Process-Based CBT: The Science and Core Clinical Competencies of Cognitive Behavioral Therapy

466 Pages·2018·40.47 MB·English

by  Steven C. Hayes PhD

“Process-Based CBT represents an important advancement in the field of cognitive
behavioral therapy (CBT). It admirably describes how to target relevant and largely
transdiagnostic processes to promote healthy growth and development. Treatment
manuals, developed for research trials for specific DSM disorders, are often quite lim-
iting, in a way that can impede their effectiveness, especially when there are comor-
bidities. Learning about the core processes presented in this book will enrich students,
practitioners, educators, and researchers.”
—Judith S. Beck, PhD, president of the Beck Institute for Cognitive
Behavior Therapy, and clinical professor of psychology in psychiatry at
the University of Pennsylvania
“Governments and healthcare policy makers, and tens of thousands of psychothera-
pists around the world, strongly endorse CBT because it works, but it doesn’t always
work, and even when it does, it is often not as effective as we would all like. In this
remarkable book, two of the leading theorists and clinical scientists in the world,
Steven Hayes and Stefan Hofmann, make a strong case that going forward CBT must
focus on fundamental transdiagnostic psychopathological processes and core behav-
ioral interventions in what they call the process model of CBT. This is clearly the
future of our science and profession.”
—David H. Barlow PhD, ABPP, professor of psychology and psychiatry
emeritus, and founder and director emeritus of the Center for Anxiety
and Related Disorders at Boston University
“As an educator, researcher, and clinician, I found Process-Based CBT to be a much-
needed and stimulating resource. Science has helped us determine what treatments
work. We now need to enhance our understanding of the complexities in precisely
how those treatments work, and why. This book, edited by leaders in clinical psychol-
ogy—Steven Hayes and Stefan Hofmann—brings a new vision for CBT. It superbly
ties together undergirding processes through our in-session work and procedures, with
an impetus for new diagnostic, formulation, assessment, design, and analytic method-
ologies. In the short term, these important ideas will inform our training curricula and
research studies. In the longer term, these ideas will influence a generation of practi-
tioners. I strongly recommend this book to all those learning, practicing, or research-
ing CBT.”
—Nikolaos Kazantzis, PhD, program director for clinical psychology, and
director of the Cognitive Behaviour Therapy Research Unit at Monash
University in Melbourne, Australia
“This is a cutting-edge book that eloquently makes the case for increasing our focus
on core therapeutic processes. It is impressive in its breadth and depth of topics, yet it
remains sensitive to historical and philosophical implications. Combined with the
expertise from leading international experts, Process-Based CBT promises to influence
the development of psychotherapy practice and training for years to come.”
—Andrew Gloster, chair of the division of clinical psychology and
intervention science at the University of Basel, Switzerland
“Imagine a roomful of experts in all the essential skills of CBT standing at the ready
to help you take the best possible care of your clients. Buy this book and that’s what
you’ll get. An outstanding toolbox for the cognitive behavior therapist who is striving
to integrate standard CBT with mindfulness- and acceptance-based approaches.”
—Jacqueline B. Persons, PhD, Cognitive Behavior Therapy and
Science Center, Oakland, CA; University of California, Berkeley
“Paving the way to the future of psychotherapy! This book goes beyond current CBT
readers, puts these approaches into a broader, even philosophical context, and hereby
opens new perspectives for improving current treatment approaches. It integrates dif-
ferent strands of psychotherapy (traditional CBT, ACT, and MBCT). This book is not
only a must-have for anyone who wants to improve treatment skills by improving and
personalizing the selection of specific interventions for specific patient problems, but
also for psychotherapy researchers who really want to bring the field forward to a new
level of developing and systemizing psychological interventions.”
—Winfried Rief, PhD, board member of the European Association of
Clinical Psychology and Psychological Therapy (EACLIPT)
“This is a remarkable and timely book. As the first, to my knowledge, to address in
one place the training standards and clinical competencies outlined by the Inter-
Organizational Task Force on Cognitive and Behavioral Psychology Doctoral Education, it
is likely to become a core text in doctoral-level CBT training programs. Moreover, its
explication of the epistemologies, theories, basic principles, and core processes that
comprise CBT as a field will facilitate the evolution of CBT and the empirically based
treatment movement from simply matching interventions and syndromes to one that
selects and customizes clinical interventions based on empirically supported theory
and contextual analysis.”
