Process Based Therapy: What It Is And How It Works

Process Based Therapy: what it is and how it works

As in all scientific disciplines, psychology and psychological intervention also experience changes over time as a result of new research and the discovery of new efficient or novel techniques to be used in different psychological treatments. Currently and in the Western social context, the Cognitive-Behavioral approach is the predominant one in psychological therapy and the most supported by science and specialists.

However, this approach has not remained stable over time, but has evolved and integrated changes and modifications resulting from research and the need for constant updating in therapy. In recent years, we are beginning to talk about the arrival of a “third wave” of Cognitive-Behavioral therapies, characterized mainly by the establishment of process-based therapies.

Process-Based Therapy seeks to move away from the need for a diagnostic label to transcend the specific protocols of Cognitive-Behavioral treatments based exclusively on statically defined disorders. This novel approach proposes the adoption of more flexible treatment models, capable of having a trans-diagnosis and organized by principles, capable of understanding disorders and their recovery as processes; not as something stable and defined.

In this article you will learn process-based Cognitive-Behavioral Therapyhaving to understand at the same time the classic characteristics of these therapies and the historical development and over time that these have had to be framed today in a new set of techniques and strategies for psychological recovery and stabilization.

Classic Cognitive-Behavioral Therapy

Standard or classic Cognitive-Behavioral Therapy refers to a whole family of interventions mainly recognized as the psychological therapies that have received the most empirical support over time. These techniques focus on linking thoughts with behaviors, understanding the reasons why a certain thought can give meaning to the emotions experienced and the behaviors that underlie them.

Typically, a combined use of techniques such as cognitive restructuring, relaxation skills training, and coping or exposure strategies is made. Normally, through Cognitive Behavioral Therapy the aim is to deal with the mass of thoughts (distorted or not) about oneself or a specific problem so that, once identified and understood, one can begin to understand the way in which these interfere in the development and implementation of different behaviors and behaviors.

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Cognitive-Behavioral Therapy is used primarily in disorders such as depression, anxiety, sleep disorders, post-traumatic stress disorders and phobias. A criticism that has been made of the more classic Cognitive-Behavioral approach is its continued association with diagnostic labels and therapeutic development almost exclusively linked to the resolution of these disorders and their symptomatology. Critics point to the need to abandon the purely diagnostic perspective based on labeling.

Historical evolution: a third wave of behavioral therapies

As we have commented previously, every scientific discipline evolves and modulates over time, adapting to the social and temporal needs of each era and integrating new disciplines to promote progress in science. Research focused on the historical evolution of Cognitive-Behavioral therapies divides its historical development into three stages or waves:

1. First wave: Learning and behaviorism

The first wave of Cognitive-Behavioral therapies refers to its birth in the 1950s when, integrating knowledge related to learning and classical behaviorism with the help of concepts developed by figures such as Ivan Pavlov, B.F. Skinner and Albert Ellis. The main characteristic of this wave is the conceptual and theoretical move of these researchers to therapeutic practice.; the first practical application of these concepts. Above all, techniques such as gradual exposure and the identification of conditioning stimuli proliferated; leaving aside the cognitive variables of these behaviors.

2. Second wave: Methodological heterogeneity

During the second wave, which began around the 1970s, cognitive and social aspects of human behavior began to be incorporated into the above. Thus, this approach began to distance itself from pure learning and behaviorism, to consider perspectives such as Bandura’s social learning. So, begin to understand cognition as a key element that guides people’s behaviors, developing cognitive restructuring and problem-solving techniques.

3. Third wave: Process-Based Therapy

Some people date the beginning of the third wave to 2004, when the experience of emotional disorders began to be understood as the assumption of maladaptive thought patterns for emotions and behaviors, assuming the need to develop new methodologies to detect and modify such patterns. Thus, the new orientations of Cognitive-Behavioral therapies begin to focus on the relationships of patients with their thoughts and emotions and not so much with their contextdeveloping new intervention models such as acceptance therapy, mindfulness techniques and functional analysis techniques.

