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Transdiagnostic Cognitive Behavioral Psychotherapy: Unified Protocol as an Example

Year 2023, Volume: 15 Issue: 1, 12 - 28, 31.03.2023
https://doi.org/10.18863/pgy.1064590

Abstract

The fact that there are many limitations of the current classification systems led to the emergence of transdiagnostic approaches (TA) that focus on the common psychopathological processes underlying disorders rather than categorical diagnoses. TA focuses on the underlying common psychopathological processes in the emergence and persistence of mental disorders. Thus, even if the disorders are categorically diagnosed differently, it can be determined how they overlap or separate with each other. TA aims to treat mental disorders using these aspects. TA has a flexible and modular structure that can be easily integrated into cognitive behavioral therapies. The rest of this review will focus on the Unified Protocol (UP), one of the most popular TA examples. The main purpose of the UP is to enable patients to recognize their feelings and give more adaptive reactions to their negative emotions. Accordingly, UP consists of eight modules. The modules can usually be completed in a total of 11 - 17 weeks. Each 50 to 60-minute individual session is held once a week. If necessary, changes can be made to the number or the frequency of sessions allocated to modules. The goals of each module of the UP and the treatment approaches towards these goals allow a very clearly defined approach. For this reason, there is a need for a detailed evaluation, conceptualization and treatment plan before the UP is put into practice. We hope that mental health professionals from Turkey will contribute to the developments in the UP.

References

  • 1. Allen LB, Tsao JC, Seidman LC, Ehrenreich-May J, Zeltzer LK (2012) A unified, transdiagnostic treatment for adolescents with chronic pain and comorbid anxiety and depression. Cognitive and Behavioral Practice, 19(1): 56-67.
  • 2. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
  • 3. Ametaj AA, Sarver NW, Anakwenze O, Ito M, Rattner-Castro M, Potluri S (2018) In: Applications of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Barlow DH, Farchione TJ (editors): pp. 268-290. New York: Oxford University Press.
  • 4. Andersen P, Toner P, Bland M, McMillan D (2016) Effectiveness of transdiagnostic cognitive behaviour therapy for anxiety and depression in adults: a systematic review and meta-analysis. Behavioural and cognitive psychotherapy, 44(6): 673-690.
  • 5. Barlow DH (1988) Anxiety and its disorders: The nature and treatment of anxiety and panic. New York, NY: Guilford Press.
  • 6. Barlow DH (2002) Anxiety and its disorders: The nature and treatment of anxiety and panic. 2d ed. New York, NY: Guilford Press.
  • 7. Barlow DH, Allen LB, Choate ML (2004) Toward a unified treatment for emotional disorders. Behavior Therapy, 35: 205–230.
  • 8. Barlow DH, Farchione TJ, Bullis JR, Gallagher MW, Murray-Latin H, Sauer-Zavala S, ... Ametaj A (2017) The unified protocol for transdiagnostic treatment of emotional disorders compared with diagnosis-specific protocols for anxiety disorders: A randomized clinical trial. JAMA psychiatry, 74(9): 875-884.
  • 9. Barlow DH, Farchione TJ, Fairholme CP, Ellard KK, Boisseau CL, Allen LB, Ehrenreich-May J (2011) Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist guide. New York, NY: Oxford University Press.
  • 10. Barlow DH, Farchione TJ, Sauer-Zavala S, Latin H, Ellard KK . . ., Cassiello-Robbins C (2018) Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist guide. 2nd ed. New York, NY: Oxford University Press.
  • 11. Barlow DH, Sauer-Zavala S, Carl JR, Bullis JR, Ellard KK (2014) The nature, diagnosis, and treatment of neuroticism: Back to the future. Clinical Psychological Science, 2(3): 344–365.
  • 12. Barlow DH, Farchione TJ (2018) Applications of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. New York: Oxford University Press.
  • 13. Batmaz S (2018) Ergen Psikopatolojisine Transdiyagnostik Yaklaşım. Bildik T, editör. Ergenlik Dönemi ve Ruhsal Bozukluklar. Ankara: Türkiye Klinikleri, pp. 74-83.
  • 14. Beck AT (1976) Cognitive therapy and the emotional disorders. Madison, CT: International Universities Press.
  • 15. Bentley KH (2017) Applying the Unified Protocol Transdiagnostic Treatment to Nonsuicidal Self‐Injury and Co‐Occurring Emotional Disorders: A Case Illustration. Journal of clinical psychology, 73(5): 547-558.
  • 16. Bentley KH, Boettcher H, Bullis JR, Carl JR, Conklin LR, Sauer-Zavala S, ... & Barlow DH (2018) Development of a single-session, transdiagnostic preventive intervention for young adults at risk for emotional disorders. Behavior modification, 42(5): 781-805.
  • 17. Bentley KH, Sauer-Zavala S, Cassiello-Robbins CF, Conklin LR, Vento S, Homer D (2017) Treating suicidal thoughts and behaviors within an emotional disorders framework: Acceptability and feasibility of the unified protocol in an inpatient setting. Behavior modification, 41(4): 529-557.
  • 18. Boettcher H, Conklin LR (2018) Transdiagnostic assessment and case formulation rationale and application with the unified protocol. Barlow DH, Farchione TJ (editors). Applications of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. New York: Oxford University Press, pp. 17-37.
  • 19. Brown TA, Antony MM, Barlow DH (1995) Diagnostic comorbidity in panic disorder: Effect on treatment outcome and course of comorbid diagnoses following treatment. Journal of Consulting and Clinical Psychology, 63: 408–418.
  • 20. Brown TA, Campbell LA, Lehman CL, Grisham JR, Mancill RB (2001) Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of Abnormal Psychology, 110: 49–58.
  • 21. Brown TA, Chorpita BF, Barlow DH (1998) Structural relationships among dimensions of the DSM-IV anxiety and mood disorders and dimensions of negative affect, positive affect, and autonomic arousal. Journal of Abnormal Psychology, 107: 179–192.
  • 22. Bullis JR, Fortune MR, Farchione TJ, Barlow DH (2014) A preliminary investigation of the long-term outcome of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Comprehensive psychiatry, 55(8): 1920-1927.
