervention techniques.
Key points
- Familiarity varied. In this sample, 57.3% had heard of PBT and 41.3% had heard of the EEMM.
- Broad agreement was possible after a brief primer. For almost all treatment components, at least 60% of respondents agreed on one primary EEMM dimension or level, excluding the broad Individual category. Agreement on secondary classifications was more variable.
- Function can cross categories. The same component may involve cognition, motivation, relationships, or other dimensions depending on its purpose and delivery. The authors identify training and clearer operational descriptions as ways to improve consistency.
- Assessment needs attention. Use of the Process-Based Assessment Tool was limited, and PBT appeared more established in intervention choices than in assessment and case conceptualization among respondents familiar with it.
What the paper does and does not establish
- The sample was predominantly U.S.-based and white, with strong representation from acceptance and commitment therapy and cognitive-behavioral therapy. The percentages should not be read as estimates for clinicians generally.
- The survey used an earlier EEMM version and did not assess Context. The current Relationships/Culture and Biology/Physiology labels clarify content previously described as Sociocultural and Biophysiological.
- This was a cross-sectional survey of clinician perspectives and classification decisions. It did not test whether PBT or EEMM training improves client outcomes.
How to cite
APA 7
Ong, C. W., Sheehan, K., Ciarrochi, J., & Lee, E. B. (2026). Clinician perspectives on process-based therapy. Practice Innovations, 11(2), 180–198. https://doi.org/10.1037/pri0000295
BibTeX
@article{ong2026clinician,
title = {Clinician perspectives on process-based therapy},
author = {Ong, Clarissa W. and Sheehan, Kate and Ciarrochi, Joseph and Lee, Eric B.},
journal = {Practice Innovations},
year = {2026},
volume = {11},
number = {2},
pages = {180--198},
doi = {10.1037/pri0000295}
}
Related work
- Process-based therapy: a common ground for therapeutic practices
- The Process-Based Assessment Tool (PBAT)
- All publications by Joseph Ciarrochi
Summary based on the full published article supplied by the author. The local PDF is the publisher version from Practice Innovations, 11(2), 180–198 (2026), first published online on 7 August 2025. Summary prepared from the full paper on 29 September 2026. Please cite the published article linked above.