Towards an Understanding of the Process and Mechanisms of Change in Cognitive Behavioral Therapy: Linking Innovative Methodology with Fundamental Questions [Editorial]

There is now consistent evidence to support the efficacy of cognitive-behavior therapy (CBT) to reduce clinical symptoms and improve quality of life across a variety of clinical problems (Butler, Chapman, Formen, & Beck, 2006). This outcome research typically relies on a pretreatment-posttreatment design and follow-up assessments at fixed intervals beyond post-test. These outcome studies have been important in answering questions about if a treatment works and, to some extent, for whom it works. However, these designs provide much less information about the mechanisms of treatment—why or how an intervention works. There has been a resurgence of interest in studying what happens between the pretreatment and posttreatment assessment–the process of change–and a recognition of the important role of this research in treatment development