Modern usages of CBT, most effectively ACT, posit a critical mediator to change is a significance placed on chosen values. The efficacy of valued choices as a motivation process facilitating change must be appreciated in the context of third-wave theory dimensions. In a word, increased emotional awareness facilitates value choices, in addition to increased cognitive & attentional flexibility.  

Syracuse University

Empirically, psychological processes of change can be categorized into the following six dimensions
-	Cognition

-	Affect

-	Attention

-	Self

-	Motivation

-	Overt behaviors



Psychological process change: Six dimensions

SG;, H. S. C. H. (n.d.). "third-wave" cognitive and behavioral therapies and the emergence of a process-based approach to intervention in psychiatry. World psychiatry : official journal of the World Psychiatric Association (WPA). Retrieved November 17, 2021, from https://pubmed.ncbi.nlm.nih.gov/34505370/?fc=None&amp;ff=20211014202414&amp;v=2.15.0. 

"Third-wave” cognitive and behavioral therapies and the emergence of a process-based approach to intervention in psychiatry

Emphasizing the changing relationship of the individual thinker and thought. Well-supported change processes include cognitive diffusion and non-reactivity. These processes mediate humane cognition by altering the relationship between the individual and their own thoughts, as opposed to seeking to change the form, frequency, or situational sensitivity of the personal thought itself. 

Psychological process change: Cognition

Third wave CBT includes additional concepts of affective processes, which focus on how an individual interacts with their emotions in the context of openness to affect, willingness to deeply engage in experiences and the ability to learn from emotional experience. Affective processes are strongly connected with acceptance, the most widely supported process of affect, including self-compassion, self- kindness and distress tolerance.

Psychological process change: Affect

Third wave CBT places strong importance on attention, especially within the usage of mindfulness-based intervention or contemplative practice, which involves training in the flexible, fluid and voluntary control of attentional processes. Such mindfulness interventions impact a broad array of change processes, thus the dimensions of mindfulness, attention and CBT significantly interact. 

Psychological process change: Attention

The concepts of self-regulation and self-management were begetting early attention in the behavior therapy era and developed further in traditional CBT, manifesting in such concepts as self-efficacy. Within the third wave of CBT, an enhanced sense of the spiritual and personal self was emphasized and utilized in evidence-based care, through such concepts as observing self, self-distancing & decentering. 

Psychological process change: Self

Psychological process change: Motivation

Behavioral targets, including restriction of safety behaviors, behavioral activation, problem-solving, social skills, planning or reductions in impulsivity. Third wave CBT has also targeted a number of skills that are often intertwined with other processes, for instance ACT’s focus on commitment to values-based actions is a skill that might mediate greater motivation. 



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