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Under this approach, we can understand process-based therapy as a therapy that does not focus on diagnostic labels, but rather seeks to understand the thought processes and maladaptive emotionality that perpetuate the experience of them in order to, once understood, move on to their treatment from a holistic and person-centered perspective.

What is Process-Based Cognitive-Behavioral Therapy?

As we have been commenting, the main characteristic of Process-Based Therapy is a change in approach and conceptualization regarding the consideration of mental disorders. Thus, the aim is to take patients into consideration in a broader and more general way, so that the therapy covers the entire person and not exclusively their diagnostic category. Challenging traditional conceptions of mental disorder, process-based therapy proposes a more concrete view of human suffering to develop more effective and patient-centered interventions.

The fundamental units of these therapies are, redundantly, the processes. The processes are general categories whose main objective is to understand a person’s experience at different levels of their life experience. A process is considered the entire sequence of events that affect a person in both positive and negative ways and both directly and indirectly. Each process can be understood through its integrative units in smaller parts.

This is therapeutically useful due to its ability to identify and understand each sub-element of each patient’s thought, emotion and behavior. Thus, the therapeutic intervention can be personalized to the maximum and direct the techniques to be used according to the experiences and experiences of each person.

Key techniques of Process Based Therapy

Next, we will present some of the most characteristic techniques of process-based Cognitive-Behavioral therapy and that most define the therapeutic orientation that it defends:

1. Full attention (mindfulness)

Mindfulness is a central technique in Process Based Therapy. It consists of developing a non-reactive, non-judgmental awareness of thoughts, emotions, bodily sensations, and experiences present in the moment. The client is encouraged to observe his thoughts and feelings as if they were passing events, without holding on to them or trying to change them. The practice of mindfulness helps to develop a greater understanding of oneself and cultivate an accepting attitude towards internal experiences.

2. Experiential clarification:

This technique involves going deeper into the client’s emotional and cognitive experience. The therapist helps the client explore and describe in detail his feelings and thoughts, encouraging him to put into words what he is experiencing internally. This helps give shape and meaning to internal customer experienceswhich can lead to greater understanding and problem solving.

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3. Focus on the process:

Instead of focusing solely on the client’s verbal contents, this approach pays close attention to how events unfold in the present moment. This includes observing emotional changes, thought patterns, and physical responses during the therapeutic session. The therapist can highlight and explore any changes or fluctuations that occur during therapy to better understand the underlying processes.

4. Acceptance and compassion:

Process-Based Therapy promotes an attitude of compassionate acceptance towards oneself and one’s internal experiences. The therapist helps the client cultivate a kind, non-judgmental attitude toward his or her thoughts and emotions, even if they are painful or difficult. Acceptance and compassion allow the client to feel safer and more open to exploring their problems. without fear of judgment.

5. Language observation

It is important to pay attention not only to the content of what the client is expressing, but also how it relates to your own language and thoughts. This involves observing patterns of communication, self-labeling, and the metaphors the client uses to describe their internal experiences. This can provide greater insight into your thinking and behavior patterns.

6. Direct experience

In process-based therapy, the importance of explore and work with the emotional and cognitive experiences that arise in the present moment. Instead of simply talking about problems or symptoms, the therapist guides the client to connect with her current emotions and reactions. By doing so, the client can gain a deeper, more authentic understanding of her problems and find new ways to cope with them.


As we have seen, Process-Based Therapy is an approach with origins in Cognitive-Behavioral Therapies and as a result of its scientific evolution and the passage of time that establishes novel therapeutic requirements to adapt to contemporary needs. This approach attempts to move away from therapeutic conceptions exclusively based on diagnostic and medical categorization, to understand therapy in a holistic way that empowers people, considering all aspects of their life and not only those that may be related to a particular person. disorder or a medical label.