Commentary on Chapter “Case Formulation in Process-Based Therapies”: Process Based CBT as an Approach to Case Conceptualization

Abstract

This Commentary describes the framework of Process-Based Cognitive Behavioral Therapy (PB-CBT). PB-CBT works under the assumption that the symptom is maintained and is also maintaining a network that is maladaptive and resilient for change; PB-CBT aims to help the client replace a maladaptive network with an adaptive one, to strengthen processes that promote well-being and experiences that goes in line with the clients’ values and ambitions. Treatment starts with a collaborative contextual idiographic assessment in which both client and therapist, using their unique personal or professional knowledge, examine a particular context to formulate a shared understanding of the process occurring in that context and to identify targets for intervention. The assessment builds-up toward a functional analysis, conceived as the identification of relevant and controllable functional relations to an individual’s specific behaviors. In PB-CBT case formulation continues as long as treatment is still ongoing. Receiving and discussing the client’s feedback on the intervention is essential in order to decide whether to adapt or change the intervention and conduct it again. Asking individualized, context related questions, using advanced tools for data collection and analysis, organizing the data in a comprehensive working model, and working in a cyclic manner throughout the therapeutic process, are indeed a new way in which case formulation can be delivered.