Transdiagnostic Therapy

Key points

Transdiagnostic therapy

The American Psychological Association’s Society of Clinical Psychology (Division 12) maintains a regularly updated database of psychotherapies deemed to meet evidentiary standards to be considered Research Supported Psychological Therapies. Within the anxiety and related disorders, cognitive therapy, behavioral therapy, or cognitive–behavioral therapy (CBT) are considered to have strong research support, defined as treatments for which “well-designed studies conducted by independent

Rationale for transdiagnostic cognitive–behavioral therapy

The case for a transdiagnostic perspective to anxiety disorders6, 10 is founded on (1) arguments regarding the dissemination and accessibility of CBT, (2) the clinical presentation of anxiety and depressive disorders, and (3) the structure of emotional disorders.¹¹

Preparation for transdiagnostic cognitive–behavioral therapy: assessment and case formulation

Although the knowledge base on the transdiagnostic case conceptualization and treatment of emotional disorders is growing rapidly, the development of transdiagnostic measures that reflect a common pathology framework is not evolving at the same pace.³⁷ The emphasis on categorical diagnostic classification systems (ie, DSM-5, International Classification of Diseases-10) has led to the development of clinician-rated structured interviews, including the commonly used Structured Clinical Interview

Implementing transdiagnostic cognitive–behavioral therapy

At their core, most transdiagnostic CBT protocols incorporate psychoeducation and some degree of cognitive restructuring and exposure therapy, although variations in the intensity and target of each approach exist across transdiagnostic CBT protocols. A general transdiagnostic CBT framework is presented here, followed by specific variations within the most well-studied treatment protocols.

Psychoeducation provides factual information regarding the nature and causes of anxiety disorders, as well

Empirical outcomes data on transdiagnostic cognitive–behavioral therapy

Given the general paucity of follow-up outcome studies for transdiagnostic CBT, the available published data on the efficacy of transdiagnostic CBT for anxiety disorders will be broken down into, first, short-term or immediate posttreatment outcomes, followed by the limited available longer term outcomes.

Summary and future directions

As noted elsewhere,⁷⁷ transdiagnostic CBT for anxiety and related disorder has undergone considerable growth over the past 2 decades since the initial theoretic models⁶ and trials were published.55, 78 For 2016, the Scopus database (accessed 14 February, 2017) returns 83 documents containing the search terms “(Transdiagnostic) AND (Anxiety) AND ((Therapy) or (Intervention))”, suggesting widespread investigation into these interventions. Transdiagnostic CBT approaches for multiple and comorbid