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      A process-based approach to cognitive behavioral therapy: A theory-based case illustration

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          Abstract

          Despite the significant contribution of cognitive-behavioral therapy to effective treatment options for specific syndromes, treatment progress has been stagnating, with response rates plateauing over the past several years. This stagnation has led clinical researchers to call for an approach that instead focuses on processes of change and the individual in their particular context. Process-based therapy (PBT) is a general approach representing a model of models, grounded in evolution science, with an emphasis on idiographic methods, network models of case conceptualization, and enhancing wellbeing. In this paper, we describe the theory underlying PBT and present a case study for how to apply PBT tools and principles to deliver process-informed and person-centered evidence-based treatment. In addition, we discuss lessons learned from our case and provide suggestions for future considerations when implementing PBT in clinical settings.

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          Most cited references52

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          Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives

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            Comparative fit indexes in structural models.

            P. Bentler (1990)
            Normed and nonnormed fit indexes are frequently used as adjuncts to chi-square statistics for evaluating the fit of a structural model. A drawback of existing indexes is that they estimate no known population parameters. A new coefficient is proposed to summarize the relative reduction in the noncentrality parameters of two nested models. Two estimators of the coefficient yield new normed (CFI) and nonnormed (FI) fit indexes. CFI avoids the underestimation of fit often noted in small samples for Bentler and Bonett's (1980) normed fit index (NFI). FI is a linear function of Bentler and Bonett's non-normed fit index (NNFI) that avoids the extreme underestimation and overestimation often found in NNFI. Asymptotically, CFI, FI, NFI, and a new index developed by Bollen are equivalent measures of comparative fit, whereas NNFI measures relative fit by comparing noncentrality per degree of freedom. All of the indexes are generalized to permit use of Wald and Lagrange multiplier statistics. An example illustrates the behavior of these indexes under conditions of correct specification and misspecification. The new fit indexes perform very well at all sample sizes.
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              Significance tests and goodness of fit in the analysis of covariance structures.

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                Author and article information

                Contributors
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                25 October 2022
                2022
                : 13
                : 1002849
                Affiliations
                [1] 1Department of Psychology, University of Toledo , Toledo, OH, United States
                [2] 2Department of Psychological and Brain Sciences, Boston University , Boston, MA, United States
                [3] 3Department of Psychology, University of Nevada, Reno , Reno, NV, United States
                [4] 4Department of Psychology, Philipps-Universität Marburg , Marburg, Germany
                Author notes

                Edited by: Giulia Landi, University of Bologna, Italy

                Reviewed by: Michael Bordieri, Murray State University, United States; Roberto Cattivelli, Italian Auxological Institute (IRCCS), Italy

                *Correspondence: Clarissa W. Ong, clarissa.ong@ 123456utoledo.edu
                Stefan G. Hofmann, shofmann@ 123456bu.edu

                This article was submitted to Psychology for Clinical Settings, a section of the journal Frontiers in Psychology

                Article
                10.3389/fpsyg.2022.1002849
                9642026
                36389539
                5a79a0de-7005-4e27-baeb-eb4929d02f57
                Copyright © 2022 Ong, Hayes and Hofmann.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 25 July 2022
                : 10 October 2022
                Page count
                Figures: 9, Tables: 1, Equations: 0, References: 53, Pages: 18, Words: 12033
                Funding
                Funded by: Alexander von Humboldt-Stiftung, doi 10.13039/100005156;
                Categories
                Psychology
                Conceptual Analysis

                Clinical Psychology & Psychiatry
                process-based therapy,case study,processes of change,network analysis,process-based approach

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