  • 23. Bullis JR, Sauer-Zavala S, Bentley KH, Thompson-Hollands J, Carl JR, Barlow DH (2015) The unified protocol for transdiagnostic treatment of emotional disorders: preliminary exploration of effectiveness for group delivery. Behavior Modification, 39(2): 295-321.
  • 24. Carl JR, Gallagher MW, Sauer-Zavala SE, Bentley KH, Barlow DH (2014) A preliminary investigation of the effects of the unified protocol on temperament. Comprehensive psychiatry, 55(6): 1426-1434.
  • 25. Cassiello-Robbins C, Sauer-Zavala S, Wilner JG, Bentley KH, Conklin LR, Farchione TJ, Barlow DH (2018) A preliminary examination of the effects of transdiagnostic versus single diagnosis protocols on anger during the treatment of anxiety disorders. The Journal of nervous and mental disease, 206(7): 549-554.
  • 26. Clark DM (1986) A cognitive approach to panic. Behaviour Research and Therapy, 24: 461–470.
  • 27. Clark LA, Watson D (1991) Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 103: 103–116.
  • 28. Dalgleish T, Black M, Johnston D, Bevan A (2020) Transdiagnostic approaches to mental health problems: Current status and future directions. Journal of consulting and clinical psychology, 88(3): 179-195.
  • 29. de Ornelas Maia ACC, Nardi AE, Cardoso A (2015) The utilization of unified protocols in behavioral cognitive therapy in transdiagnostic group subjects: A clinical trial. Journal of affective disorders, 172: 179-183.
  • 30. de Ornelas Maia ACC, Sanford J, Boettcher H, Nardi AE, Barlow D (2017) Improvement in quality of life and sexual functioning in a comorbid sample after the unified protocol transdiagnostic group treatment. Journal of psychiatric research, 93: 30-36.
  • 31. De Paul NF, Caver KA (2021) A pilot study of a brief group adaptation of the Unified Protocol in integrated primary care. Psychological Services, 18(3): 416-425.
  • 32. Eckhardt S, Martell C, Lowe KD, Le Grange D, Ehrenreich-May J (2019) An ARFID case report combining family-based treatment with the unified protocol for Transdiagnostic treatment of emotional disorders in children. Journal of eating disorders, 7(1): 34. doi: 10.1186/s40337-019-0267-x.
  • 33. Ehrenreich JT, Goldstein CR, Wright LR, Barlow DH (2009) Development of a unified protocol for the treatment of emotional disorders in youth. Child & family behavior therapy, 31(1): 20-37.
  • 34. Ehrenreich-May J, Rosenfield D, Queen AH, Kennedy SM, Remmes CS, Barlow DH (2017) An initial waitlist-controlled trial of the unified protocol for the treatment of emotional disorders in adolescents. Journal of Anxiety Disorders, 46: 46-55.
  • 35. Ellard KK, Bernstein EE, Hearing C, Baek JH, Sylvia LG, Nierenberg AA, ... Deckersbach T (2017) Transdiagnostic treatment of bipolar disorder and comorbid anxiety using the Unified Protocol for Emotional Disorders: A pilot feasibility and acceptability trial. Journal of affective disorders, 219: 209-221.
  • 36. Ellard KK, Deckersbach T, Sylvia LG, Nierenberg AA, Barlow DH (2012) Transdiagnostic treatment of bipolar disorder and comorbid anxiety with the unified protocol: a clinical replication series. Behavior modification, 36(4): 482-508.
  • 37. Ewing DL, Monsen JJ, Thompson EJ (2015) A meta-analysis of transdiagnostic cognitive behavioural therapy in the treatment of child and young person anxiety disorders. Behavioural and Cognitive Psychotherapy, 43: 562-77.
  • 38. Farchione TJ, Fairholme CP, Ellard KK, Boisseau CL, Thompson-Hollands J, Carl JR, ... Barlow DH (2012) Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behavior therapy, 43(3): 666-678.
  • 39. Fichter MM, Quadflieg N, Fischer UC, Kohlboeck G (2010) Twenty-five-year course and outcome in anxiety and depression in the Upper Bavarian Longitudinal Community Study. Acta Psychiatrica Scandinavica, 122: 75–85.
  • 40. Fidel SK, Alcántara AT, Castan EC, Costa GR, Diez CQ, Lligoña AG, ... Peri JN (2015) Unified Protocol for psychiatric and psychological assessment of candidates for transplantation of organs and tissues, PSI-CAT. Revista de psiquiatria y salud mental, 8(3): 130-136.
  • 41. Fried EI (2017) The 52 symptoms of major depression: Lack of content overlap among seven common depression scales. Journal of Affective Disorders, 208: 191–197.
  • 42. Fried EI, Nesse RM (2015) Depression is not a consistent syndrome: An investigation of unique symptom patterns in the STAR_D study. Journal of Affective Disorders, 172: 96–102.
  • 43. Galatzer-Levy IR, Bryant RA (2013) 636,120 ways to have posttraumatic stress disorder. Perspectives on Psychological Science, 8: 651–662.
  • 44. Gallagher MW, Sauer-Zavala SE, Boswell JF, Carl JR, Bullis J, Farchione TJ, Barlow DH (2013) The impact of the unified protocol for emotional disorders on quality of life. International journal of cognitive therapy, 6(1): 57-72.
  • 45. Garcia-Escalera J, Chorot P, Valiente RM (2016) Efficacy of transdiagnostic cognitive-behavioral therapy for anxiety and depression in adults, children and adolescents: A metaanalysis. Revista de Psicopatologia y Psicologia Clinica, 21: 147-75.
  • 46. Girio-Herrera E, Ehrenreich-May J (2014) Using flexible clinical processes in the Unified Protocol for the Treatment of Emotional Disorders in Adolescence. Psychotherapy, 51(1): 117-122.
  • 47. Gorman JM (2007) The essential guide to psychiatric drugs. 4th ed. New York, NY: St. Martin’s Griffin.
  • 48. Gray JA (1982) The neuropsychology of anxiety. New York, NY: Oxford University Press.
  • 49. Gündüz A, Gündoğmuş İ, Sertçelik S, Engin BH, İşler A, Çipil A, Sungur MZ (2019) Validity and Reliability of Cognitive Attentional Syndrome-1 Questionnaire. Psychiatry investigation, 16(5): 355-362.
