Background
Process-based therapy (PBT) focuses on how treatments work, rather than what treatments work (Hayes et al., 2020). PBT uses evidence-based processes of change that are cross-theoretical, not limited to particular therapy orientations, and use individually tailored intervention plans that focus on client needs. PBT includes identifying and testing key change processes that build upon each other and support the intervention with the individual in a particular context at a particular point in time. PBT asks what core biopsychosocial processes could be targeted with this client, given this goal, in this situation, and how can they most efficiently and effectively be changed? (Hayes et al., 2020). Recently, the utility of aligning of positive psychological interventions (PPIs) with PBT has been highlighted (Ciarrochi et al., 2022).
Aims
To demonstrate how PBT can be applied to the use of a specific PPI, namely Loving-Kindness Meditation (LKM) to improve wellbeing in an individual client.
Method
Daily client outcomes data were collected during a four-week LKM intervention using ABAB design. Measures included the Five-Facets of Mindfulness (FFMQ-15), PERMA-Profiler, modified Differential Emotions scale, and the Kessler-10. Self-reflection supported the immediate impact of LKM on both wellbeing and illbeing, highlighted the supportive influence of mindfulness skills, and identified challenges with engaging in an LKM practice. Weekly qualitative feedback from the client was also recorded.
Results
Overall, all measures showed a substantive increase from initial baseline to the first LKM intervention week, with variable patterns of plateaued or incremental gains across second baseline and intervention phases. These improvements will be discussed using PBT including the Extended Evolutionary Meta-Model (EEMM) and a network model to explain how LKM engages specific processes of change.
Conclusion
PBT innovatively informs an integrated and dynamic understanding of processes of change for a client during a PPI. In particular, PBT highlights how processes can interact to create synergistic change and sustained wellbeing outcomes for a client.