Transdiagnostic Therapy For Anxiety

In the last decade, clinical psychology has seen many advances in treatments available to help patients. One of them is transdiagnostic therapy.

Therapists usually learn how to use a specific treatment for each psychopathology. However, some studies have shown that it may be more effective to use the same treatment for multiple disorders. This concept is called transdiagnostic therapy.

Transdiagnostic therapy focuses on the common common thread that runs through various disorders. For example, panic, phobias and general anxiety share a set of characteristics that are common in all anxiety disorders. These can be troublesome or negative thoughts, physiological hyperactivation, avoidance or safety behaviors.

Does it then make sense to use one type of cognitive behavioral therapy (CAT) for each specific disorder? According to the Norton Group at the University of Houston (Norton, Hayes, & Hope 2004; Norton and Hope, 2005), the answer is no.

The researchers performed randomized clinical trials using transdiagnostic cognitive-behavioral group therapy in a group of patients with various depressive and anxiety disorders. Not only did the anxiety symptoms improve, but so did the comorbid secondary diagnosis that was not related to anxiety (depression, for example).

“According to Peter Norton, associate professor of clinical psychology and director of the Anxiety Disorder Clinic at the University of Houston (UH), the combination was more effective than KAT combined with other types of anxiety disorders, such as relaxation training.”

What does transdiagnostic therapy for anxiety look like?

The key to transdiagnostic therapy is a therapist who is able to find the common thread that runs through several anxiety disorders.

It does not matter if you suffer from panic attacks, spider phobia, or obsessive-compulsive disorder (OCD). In transdiagnostic therapy, one forgets the specific labels, and simply says that the patient suffers from anxiety. The special manifestation of anxiety does not matter.

For Clark and Watson, the tripartite model of anxiety and depression suggests that depression and anxiety have shared components (generalized negative impact) as well as unique components (anhedonia and physiological hyperactivation).

Norton used these references and assumed that adverse effects can be seen as a central psychopathological component in both anxiety and depression. Consistent with this theoretical model, the process and components of treatment are the same for different and unique manifestations of anxiety.

The common ingredients in transdiagnostic KAT are:

Psychoduka

The therapist teaches the patient about anxiety in general: what it looks like, why it happens, and why it persists. By following the tripartite model, the therapist will also offer information about the negative effects, which are common in anxiety and depression.

Mental health professionals should understand that if they manage emotionality and move away from artificial distinctions, the comorbidity of each patient will improve.

Cognitive restructuring

We know that most patients with anxiety suffer from bothersome or negative thought patterns. We also know that anxiety is a feeling of potential danger.

Studies show that the intuitive response to danger does not work properly for patients with anxiety. Their thoughts are exaggerated and out of touch with reality. Good training with cognitive reconstruction can help patients identify and modify their troublesome thoughts. They can use Socratic dialogue to replace the negative thoughts with more realistic thoughts.

For example, when someone is panicking, they often think of things like “ Am I going to have a panic attack? ”Or“ Am I going crazy? Someone with general anxiety may be thinking, ” What if my daughter is raped when she goes out tonight?” ”

Exposure and response prevention

This strategy is useful for exposing the patient to things they are afraid of. The exposure can be real, imagined or introspective. The idea is to use exposure to help patients with panic disorder deal with the emotions that often arise.

Exposure helps with the physiological habituation of anxiety, as well as anxiety triggers. The second outcome is that the patient learns to stop dealing with incidents by avoiding the situation. Coping methods include the thoughts and actions of obsessive-compulsive disorder, generalized anxiety disorder behavior, or taking sedatives for a panic disorder.

Conclusions on transdiagnostic therapy

Transdiagnostic therapy gives good results. According to Norton, patients see more improvement with transdiagnostic therapy than with regular therapy. They also see a positive impact on secondary diagnoses. Two-thirds of the comorbidities disappeared, compared with a 40% success rate when treating each individual disorder.

You can see that transdiagnostic therapy is more effective for patients in general. It is also more effective for the therapist, who can treat a group of people with the same diagnosis at the same time.

We can also conclude that researchers have underestimated the importance of other emotions, such as disgust. Recent studies have shown that anhedonia and fear also play an important role in some anxiety disorders, especially phobias and OCD.

Although researchers have not found the role of aversion in the general negative influence disorder, everything seems to indicate that there may be a generic transdiagnostic dimension of sensitivity to aversion, which may be etiologically implied in some groups of mental disorders.

Logically, CBT should include modification of said construct in new transdiagnostic protocols. But in any case, the result is very promising so far. Not only is transdiagnostic therapy effective for adults, but also for children and adolescents, who are often more difficult to diagnose.