  • 50. Harvey AG, Watkins ER, Mansell W, Shafran R (2004) Cognitive behavioural processes across psychological disorders: A transdiagnostic approach in research and treatment. Oxford, UK: Oxford University Press.
  • 51. Haslam N, Holland E, Kuppens P (2012) Categories versus dimensions in personality and psychopathology: A quantitative review of taxometric research. Psychological Medicine, 42: 903–920.
  • 52. Hawks JL, Kennedy SM, Holzman JB, Ehrenreich–May J (2019) Development and Application of an Innovative Transdiagnostic Treatment Approach for Pediatric Irritability. Behavior Therapy, 51(2): 334-349.
  • 53. Hayes SC, Hofmann SG (Eds.) (2018) Process-based CBT: The science and core clinical competencies of cognitive behavioral therapy. Oakland, CA: New Harbinger Publications.
  • 54. Hayes SC, Strosahl KD, Wilson KG (2011) Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.
  • 55. Hayes SC, Wilson KG, Gifford EV, Follette VM, Strosahl K (1996) Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64: 1152–1168.
  • 56. Ito M, Horikoshi M, Kato N, Oe Y, Fujisato H, Nakajima S, ... Usuki M (2016) Transdiagnostic and transcultural: pilot study of unified protocol for depressive and anxiety disorders in Japan. Behavior therapy, 47(3): 416-430.
  • 57. Kabat-Zinn J (1982) An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General Hospital Psychiatry, 4: 33–47.
  • 58. Kendler KS (2012) The dappled nature of causes of psychiatric illness: Replacing the organic-functional/hardware-software dichotomy with empirically based pluralism. Molecular Psychiatry, 17: 377–388.
  • 59. Kennedy AK, Barlow DH (2018) The unified protocol for transdiagnostic treatment of emotional disorders. An introduction. Barlow, D. H., & Farchione, T. J. (editors). Applications of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. New York: Oxford University Press, pp. 1-16.
  • 60. Kennedy SM, Bilek EL, Ehrenreich-May J (2019) A randomized controlled pilot trial of the unified protocol for transdiagnostic treatment of emotional disorders in children. Behavior modification, 43(3): 330-360.
  • 61. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE (2005) Prevalence, severity, and comorbidity of 12-month DSM–IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62: 617–627.
  • 62. Khakpoor S, Saed O, Armani Kian A (2019) Emotion regulation as the mediator of reductions in anxiety and depression in the Unified Protocol (UP) for transdiagnostic treatment of emotional disorders: double-blind randomized clinical trial. Trends in psychiatry and psychotherapy, 41(3): 227-236.
  • 63. Kotov R, Krueger RF, Watson D. (2018) A paradigm shift in psychiatric classification: The Hierarchical Taxonomy Of Psychopathology (HiTOP). World Psychiatry, 17: 24–25.
  • 64. Laposa JM, Mancuso E, Abraham G, Loli-Dano L (2017) Unified protocol transdiagnostic treatment in group format: a preliminary investigation with anxious individuals. Behavior modification, 41(2): 253-268.
  • 65. Leahy RL (2015) Emotional schema therapy. Guilford Publications.
  • 66. Linehan M (2014) DBT Skills training manual. Guilford Publications.
  • 67. Maia ACC, Braga AA, Nunes CA, Nardi AE, Silva AC (2013) Transdiagnostic treatment using a unified protocol: application for patients with a range of comorbid mood and anxiety disorders. Trends in psychiatry and psychotherapy, 35(2): 134-140.
  • 68. Mansell W, Carey TA, Tai S (2012) A Transdiagnostic approach to CBT using method of levels therapy. East Sussex: Routledge.
  • 69. Mansell W, Harvey A, Watkins E, Shafran R (2008) Cognitive behavioural processes across psychological disorders: A review of the utility and validity of the transdiagnostic approach. International Journal of Cognitive Therapy, 1: 181–191.
  • 70. Mohajerin B, Bakhtiyar M, Olesnycky OS, Dolatshahi B, Motabi F (2019) Application of a transdiagnostic treatment for emotional disorders to body dysmorphic disorder: A randomized controlled trial. Journal of affective disorders, 245: 637-644.
  • 71. Mohammadi A, Soleimani M, Mohammadi MR, Abasi I, Foroughi AA (2019) Unified Protocol for Transdiagnostic Prevention of Depression and Anxiety in Iranian Adolescents: Protocol Development and Initial Outcome Data. Iranian journal of psychiatry, 14(2): 171-178.
  • 72. Mohsenabadi H, Zanjani Z, Shabani MJ, Arj A (2018) A randomized clinical trial of the Unified Protocol for Transdiagnostic treatment of emotional and gastrointestinal symptoms in patients with irritable bowel syndrome: evaluating efficacy and mechanism of change. Journal of psychosomatic research, 113: 8-15.
  • 73. Newby JM, McKinnon A, Kuyken W, Gilbody S, Dalgleish T (2015) Systematic review and meta-analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood. Clinical psychology review, 40: 91-110.
  • 74. Newby JM, Twomey C, Li S, Andrews G (2016) Transdiagnostic computerised cognitive behavioural therapy for depression and anxiety: A systematic review and meta-analysis. Journal of Affective Disorders, 199: 30–41.
  • 75. Newman MG, Llera SJ (2011) A novel theory of experiential avoidance in generalized anxiety disorder: A review and synthesis of research supporting a contrast avoidance model of worry. Clinical Psychology Review, 31(3): 371–382.
  • 76. Nolen-Hoeksema S (1991) Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology, 100: 569–582.
  • 77. Norcross JC, Wampold BE (2011) Evidence-based therapy relationships: Research conclusions and clinical practices. Psychotherapy, 48: 98–102.
  • 78. Nordahl H, Wells A (2019) Measuring the Cognitive Attentional Syndrome Associated with Emotional Distress: Psychometric Properties of the CAS-1. International Journal of Cognitive Therapy, 12(4): 292-306.
