University of Nevada, Reno, USA.
Boston University, USA.
Clin Psychol Rev. 2020 Dec;82:101908. doi: 10.1016/j.cpr.2020.101908. Epub 2020 Sep 7.
For half a century, the dominant paradigm in psychotherapy research has been to develop syndrome-specific treatment protocols for hypothesized but unproved latent disease entities, as defined by psychiatric nosological systems. While this approach provided a common language for mental health problems, it failed to achieve its ultimate goal of conceptual and treatment utility. Process-based therapy (PBT) offers an alternative approach to understanding and treating psychological problems, and promoting human prosperity. PBT targets empirically established biopsychosocial processes of change that researchers have shown are functionally important to long terms goals and outcomes. By building on concepts of known clinical utility, and organizing them into coherent theoretical models, an idiographic, functional-analytic approach to diagnosis is within our grasp. We argue that a multi-dimensional, multi-level extended evolutionary meta-model (EEMM) provides consilience and a common language for process-based diagnosis. The EEMM applies the evolutionary concepts of context-appropriate variation, selection, and retention to key biopsychosocial dimensions and levels related to human suffering, problems, and positive functioning. The EEMM is a meta-model of diagnostic and intervention approaches that can accommodate any set of evidence-based change processes, regardless of the specific therapy orientation. In a preliminary way, it offers an idiographic, functional analytic, and clinically useful alternative to contemporary psychiatric nosological systems.
半个世纪以来，心理治疗研究的主导范式一直是针对假设但未经证实的潜在疾病实体，根据精神病学分类系统制定特定综合征的治疗方案。虽然这种方法为心理健康问题提供了共同的语言，但未能实现其最终目标，即概念和治疗实用性。基于过程的治疗（PBT）为理解和治疗心理问题以及促进人类繁荣提供了一种替代方法。PBT 针对的是经过实证验证的生物心理社会变化过程，研究人员已经证明这些过程对长期目标和结果具有功能重要性。通过利用已知的临床实用概念，并将其组织成连贯的理论模型，我们可以掌握一种基于个体的、功能分析的诊断方法。我们认为，多维、多层次扩展进化元模型（EEMM）为基于过程的诊断提供了一致性和共同的语言。EEMM 将进化的适当变化、选择和保留的概念应用于与人类痛苦、问题和积极功能相关的关键生物心理社会维度和水平。EEMM 是一种诊断和干预方法的元模型，可以容纳任何一组基于证据的变化过程，而不论特定的治疗方向如何。它初步为当代精神病学分类系统提供了一种基于个体的、功能分析的和临床有用的替代方法。
