December 14, 2021  |  by Nicole Siegfried, Ph.D., CEDS

How can it be that, during the height of human advancement, we’re suffering more than ever?
Humans are more depressed and anxious than ever. As I write this, 1 in 5 Americans is living with a mental health disorder.

But why? Our brains are genetically programmed to be great at evaluating, threat-detecting, and problem-solving. Throughout millennia, we’ve driven progress, developed innovative technologies, and discovered new cures.

So how can it be that, during the height of human advancement, we’re suffering more than ever?

Turns out, that same genetic wiring that fuels human advancement is scorching the foundation of our mental and emotional health. Our evolutionarily advanced analytical brains may be fantastic at threat-detecting and problem-solving, but we suffer emotionally and psychologically in the process.

Analytical becomes critical. Threat-detecting becomes hyper-vigilant and pessimistic.

The Way in Is Not the Way Out

Oh, and it gets worse. When we finally recognize that we’re miserable and suffering, we lean on the same mental processes to address our symptoms of depression and anxiety.

Hello, vicious cycle. The analytical thinking skills we use to guide us out of suffering paradoxically steer us back into misery like a faulty compass.

Mental health treatment is a phenomenon in which the route into suffering cannot be the path to recovery.

But what if the mental health issue isn’t the real problem? What if the process by which we got to the problem—and the process by which we are trying to address it—are the real problems?

Enter process-based therapy.

What Is Process-Based Therapy?

Process-based therapy, or PBT, is a framework for addressing the core processes at the root of human suffering (Hayes & Hoffman, 2018). Instead of focusing on symptom reduction, PBT homes in on the mental and emotional processes perpetuating the symptoms.

At Lightfully, we’ve classified four core processes at the foundation of human suffering:

  1. Emotion dysregulation and avoidance
  2. Life without meaning and commitment
  3. Self-criticism and shame
  4. Lack of belonging and connection

Utilizing the PBT framework, we target these processes in our treatment model.

How do we target core processes? Currently, there are close to 100 diagnosis-specific, evidence-based treatments identified by the American Psychological Association. It’s nearly impossible for a clinician to become trained in every syndrome-based protocol to address the myriad of symptoms with which clients present.

Furthermore, the delivery of the evidence-based treatments in the therapy office for the individual client with a host of comorbid diagnoses and long list of medications often does not meet the replicability standards for evidence-based intervention.

A review of evidence-based therapies reveals that many evidence-based modalities share common interventions. For instance, most therapies include some version of emotion regulation and mindfulness techniques.

In PBT, the interventions that are common across evidence-based therapies are the fundamentals of clinical practice. At Lightfully, these interventions are applied based on data-driven clinical decision-making to deliver a personalized approach based on the needs of each client.

At Lightfully, we help guide clients to the path out of suffering and into living.

How Are Clinicians Trained in PBT?

Process-based therapy requires robust and intentional training for clinicians to be able to deliver interventions effectively and proficiently. Competency-based and feedback-driven training is the gold standard for clinical training programs.

At Lightfully, under the leadership of Amber Parris Claudon, LICSW, Vice President of Clinical Training, we have developed the Equip Model of training to ensure that clinicians are competent and proficient in PBT.

Unique to Lightfully, Equip integrates a “learn, practice, share” method of training in which clinicians first learn the methods, practice the methods under supervision, and then share their practice for feedback from peers and supervisors (through video recordings or direct observation) to achieve competence in each of the therapeutic interventions. Equip ensures that clinicians are well-trained and delivering PBT effectively.

Process-based therapy is the foundation of the Lightfully clinical model. This model provides the framework for how we understand mental health disorders and treat our clients. PBT is at the heart of our clinical philosophy in which clients are treated as more than a diagnosis or a symptom profile and treatment is more than a manual or a protocol.

At our mental health treatment center, we help guide clients to the path out of suffering and into living.


About the Author

Dr. Nicole Siegfried is the Chief Clinical Officer for Lightfully Behavioral Health. She is a licensed clinical psychologist and serves as an adjunct assistant professor of psychology at University of Alabama at Birmingham. She has worked in mental health for over 20 years and has served in national leadership positions for the past 10 years.

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