  • 79. Oğuz G, Batmaz S (2020) Transdiyagnostik Bilişsel Davranışçı Yaklaşıma Göre Psikopatolojik Süreçlerin Değerlendirilmesi: Bilişsel ve Davranışçı Süreçler Ölçeği'nin Türkçe Sürümünün Geçerliliği ve Güvenilirliği. Journal of Cognitive-Behavioral Psychotherapy and Research, 9(3): 173-186.
  • 80. Osma J, Sánchez-Gómez A, Peris-Baquero Ó (2018) Applying the unified protocol to a single case of major depression with schizoid and depressive personality traits. Psicothema, 30(4): 364-369.
  • 81. Păsărelu CR, Andersson G, Bergman Nordgren L, Dobrean A (2017) Internet-delivered transdiagnostic and tailored cognitive behavioral therapy for anxiety and depression: a systematic review and meta-analysis of randomized controlled trials. Cognitive Behaviour Therapy, 46(1): 1–28.
  • 82. Patel T, Mansell W, Veale D (2015) The cognitive behavioural processes questionnaire: a preliminary analysis within student, mixed clinical and community samples and the identification of a core transdiagnostic process. Cognitive Therapy and Research, 39(2): 193-203.
  • 83. Pearl SB, Norton PJ (2016) Transdiagnostic versus diagnosis specific cognitive behavioural therapies for anxiety: A meta-analysis. Journal of Anxiety Disorders, 46: 11–24.
  • 84. Rachman S, de Silva P (1978) Abnormal and normal obsessions. Behaviour Research and Therapy, 16(4): 233–248.
  • 85. Reinholt N, Aharoni R, Winding C, Rosenberg N, Rosenbaum B, Arnfred S (2017) Transdiagnostic group CBT for anxiety disorders: the unified protocol in mental health services. Cognitive behaviour therapy, 46(1): 29-43.
  • 86. Reinholt N, Krogh J (2014) Efficacy of transdiagnostic cognitive behaviour therapy for anxiety disorders: a systematic review and meta-analysis of published outcome studies. Cognitive Behaviour Therapy, 43(3): 171-184.
  • 87. Reiss S (1991) Expectancy model of fear, anxiety, and panic. Clinical Psychology Review, 11: 141–153.
  • 88. Rosellini AJ, Boettcher H, Brown TA, Barlow DH (2015) A transdiagnostic temperament-phenotype profile approach to emotional disorder classification: An update. Psychopathology Review, 2: 110–128.
  • 89. Sakiris N, Berle D (2019) A systematic review and meta-analysis of the unified protocol as a transdiagnostic emotion regulation based intervention. Clinical psychology review, 72: 101751. doi: 10.1016/j.cpr.2019.101751.
  • 90. Santor DA, Gregus M, Welch A (2006) FOCUS ARTICLE: Eight Decades of Measurement in Depression. Measurement: Interdisciplinary Research and Perspectives, 4: 135–155.
  • 91. Sauer-Zavala S, Bentley KH, Steele SJ, Tirpak JW, Ametaj AA, Nauphal M, ... Barlow DH (2020) Treating depressive disorders with the Unified Protocol: A preliminary randomized evaluation. Journal of Affective Disorders, 264: 438-445.
  • 92. Sauer-Zavala S, Boswell JF, Gallagher MW, Bentley KH, Ametaj A, Barlow DH (2012) The role of negative affectivity and negative reactivity to emotions in predicting outcomes in the unified protocol for the transdiagnostic treatment of emotional disorders. Behaviour research and therapy, 50(9): 551-557.
  • 93. Sauer-Zavala S, Cassiello-Robbins C, Ametaj AA, Wilner JG, Pagan D (2019) Transdiagnostic treatment personalization: The feasibility of ordering unified protocol modules according to patient strengths and weaknesses. Behavior modification, 43(4): 518-543.
  • 94. Sauer-Zavala S, Cassiello-Robbins C, Conklin LR, Bullis JR, Thompson-Hollands J, Kennedy KA (2017b) Isolating the unique effects of the unified protocol treatment modules using single case experimental design. Behavior modification, 41(2): 286-307.
  • 95. Sauer-Zavala S, Gutner CA, Farchione TJ, Boettcher HT, Bullis JR, Barlow DH (2017a) Current definitions of “transdiagnostic” in treatment development: A search for consensus. Behavior Therapy, 48: 128–138.
  • 96. Stanton K, McDonnell CG, Hayden EP, Watson D (2020) Transdiagnostic approaches to psychopathology measurement: Recommendations for measure selection, data analysis, and participant recruitment. Journal of Abnormal Psychology, 129(1): 21-28.
  • 97. Steele SJ, Farchione TJ, Cassiello-Robbins C, Ametaj A, Sbi S, Sauer-Zavala S, Barlow DH (2018) Efficacy of the Unified Protocol for transdiagnostic treatment of comorbid psychopathology accompanying emotional disorders compared to treatments targeting single disorders. Journal of psychiatric research, 104: 211-216.
  • 98. Trosper SE, Buzzella BA, Bennett SM, Ehrenreich JT (2009) Emotion regulation in youth with emotional disorders: Implications for a unified treatment approach. Clinical Child and Family Psychology Review, 12(3): 234-254.
  • 99. Tulbure BT, Rusu A, Sava FA, Sălăgean N, Farchione TJ (2018) A web-based transdiagnostic intervention for affective and mood disorders: randomized controlled trial. JMIR mental health, 5(2): e36. doi: 10.2196/mental.8901.
  • 100. van Loo HM, Romeijn JW (2015) Psychiatric comorbidity: Fact or artifact? Theoretical Medicine and Bioethics, 36: 41–60.
  • 101. Varkovitzky RL, Sherrill AM, Reger GM (2018) Effectiveness of the unified protocol for Transdiagnostic treatment of emotional disorders among veterans with posttraumatic stress disorder: a pilot study. Behavior modification, 42(2): 210-230.
  • 102. Wegner DM, Schneider DJ, Carter SR, White TL (1987) The paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53: 5–13.
  • 103. Wells A (2011) Metacognitive therapy for anxiety and depression. Guilford press.
  • 104. Wittchen HU, Nocon A, Beesdo K, Pine DS, Hofler M, Lieb R, Gloster AT (2008) Agoraphobia and panic. Prospective longitudinal relations suggest a rethinking of diagnostic concepts. Psychotherapy and Psychosomatics, 77: 147–157.