—Michael J. Dougher, PhD, University of New Mexico
“The most challenging task for today’s practicing psychotherapists, as well as psycho-
therapy researchers, is to personalize the process of evidence-based psychotherapy
using the available selection of treatment strategies and assessment tools. I cannot
imagine a better resource for this task than this outstanding book by the two leading
experts: Steven Hayes and Stefan Hofmann. This rich collection of topics integrates
the behavioral, cognitive, emotional, motivational, and interpersonal as well as accep-
tance and mindfulness traditions within psychological treatments. It is a major step
forward and provides a new standard for the future of evidence-based psychotherapy.
Anyone interested in psychological treatments will find it comprehensive as well as
fun to read. It provides an exceptional resource for practicing clinicians as well as
clinical training.”
—Wolfgang Lutz, PhD, department of psychology at the University
of Trier, Germany
“Clients are at risk for receiving less-than-optimal services when clinicians fail to
follow a science-based approach to clinical intervention. This book by Hayes and
Hofmann is the first to present a comprehensive overview of evidence-based core
principles, practices, and processes that integrate intervention competencies and strat-
egies across multiple treatment models and multiple syndromes.”
—Stephen N. Haynes, emeritus professor of psychology at the
University of Hawai’i at Mãnoa, and editor of the American
Psychological Association journal Psychological Assessment
“Too many books on this topic have emphasized either the ‘C’ or the ‘B’ in CBT, the
differences between acceptance-based versus change-based interventions, or the dis-
tinction between branded CBT manuals compared to common, non-specific elements
across psychotherapy. Hayes, Hofmann, and colleagues have taken an entirely differ-
ent approach. They move the field forward by eschewing false dichotomies and unnec-
essarily simplistic caricatures of CBT, and by embracing the many empirically
supported processes of change underlying cognitive and behavioral therapies. What
emerges is clear and practical for clinicians: yesterday’s CBT has been replaced by
today’s growing and diverse family of contemporary CBTs.”
—M. Zachary Rosenthal, PhD, associate professor, vice chair, and clinical
director at the Cognitive-Behavioral Research and Treatment Program;
director of the Clinical Psychology Fellowship Program; and director of
the Misophonia and Emotion Regulation Program in the department of
psychiatry and behavioral sciences, and the department of psychology
and neuroscience at Duke University

PROCESS-
BASED
C B T
The Science and Core Clinical
Competencies of Cognitive
Behavioral Therapy
Edited by
STEVEN C. HAYES, P D
h
STEFAN G. HOFMANN, P D
h
C P
ontext ress
An Imprint of New Harbinger Publications, Inc.
Publisher’s Note
This publication is designed to provide accurate and authoritative information in regard to the
subject matter covered. It is sold with the understanding that the publisher is not engaged in render-
ing psychological, financial, legal, or other professional services. If expert assistance or counseling is
needed, the services of a competent professional should be sought.
Distributed in Canada by Raincoast Books
Copyright © 2018 by Steven C. Hayes and Stefan G. Hofmann
Context Press
An imprint of New Harbinger Publications, Inc.
5674 Shattuck Avenue
Oakland, CA 94609
www.newharbinger.com
Figure 1 in chapter 11 is reprinted from Cahill, K., Hartmann-Boyce, J., & Perera, R. (2015).
Incentives for smoking cessation. Cochrane Database of Systematic Reviews, 5(CD004307).
Copyright © 2015 Wiley. Used by permission of Wiley.
