In plain language
For decades, therapy research has followed one recipe: define a psychiatric syndrome (such as “major depression”), build a treatment protocol for it, and test the protocol in randomised trials. This influential article argues that this “protocols for syndromes” era is drawing to a close, and asks what should replace it. The authors’ answer is process-based therapy (PBT): a focus on how to target and change the core biopsychosocial processes that matter for a specific person, in a specific situation, with specific goals.
That is an inherently individual (idiographic) question, and the paper shows why the field’s standard group-based statistics cannot answer it. Group averages only describe an individual under an implausible “ergodic” assumption — that everyone is essentially the same and stable over time. Because change processes form complex, dynamic, bidirectional networks rather than simple one-way chains, the authors argue that research must start at the level of the individual and only then build back up to generalisations.
The article maps out concrete tools for this new era: functional analysis, intensive repeated measurement, time-series and dynamic network analyses, and complex network models — combined into a multi-dimensional, multi-level “functional periodic table” of change processes rooted in evolutionary science. The payoff, they argue, is intervention science that is sensitive to the individual client while still producing rigorous, generalisable knowledge.
Key findings
- The foundational assumptions of the “protocols for syndromes” era of evidence-based therapy — latent disease entities, discoverable syndrome sets, protocol testing via RCTs — are all now being openly questioned.
- Process-based therapy reframes the core question: how best to target and change core biopsychosocial processes in specific situations, for given goals, with given clients.
- Classic group-level (nomothetic) analyses only apply to individuals under implausible ergodic assumptions; conclusions drawn from group averages can badly misrepresent any single client.
- Therapeutic change processes are not uni-directional but form complex dynamic networks that change over time, requiring dynamic, intensive, within-person assessment.
- Modern idiographic methods — functional analysis, time-series analysis, dynamic network models (e.g., Fisher’s work showing opposite avoidance–distress dynamics in different patients) — can be embedded in randomised trials to integrate idiographic and nomothetic research.
- The authors propose a multi-dimensional, multi-level “functional periodic table” of change processes as a structure for building and testing process-based therapy models.
How to cite
APA
Hayes, S. C., Hofmann, S. G., Stanton, C. E., Carpenter, J. K., Sanford, B. T., Curtiss, J. E., & Ciarrochi, J. (2019). The role of the individual in the coming era of process-based therapy. Behaviour Research and Therapy, 117, 40–53. https://doi.org/10.1016/j.brat.2018.10.005
BibTeX
@article{hayes2019role,
author = {Hayes, Steven C. and Hofmann, Stefan G. and Stanton, Cory E. and Carpenter, Joseph K. and Sanford, Brandon T. and Curtiss, Joshua E. and Ciarrochi, Joseph},
title = {The role of the individual in the coming era of process-based therapy},
journal = {Behaviour Research and Therapy},
year = {2019},
volume = {117},
pages = {40--53},
doi = {10.1016/j.brat.2018.10.005}
}
Related work
- All publications by Joseph Ciarrochi (searchable, with free PDFs)
- Process-Based Therapy & Idionomic Analysis
Author: Joseph Ciarrochi (ORCID 0000-0003-0471-8100). Free copy hosted with permission for scholarly use. Please cite the published version via the DOI above.