  • 105. World Health Organization (‎1992)‎ The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. World Health Organization.

Ötetanısal (Transdiyagnostik) Bilişsel Davranışçı Psikoterapi: Bütünleşik Protokol Örneği

Year 2023, Volume: 15 Issue: 1, 12 - 28, 31.03.2023
https://doi.org/10.18863/pgy.1064590

Abstract

Kategorik sınıflandırmaya imkân veren yaklaşımların pek çok kısıtlılığının olması, tanılardan ziyade tanıların altında yatan ortak psikopatolojik süreçlere odaklanan ve kesitsel yerine boylamsal (uzunlamasına) değerlendirmeyi vurgulayan ötetanısal (transdiyagnostik, tanılarötesi) yaklaşımların (ÖY) öne çıkmasına yol açmıştır. ÖY ruhsal bozuklukların ortaya çıkmasında ve sürmesinde altta yatan ortak psikopatolojik süreçlere odaklanır. Böylelikle kategorik açıdan bozukluklar farklı şekilde tanı alsa dahi birbirleriyle ne açıdan örtüştükleri ya da ayrıştıkları tespit edilebilir. ÖY, bu yönleri kullanarak ruhsal bozuklukları tedavi etmeyi amaçlar. ÖY, bilişsel davranışçı terapilerin işleyişine kolaylıkla entegre edilebilecek esnek ve modüler bir yapıya sahiptir. Bu gözden geçirme yazısının geri kalan kısmında en popüler ÖY örneklerinden biri olan Bütünleşik Protokol (BP) üzerinde durulacaktır. BP’de temel amaç hastaların duygularını tanımaları ve olumsuz nitelikteki duygularına daha işlevsel tepkiler vermelerini sağlamaktır. Bu doğrultuda BP sekiz modülden oluşur. Modüller genellikle haftada bir sıklıkta, her biri 50 – 60 dakika süren bireysel görüşmeler ile toplam 11 – 17 hafta içerisinde tamamlanabilir. Gereklilik olması halinde modüllere ayrılan oturum sayılarında veya oturumların sıklığında değişiklik yapılabilir. BP’nin her bir modülü hedefleri ve bu hedeflere dönük tedavi yaklaşımları son derece net bir şekilde belirlenmiş bir yaklaşıma imkân verir. Bu nedenle BP’nin uygulamaya geçirilmesinden önce detaylı bir değerlendirme, olgu kavramsallaştırması ve tedavi planı ortaya çıkarma gereği vardır. BP konusundaki gelişmelere Türkiye’den ruh sağlığı ve hastalıkları uzmanları ve çalışanlarının da katkı yapması ümit edilmektedir.

References

  • 1. Allen LB, Tsao JC, Seidman LC, Ehrenreich-May J, Zeltzer LK (2012) A unified, transdiagnostic treatment for adolescents with chronic pain and comorbid anxiety and depression. Cognitive and Behavioral Practice, 19(1): 56-67.
  • 2. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
  • 3. Ametaj AA, Sarver NW, Anakwenze O, Ito M, Rattner-Castro M, Potluri S (2018) In: Applications of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Barlow DH, Farchione TJ (editors): pp. 268-290. New York: Oxford University Press.
  • 4. Andersen P, Toner P, Bland M, McMillan D (2016) Effectiveness of transdiagnostic cognitive behaviour therapy for anxiety and depression in adults: a systematic review and meta-analysis. Behavioural and cognitive psychotherapy, 44(6): 673-690.
  • 5. Barlow DH (1988) Anxiety and its disorders: The nature and treatment of anxiety and panic. New York, NY: Guilford Press.
  • 6. Barlow DH (2002) Anxiety and its disorders: The nature and treatment of anxiety and panic. 2d ed. New York, NY: Guilford Press.
  • 7. Barlow DH, Allen LB, Choate ML (2004) Toward a unified treatment for emotional disorders. Behavior Therapy, 35: 205–230.
  • 8. Barlow DH, Farchione TJ, Bullis JR, Gallagher MW, Murray-Latin H, Sauer-Zavala S, ... Ametaj A (2017) The unified protocol for transdiagnostic treatment of emotional disorders compared with diagnosis-specific protocols for anxiety disorders: A randomized clinical trial. JAMA psychiatry, 74(9): 875-884.
  • 9. Barlow DH, Farchione TJ, Fairholme CP, Ellard KK, Boisseau CL, Allen LB, Ehrenreich-May J (2011) Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist guide. New York, NY: Oxford University Press.
  • 10. Barlow DH, Farchione TJ, Sauer-Zavala S, Latin H, Ellard KK . . ., Cassiello-Robbins C (2018) Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist guide. 2nd ed. New York, NY: Oxford University Press.
  • 11. Barlow DH, Sauer-Zavala S, Carl JR, Bullis JR, Ellard KK (2014) The nature, diagnosis, and treatment of neuroticism: Back to the future. Clinical Psychological Science, 2(3): 344–365.
  • 12. Barlow DH, Farchione TJ (2018) Applications of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. New York: Oxford University Press.
  • 13. Batmaz S (2018) Ergen Psikopatolojisine Transdiyagnostik Yaklaşım. Bildik T, editör. Ergenlik Dönemi ve Ruhsal Bozukluklar. Ankara: Türkiye Klinikleri, pp. 74-83.
  • 14. Beck AT (1976) Cognitive therapy and the emotional disorders. Madison, CT: International Universities Press.
  • 15. Bentley KH (2017) Applying the Unified Protocol Transdiagnostic Treatment to Nonsuicidal Self‐Injury and Co‐Occurring Emotional Disorders: A Case Illustration. Journal of clinical psychology, 73(5): 547-558.
  • 16. Bentley KH, Boettcher H, Bullis JR, Carl JR, Conklin LR, Sauer-Zavala S, ... & Barlow DH (2018) Development of a single-session, transdiagnostic preventive intervention for young adults at risk for emotional disorders. Behavior modification, 42(5): 781-805.
  • 17. Bentley KH, Sauer-Zavala S, Cassiello-Robbins CF, Conklin LR, Vento S, Homer D (2017) Treating suicidal thoughts and behaviors within an emotional disorders framework: Acceptability and feasibility of the unified protocol in an inpatient setting. Behavior modification, 41(4): 529-557.
