Nonhierarchical, Multidirectional, and Oscillatory Processing in Neuroscience-Informed Cognitive-Behavior Therapy

Since the first neuroscience-informed cognitive-behavior therapy (nCBT) article was published in the Journal of Mental Health Counseling in 2015, the model has evolved to reflect developments in the scientific literature. In this article, we describe a more integrated and consilient framework that reflects the harmonious, synergistic, and complementary relationship among nervous systems and brain structures in which no single system or structure has dominance or primacy over another. We review literature on nonhierarchical and multidirectional understandings of the dual process model and oscillatory transitions between the two processing systems. We also discuss current thinking regarding brain development and unsupported theories. We propose an updated nCBT model to support new information regarding brain processing. A case study is woven throughout, to provide an example of how these concepts might be applied in clinical practice.