In plain language
For half a century, mental health care has organized itself around diagnostic labels like those in the DSM. But diagnoses overlap heavily, say little about what to actually treat, and have not produced a cumulative science of case conceptualization. This study tested an alternative: instead of asking “what disorder does this person have?”, ask “which psychological processes of change matter for this particular person, in their daily life?”
Fifty adults completed the Process-Based Assessment Tool (PBAT) — a set of items measuring processes of variation, selection and retention across psychological, sociocultural and biophysiological dimensions, drawn from the Extended Evolutionary Meta-Model of Process-Based Therapy — along with common clinical outcome items (such as sadness, anxiety and life satisfaction), twice daily for 35 days. This yielded at least 60 measurement occasions per person, which were analysed with Group Iterative Multiple Model Estimation (GIMME), a method that builds a network model for each individual before looking for shared patterns.
The processes measured by the PBAT related to clinical outcomes for virtually every participant — but the specific pattern of relationships was different from person to person. No overall group-level pattern emerged, and the data violated the ergodic assumptions that justify applying group statistics to individuals. Subgroups did share some links for sadness, anxiety and life satisfaction, yet most process-outcome relationships were unique to the individual, though still interpretable through the psychological flexibility framework. The result points to a practical, replicable way to build empirical, person-specific case conceptualizations rather than fitting clients to diagnostic categories.
Key findings
- 50 individuals completed the PBAT and clinical outcome items in an experience-sampling format over 35 days, yielding at least 60 measurement occasions per person.
- Person-specific network analyses (GIMME) showed PBAT processes related to common clinical outcomes for virtually all participants.
- Participants’ responses violated the ergodic assumptions underlying classical normative statistics, meaning group-level averages could not stand in for individual dynamics.
- No overall group-level pattern of process–outcome relationships was found.
- Subgroup relations emerged for three common outcomes — sadness, anxiety and life satisfaction — but most process-to-outcome relationships were idiographic (person-specific).
- Idiographic networks were interpretable using the broadened psychological flexibility approach of the Extended Evolutionary Meta-Model, supporting idionomic network analysis as a replicable form of empirical functional analysis and process-based case conceptualization.
How to cite
APA
Sanford, B. T., Ciarrochi, J., Hofmann, S. G., Chin, F., Gates, K. M., & Hayes, S. C. (2022). Toward empirical process-based case conceptualization: An idionomic network examination of the process-based assessment tool. Journal of Contextual Behavioral Science, 25, 10–25. https://doi.org/10.1016/j.jcbs.2022.05.006
BibTeX
@article{sanford2022toward,
author = {Sanford, Brandon T. and Ciarrochi, Joseph and Hofmann, Stefan G. and Chin, Fredrick and Gates, Kathleen M. and Hayes, Steven C.},
title = {Toward empirical process-based case conceptualization: An idionomic network examination of the process-based assessment tool},
journal = {Journal of Contextual Behavioral Science},
year = {2022},
volume = {25},
pages = {10--25},
doi = {10.1016/j.jcbs.2022.05.006}
}
Related work
- All publications by Joseph Ciarrochi (searchable, with free PDFs)
- Process-Based Therapy & Idionomic Analysis
- The Process-Based Assessment Tool (free download)
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.