Cover design by Amy Shoup
Acquired by Catharine Meyers
Edited by James Lainsbury
Indexed by James Minkin
All Rights Reserved
Library of Congress Cataloging-in-Publication Data on file
20 19 18
10 9 8 7 6 5 4 3 2 1 First Printing
Contents
Introduction � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 1
Steven C. Hayes, PhD, Department of Psychology, University of Nevada, Reno;
Stefan G. Hofmann, PhD, Department of Psychological and Brain Sciences,
Boston University
Part 1
1 The History and Current Status of CBT as an
Evidence- Based Therapy � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 7
Stefan G. Hofmann, PhD, Department of Psychological and Brain Sciences,
Boston University; Steven C. Hayes, PhD, Department of Psychology, University
of Nevada, Reno
2 The Philosophy of Science As It Applies to Clinical Psychology� � � 23
Sean Hughes, PhD, Department of Experimental Clinical and Health Psychology,
Ghent University
3 Science in Practice � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 45
Kelly Koerner, PhD, Evidence- Based Practice Institute
4 Information Technology and the Changing Role of Practice � � � � � � 67
Gerhard Andersson, PhD, Department of Behavioral Sciences and Learning,
Linköping University, and Karolinska Institute
5 Ethical Competence in Behavioral and Cognitive Therapies � � � � � � 83
Kenneth S. Pope, PhD, Independent Practice, Norwalk, CT
Part 2
6 Core Behavioral Processes � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 101
Mark R. Dixon, PhD, and Ruth Anne Rehfeldt, PhD, Rehabilitation Institute,
Southern Illinois University
Process-Based CBT
7 What Is Cognition? A Functional- Cognitive Perspective � � � � � � � � 119
Jan De Houwer, PhD, Dermot Barnes- Holmes, DPhil, and Yvonne Barnes-
Holmes, PhD; Department of Experimental Clinical and Health Psychology,
Ghent University
8 Emotions and Emotion Regulation � � � � � � � � � � � � � � � � � � � � � � � � � � � 137
Anthony Papa, PhD, and Emerson M. Epstein, MA; Clinical Psychology PhD
Program, University of Nevada, Reno
9 Neuroscience Relevant to Core Processes in Psychotherapy � � � � � 153
Greg J. Siegle, PhD, Western Psychiatric Institute and Clinic, University of
Pittsburgh, Pittsburgh; James Coan, PhD, University of Virginia
10 Evolutionary Principles for Applied Psychology � � � � � � � � � � � � � � � � �179
Steven C. Hayes, PhD, Department of Psychology, University of Nevada;
Jean- Louis Monestès, PhD, Department of Psychology, LIP/PC2S Lab, University
Grenoble Alpes; and David Sloan Wilson, PhD, Departments of Biology and
Anthropology, Binghamton University
Part 3
11 Contingency Management � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 197
Stephen T. Higgins, PhD, Vermont Center on Behavior and Health; Departments
of Psychiatry and Psychological Science, University of Vermont; Allison N. Kurti,
PhD, Vermont Center on Behavior and Health; Department of Psychiatry,
University of Vermont; and Diana R. Keith, PhD, Vermont Center on Behavior
and Health; Department of Psychiatry, University of Vermont
12 Stimulus Control � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �211
William J. McIlvane, PhD, University of Massachusetts Medical School
13 Shaping � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 223
Raymond G. Miltenberger, PhD, Bryon G. Miller, MS, Heather H. Zerger, MS,
and Marissa A. Novotny, MS, Department of Child and Family Studies,
University of South Florida
14 Self- Management � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 233
Edward P. Sarafino, PhD, Department of Psychology, College of New Jersey
iv
Contents
15 Arousal Reduction � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 245
Matthew McKay, PhD, The Wright Institute, Berkeley, CA
16 Coping and Emotion Regulation � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 261
Amelia Aldao, PhD, and Andre J. Plate, BS, Department of Psychology,
The Ohio State University
17 Problem Solving � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 273
Arthur M. Nezu, PhD, Christine Maguth Nezu, PhD, and Alexandra P.
Greenfield, MS, Department of Psychology, Drexel University
18 Exposure Strategies � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 285
Carolyn D. Davies, MA, and Michelle G. Craske, PhD, Department of
Psychology, University of California, Los Angeles
19 Behavioral Activation � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 299
Christopher R. Martell, PhD, ABPP, Department of Psychological and Brain
Sciences, University of Massachusetts, Amherst
20 Interpersonal Skills � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 309
Kim T. Mueser, PhD, Center for Psychiatric Rehabilitation and Departments
of Occupational Therapy, Psychology, and Psychiatry, Boston University
21 Cognitive Reappraisal � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 325
Amy Wenzel, PhD, ABPP, University of Pennsylvania School of Medicine
22 Modifying Core Beliefs � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 339
Arnoud Arntz, PhD, Department of Clinical Psychology, University of
Amsterdam; Department of Clinical Psychological Science, Maastricht University
23 Cognitive Defusion � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 351
J. T. Blackledge, PhD, Department of Psychology, Morehead State University
24 Cultivating Psychological Acceptance � � � � � � � � � � � � � � � � � � � � � � � � 363
John P. Forsyth, PhD, and Timothy R. Ritzert, MA, Department of Psychology,
University at Albany, State University of New York
v