  • 18. Boettcher H, Conklin LR (2018) Transdiagnostic assessment and case formulation rationale and application with the unified protocol. Barlow DH, Farchione TJ (editors). Applications of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. New York: Oxford University Press, pp. 17-37.
  • 19. Brown TA, Antony MM, Barlow DH (1995) Diagnostic comorbidity in panic disorder: Effect on treatment outcome and course of comorbid diagnoses following treatment. Journal of Consulting and Clinical Psychology, 63: 408–418.
  • 20. Brown TA, Campbell LA, Lehman CL, Grisham JR, Mancill RB (2001) Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of Abnormal Psychology, 110: 49–58.
  • 21. Brown TA, Chorpita BF, Barlow DH (1998) Structural relationships among dimensions of the DSM-IV anxiety and mood disorders and dimensions of negative affect, positive affect, and autonomic arousal. Journal of Abnormal Psychology, 107: 179–192.
  • 22. Bullis JR, Fortune MR, Farchione TJ, Barlow DH (2014) A preliminary investigation of the long-term outcome of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Comprehensive psychiatry, 55(8): 1920-1927.
  • 23. Bullis JR, Sauer-Zavala S, Bentley KH, Thompson-Hollands J, Carl JR, Barlow DH (2015) The unified protocol for transdiagnostic treatment of emotional disorders: preliminary exploration of effectiveness for group delivery. Behavior Modification, 39(2): 295-321.
  • 24. Carl JR, Gallagher MW, Sauer-Zavala SE, Bentley KH, Barlow DH (2014) A preliminary investigation of the effects of the unified protocol on temperament. Comprehensive psychiatry, 55(6): 1426-1434.
  • 25. Cassiello-Robbins C, Sauer-Zavala S, Wilner JG, Bentley KH, Conklin LR, Farchione TJ, Barlow DH (2018) A preliminary examination of the effects of transdiagnostic versus single diagnosis protocols on anger during the treatment of anxiety disorders. The Journal of nervous and mental disease, 206(7): 549-554.
  • 26. Clark DM (1986) A cognitive approach to panic. Behaviour Research and Therapy, 24: 461–470.
  • 27. Clark LA, Watson D (1991) Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 103: 103–116.
  • 28. Dalgleish T, Black M, Johnston D, Bevan A (2020) Transdiagnostic approaches to mental health problems: Current status and future directions. Journal of consulting and clinical psychology, 88(3): 179-195.
  • 29. de Ornelas Maia ACC, Nardi AE, Cardoso A (2015) The utilization of unified protocols in behavioral cognitive therapy in transdiagnostic group subjects: A clinical trial. Journal of affective disorders, 172: 179-183.
  • 30. de Ornelas Maia ACC, Sanford J, Boettcher H, Nardi AE, Barlow D (2017) Improvement in quality of life and sexual functioning in a comorbid sample after the unified protocol transdiagnostic group treatment. Journal of psychiatric research, 93: 30-36.
  • 31. De Paul NF, Caver KA (2021) A pilot study of a brief group adaptation of the Unified Protocol in integrated primary care. Psychological Services, 18(3): 416-425.
  • 32. Eckhardt S, Martell C, Lowe KD, Le Grange D, Ehrenreich-May J (2019) An ARFID case report combining family-based treatment with the unified protocol for Transdiagnostic treatment of emotional disorders in children. Journal of eating disorders, 7(1): 34. doi: 10.1186/s40337-019-0267-x.
  • 33. Ehrenreich JT, Goldstein CR, Wright LR, Barlow DH (2009) Development of a unified protocol for the treatment of emotional disorders in youth. Child & family behavior therapy, 31(1): 20-37.
  • 34. Ehrenreich-May J, Rosenfield D, Queen AH, Kennedy SM, Remmes CS, Barlow DH (2017) An initial waitlist-controlled trial of the unified protocol for the treatment of emotional disorders in adolescents. Journal of Anxiety Disorders, 46: 46-55.
  • 35. Ellard KK, Bernstein EE, Hearing C, Baek JH, Sylvia LG, Nierenberg AA, ... Deckersbach T (2017) Transdiagnostic treatment of bipolar disorder and comorbid anxiety using the Unified Protocol for Emotional Disorders: A pilot feasibility and acceptability trial. Journal of affective disorders, 219: 209-221.
  • 36. Ellard KK, Deckersbach T, Sylvia LG, Nierenberg AA, Barlow DH (2012) Transdiagnostic treatment of bipolar disorder and comorbid anxiety with the unified protocol: a clinical replication series. Behavior modification, 36(4): 482-508.
  • 37. Ewing DL, Monsen JJ, Thompson EJ (2015) A meta-analysis of transdiagnostic cognitive behavioural therapy in the treatment of child and young person anxiety disorders. Behavioural and Cognitive Psychotherapy, 43: 562-77.
  • 38. Farchione TJ, Fairholme CP, Ellard KK, Boisseau CL, Thompson-Hollands J, Carl JR, ... Barlow DH (2012) Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behavior therapy, 43(3): 666-678.
  • 39. Fichter MM, Quadflieg N, Fischer UC, Kohlboeck G (2010) Twenty-five-year course and outcome in anxiety and depression in the Upper Bavarian Longitudinal Community Study. Acta Psychiatrica Scandinavica, 122: 75–85.
  • 40. Fidel SK, Alcántara AT, Castan EC, Costa GR, Diez CQ, Lligoña AG, ... Peri JN (2015) Unified Protocol for psychiatric and psychological assessment of candidates for transplantation of organs and tissues, PSI-CAT. Revista de psiquiatria y salud mental, 8(3): 130-136.
  • 41. Fried EI (2017) The 52 symptoms of major depression: Lack of content overlap among seven common depression scales. Journal of Affective Disorders, 208: 191–197.
  • 42. Fried EI, Nesse RM (2015) Depression is not a consistent syndrome: An investigation of unique symptom patterns in the STAR_D study. Journal of Affective Disorders, 172: 96–102.
  • 43. Galatzer-Levy IR, Bryant RA (2013) 636,120 ways to have posttraumatic stress disorder. Perspectives on Psychological Science, 8: 651–662.
