Process-based behaviour therapy: an introduction

Process-based Behaviour Therapy (PBBT®) is an exciting new scientifically-based psychotherapy that works by changing the relationship people have with themselves and helps them in redirecting their behaviour towards a more meaningful life.

The therapy was developed by the founders of Perspectives Ireland, Dr. Yvonne Barnes-Holmes and Dr. Ciara McEnteggart.

PBBT and it’s grounding in RFT

Since its inception, PBBT has offered clinicians a series of core therapeutic pieces, involving analytic and intervention aids, to understand and change complex behaviour. These pieces evolved organically from broad clinical applications of Relational Frame Theory (RFT). The success of this work has now facilitated the expansion of PBBT into a full therapy regime. What is unique about this development is that PBBT’s analyses, formulations and interventions still sit directly on top of its RFT underpinnings. This makes PBBT the only whole therapeutic programme ever developed that is underpinned entirely by RFT.

The self and others

Consistent with conceptual and empirical updates to RFT published around 2015, PBBT conceptualises clinical behaviour in terms of its meanings for the self and others, and the behavioural functions that serve these meanings. The self-meanings (i.e. self-relating) that have been acquired developmentally are organised by PBBT into three evolving time-frames that span from childhood, through adolescence, to the current time.  These ‘layers’ of meaning capture the dominant self-based ROE (relating, orienting and evoking) units that are the core basis of complex behaviour, as postulated by RFT. The self-meaning that defines each layer is identified and verified in iterative fashion through an evolving dialogue with the client. These layers or ROE units are then targeted and weakened systematically in the clinical pathway that defines PBBT from start to finish. This structure creates a respectful shared narrative which gently but precisely works back through the developmental acquisition of self-meaning to enable the PBBT practitioner to fully appreciate what clients mean to themselves and how that came to be.

Activated functions

For updated RFT, the ROE unit emphasised the dynamical interactions between meanings and their orienting and evoked functions. This reticulation between self-meaning and its functions sits at the heart of PBBT with its unique focus on activated functions (S+s). Activated functions are manifestations of meaning, and highly precise clinical analyses can be achieved when both key aspects of complex behaviour are understood as a single unit.

Working on each layer of self-meaning in PBBT naturally incorporates a systematic analysis of the activated and avoidant functions attached to the layer’s meaning. This reticulation provides the practitioner with the best possible means of creating a context and effective, palatable interventions for weakening these functions.

Recognising the importance of self-other relating is perhaps an unexpected additional critical element of PBBT. This focus comes from an appreciation of the overlap between the meanings of self and the meanings of others. This overlap naturally influences the on-going relation and functions that define therapeutic exchanges early on. Hence, the first step in PBBT is to assess the meaning the client attributes to the practitioner as a proxy for others in general. Naturally, this meaning dictates existing activated functions which have the potential to obstruct and suffocate the therapeutic alliance even before any work on self-meaning is undertaken.

PBBT for complex behaviours

Having a comprehensive understanding of the ROE units equips practitioners with a powerful tool to navigate the intricate relationship between language and its evolving functions. This knowledge enables practitioners to work with highly complex behaviours in a precise and impactful manner. By capturing the nuances within these units, practitioners can systematically design tailored interventions that facilitate significant changes for the client. This approach allows for a focused and effective therapeutic process.

To find out more about PBBT, visit the Perspectives Ireland website.

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