Traditional Workshop 21 - A Process-based Approach to Evidence-based Practice

This workshop introduces process-based therapy (PBT) as a flexible, evidence-based framework for CBT practitioners, integrated with idionomics-a science prioritizing idiographic longitudinal data to personalize interventions. Drawing from evolutionary principles and the extended evolutionary meta-model (EEMM), participants will explore how PBT shifts from syndromal protocols to targeting dynamic processes of change (e.g., cognitive defusion, values clarification) tailored to individuals. We address the ergodic illusion in traditional statistics, demonstrating why aggregates fail personalization and how idionomic methods (e.g., ARIMAX, iBoruta) helps solve these problems. The psychological flexibility model will be used a framework for the workshop, and an expanded view of Acceptance and Commitment Therapy or Training (ACT in either case) will be used to explain key points of the general approach. Through didactic presentations, case examples, small-group exercises, and hands-on analysis of sample EMA datasets, attendees will practice building idiographic process networks, selecting therapeutic kernels, and see how AI-assisted tools can be applied for real-time adaptation. Historical context, statistical objections, and implementation challenges (e.g., scalability, ethics) will be discussed, empowering clinicians to foster equitable, context-sensitive care beyond WEIRD biases. Ideal for therapists seeking practical skills in precision behavioral health.

Outline:

I. Why evidence-based practice needs a process-based turn
a. Stalled progress in psychotherapy outcomes
b. Limits of syndromal diagnosis for treatment utility
c. Fragmentation across treatment packages and methods
d. The need to address whole-person functioning beyond “mental disorders”

II. Historical roots of a process-based approach
a. The behavioral and cognitive therapy traditions
b. Functional analysis and the idiographic roots of behavior therapy
c. The ACT/RFT/CBS tradition as a bridge between behavioral principles and cognition
d. Prediction and influence as pragmatic scientific goals

III. Defining processes of change
a. Changeable, situated biopsychosocial pathways linked to outcomes
b. Dynamic, progressive, multi-level, and contextually bound processes
c. Linking evidence-based procedures to evidence-based processes
d. The role of proximal process measurement in guiding intervention

IV. Organizing processes through the psychological flexibility model and EEMM
a. Psychological flexibility as open, aware, and actively engaged living
b. Emotional, cognitive, attentional, motivational, behavioral, and self-related flexibility
c. Extending flexibility processes to biological, relational, and cultural levels
d. Using a meta-model to allow evidence-based methods to speak to one another

V. Personalization and the problem of fit
a. Negative client experiences when interventions do not fit
b. Evidence that personalization improves outcomes
c. Moving from protocols for syndromes to kernels that fit persons
d. Treating problems and promoting prosperity across life domains

VI. The ergodic error and its implications for evidence-based practice
a. Why group averages often fail to describe individual change over time
b. The limits of standard biostatistics for clinical decision-making
c. Reframing the treatment utility, replication, and diversity crises
d. Why clinicians need idiographic, longitudinal information

VII. Idionomic analysis as a path forward
a. Measuring particular people over time
b. Modeling within-person networks and process-outcome relations
c. Identifying heterogeneity, equisyncratic effects, and person-specific leverage points
d. Integrating nomothetic science with idiographic clinical practice

VIII. Implications for the future of CBT
a. A process-based CBT that can cross methods, populations, cultures, and problem areas
b. Training clinicians to measure, model, and personalize care
c. Building a bottom-up science of clinical practice
d. Listening to the particular person: if we are not measuring and personalizing, we are not fully treating