  • 44. Gallagher MW, Sauer-Zavala SE, Boswell JF, Carl JR, Bullis J, Farchione TJ, Barlow DH (2013) The impact of the unified protocol for emotional disorders on quality of life. International journal of cognitive therapy, 6(1): 57-72.
  • 45. Garcia-Escalera J, Chorot P, Valiente RM (2016) Efficacy of transdiagnostic cognitive-behavioral therapy for anxiety and depression in adults, children and adolescents: A metaanalysis. Revista de Psicopatologia y Psicologia Clinica, 21: 147-75.
  • 46. Girio-Herrera E, Ehrenreich-May J (2014) Using flexible clinical processes in the Unified Protocol for the Treatment of Emotional Disorders in Adolescence. Psychotherapy, 51(1): 117-122.
  • 47. Gorman JM (2007) The essential guide to psychiatric drugs. 4th ed. New York, NY: St. Martin’s Griffin.
  • 48. Gray JA (1982) The neuropsychology of anxiety. New York, NY: Oxford University Press.
  • 49. Gündüz A, Gündoğmuş İ, Sertçelik S, Engin BH, İşler A, Çipil A, Sungur MZ (2019) Validity and Reliability of Cognitive Attentional Syndrome-1 Questionnaire. Psychiatry investigation, 16(5): 355-362.
  • 50. Harvey AG, Watkins ER, Mansell W, Shafran R (2004) Cognitive behavioural processes across psychological disorders: A transdiagnostic approach in research and treatment. Oxford, UK: Oxford University Press.
  • 51. Haslam N, Holland E, Kuppens P (2012) Categories versus dimensions in personality and psychopathology: A quantitative review of taxometric research. Psychological Medicine, 42: 903–920.
  • 52. Hawks JL, Kennedy SM, Holzman JB, Ehrenreich–May J (2019) Development and Application of an Innovative Transdiagnostic Treatment Approach for Pediatric Irritability. Behavior Therapy, 51(2): 334-349.
  • 53. Hayes SC, Hofmann SG (Eds.) (2018) Process-based CBT: The science and core clinical competencies of cognitive behavioral therapy. Oakland, CA: New Harbinger Publications.
  • 54. Hayes SC, Strosahl KD, Wilson KG (2011) Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.
  • 55. Hayes SC, Wilson KG, Gifford EV, Follette VM, Strosahl K (1996) Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64: 1152–1168.
  • 56. Ito M, Horikoshi M, Kato N, Oe Y, Fujisato H, Nakajima S, ... Usuki M (2016) Transdiagnostic and transcultural: pilot study of unified protocol for depressive and anxiety disorders in Japan. Behavior therapy, 47(3): 416-430.
  • 57. Kabat-Zinn J (1982) An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General Hospital Psychiatry, 4: 33–47.
  • 58. Kendler KS (2012) The dappled nature of causes of psychiatric illness: Replacing the organic-functional/hardware-software dichotomy with empirically based pluralism. Molecular Psychiatry, 17: 377–388.
  • 59. Kennedy AK, Barlow DH (2018) The unified protocol for transdiagnostic treatment of emotional disorders. An introduction. Barlow, D. H., & Farchione, T. J. (editors). Applications of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. New York: Oxford University Press, pp. 1-16.
  • 60. Kennedy SM, Bilek EL, Ehrenreich-May J (2019) A randomized controlled pilot trial of the unified protocol for transdiagnostic treatment of emotional disorders in children. Behavior modification, 43(3): 330-360.
  • 61. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE (2005) Prevalence, severity, and comorbidity of 12-month DSM–IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62: 617–627.
  • 62. Khakpoor S, Saed O, Armani Kian A (2019) Emotion regulation as the mediator of reductions in anxiety and depression in the Unified Protocol (UP) for transdiagnostic treatment of emotional disorders: double-blind randomized clinical trial. Trends in psychiatry and psychotherapy, 41(3): 227-236.
  • 63. Kotov R, Krueger RF, Watson D. (2018) A paradigm shift in psychiatric classification: The Hierarchical Taxonomy Of Psychopathology (HiTOP). World Psychiatry, 17: 24–25.
  • 64. Laposa JM, Mancuso E, Abraham G, Loli-Dano L (2017) Unified protocol transdiagnostic treatment in group format: a preliminary investigation with anxious individuals. Behavior modification, 41(2): 253-268.
  • 65. Leahy RL (2015) Emotional schema therapy. Guilford Publications.
  • 66. Linehan M (2014) DBT Skills training manual. Guilford Publications.
  • 67. Maia ACC, Braga AA, Nunes CA, Nardi AE, Silva AC (2013) Transdiagnostic treatment using a unified protocol: application for patients with a range of comorbid mood and anxiety disorders. Trends in psychiatry and psychotherapy, 35(2): 134-140.
  • 68. Mansell W, Carey TA, Tai S (2012) A Transdiagnostic approach to CBT using method of levels therapy. East Sussex: Routledge.
  • 69. Mansell W, Harvey A, Watkins E, Shafran R (2008) Cognitive behavioural processes across psychological disorders: A review of the utility and validity of the transdiagnostic approach. International Journal of Cognitive Therapy, 1: 181–191.
  • 70. Mohajerin B, Bakhtiyar M, Olesnycky OS, Dolatshahi B, Motabi F (2019) Application of a transdiagnostic treatment for emotional disorders to body dysmorphic disorder: A randomized controlled trial. Journal of affective disorders, 245: 637-644.
  • 71. Mohammadi A, Soleimani M, Mohammadi MR, Abasi I, Foroughi AA (2019) Unified Protocol for Transdiagnostic Prevention of Depression and Anxiety in Iranian Adolescents: Protocol Development and Initial Outcome Data. Iranian journal of psychiatry, 14(2): 171-178.
  • 72. Mohsenabadi H, Zanjani Z, Shabani MJ, Arj A (2018) A randomized clinical trial of the Unified Protocol for Transdiagnostic treatment of emotional and gastrointestinal symptoms in patients with irritable bowel syndrome: evaluating efficacy and mechanism of change. Journal of psychosomatic research, 113: 8-15.
  • 73. Newby JM, McKinnon A, Kuyken W, Gilbody S, Dalgleish T (2015) Systematic review and meta-analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood. Clinical psychology review, 40: 91-110.
  • 74. Newby JM, Twomey C, Li S, Andrews G (2016) Transdiagnostic computerised cognitive behavioural therapy for depression and anxiety: A systematic review and meta-analysis. Journal of Affective Disorders, 199: 30–41.
  • 75. Newman MG, Llera SJ (2011) A novel theory of experiential avoidance in generalized anxiety disorder: A review and synthesis of research supporting a contrast avoidance model of worry. Clinical Psychology Review, 31(3): 371–382.
  • 76. Nolen-Hoeksema S (1991) Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology, 100: 569–582.
  • 77. Norcross JC, Wampold BE (2011) Evidence-based therapy relationships: Research conclusions and clinical practices. Psychotherapy, 48: 98–102.
  • 78. Nordahl H, Wells A (2019) Measuring the Cognitive Attentional Syndrome Associated with Emotional Distress: Psychometric Properties of the CAS-1. International Journal of Cognitive Therapy, 12(4): 292-306.
  • 79. Oğuz G, Batmaz S (2020) Transdiyagnostik Bilişsel Davranışçı Yaklaşıma Göre Psikopatolojik Süreçlerin Değerlendirilmesi: Bilişsel ve Davranışçı Süreçler Ölçeği'nin Türkçe Sürümünün Geçerliliği ve Güvenilirliği. Journal of Cognitive-Behavioral Psychotherapy and Research, 9(3): 173-186.
  • 80. Osma J, Sánchez-Gómez A, Peris-Baquero Ó (2018) Applying the unified protocol to a single case of major depression with schizoid and depressive personality traits. Psicothema, 30(4): 364-369.
  • 81. Păsărelu CR, Andersson G, Bergman Nordgren L, Dobrean A (2017) Internet-delivered transdiagnostic and tailored cognitive behavioral therapy for anxiety and depression: a systematic review and meta-analysis of randomized controlled trials. Cognitive Behaviour Therapy, 46(1): 1–28.
  • 82. Patel T, Mansell W, Veale D (2015) The cognitive behavioural processes questionnaire: a preliminary analysis within student, mixed clinical and community samples and the identification of a core transdiagnostic process. Cognitive Therapy and Research, 39(2): 193-203.
  • 83. Pearl SB, Norton PJ (2016) Transdiagnostic versus diagnosis specific cognitive behavioural therapies for anxiety: A meta-analysis. Journal of Anxiety Disorders, 46: 11–24.
  • 84. Rachman S, de Silva P (1978) Abnormal and normal obsessions. Behaviour Research and Therapy, 16(4): 233–248.
  • 85. Reinholt N, Aharoni R, Winding C, Rosenberg N, Rosenbaum B, Arnfred S (2017) Transdiagnostic group CBT for anxiety disorders: the unified protocol in mental health services. Cognitive behaviour therapy, 46(1): 29-43.
  • 86. Reinholt N, Krogh J (2014) Efficacy of transdiagnostic cognitive behaviour therapy for anxiety disorders: a systematic review and meta-analysis of published outcome studies. Cognitive Behaviour Therapy, 43(3): 171-184.
  • 87. Reiss S (1991) Expectancy model of fear, anxiety, and panic. Clinical Psychology Review, 11: 141–153.
  • 88. Rosellini AJ, Boettcher H, Brown TA, Barlow DH (2015) A transdiagnostic temperament-phenotype profile approach to emotional disorder classification: An update. Psychopathology Review, 2: 110–128.
  • 89. Sakiris N, Berle D (2019) A systematic review and meta-analysis of the unified protocol as a transdiagnostic emotion regulation based intervention. Clinical psychology review, 72: 101751. doi: 10.1016/j.cpr.2019.101751.
  • 90. Santor DA, Gregus M, Welch A (2006) FOCUS ARTICLE: Eight Decades of Measurement in Depression. Measurement: Interdisciplinary Research and Perspectives, 4: 135–155.
  • 91. Sauer-Zavala S, Bentley KH, Steele SJ, Tirpak JW, Ametaj AA, Nauphal M, ... Barlow DH (2020) Treating depressive disorders with the Unified Protocol: A preliminary randomized evaluation. Journal of Affective Disorders, 264: 438-445.
  • 92. Sauer-Zavala S, Boswell JF, Gallagher MW, Bentley KH, Ametaj A, Barlow DH (2012) The role of negative affectivity and negative reactivity to emotions in predicting outcomes in the unified protocol for the transdiagnostic treatment of emotional disorders. Behaviour research and therapy, 50(9): 551-557.
  • 93. Sauer-Zavala S, Cassiello-Robbins C, Ametaj AA, Wilner JG, Pagan D (2019) Transdiagnostic treatment personalization: The feasibility of ordering unified protocol modules according to patient strengths and weaknesses. Behavior modification, 43(4): 518-543.
  • 94. Sauer-Zavala S, Cassiello-Robbins C, Conklin LR, Bullis JR, Thompson-Hollands J, Kennedy KA (2017b) Isolating the unique effects of the unified protocol treatment modules using single case experimental design. Behavior modification, 41(2): 286-307.
  • 95. Sauer-Zavala S, Gutner CA, Farchione TJ, Boettcher HT, Bullis JR, Barlow DH (2017a) Current definitions of “transdiagnostic” in treatment development: A search for consensus. Behavior Therapy, 48: 128–138.
  • 96. Stanton K, McDonnell CG, Hayden EP, Watson D (2020) Transdiagnostic approaches to psychopathology measurement: Recommendations for measure selection, data analysis, and participant recruitment. Journal of Abnormal Psychology, 129(1): 21-28.
  • 97. Steele SJ, Farchione TJ, Cassiello-Robbins C, Ametaj A, Sbi S, Sauer-Zavala S, Barlow DH (2018) Efficacy of the Unified Protocol for transdiagnostic treatment of comorbid psychopathology accompanying emotional disorders compared to treatments targeting single disorders. Journal of psychiatric research, 104: 211-216.
  • 98. Trosper SE, Buzzella BA, Bennett SM, Ehrenreich JT (2009) Emotion regulation in youth with emotional disorders: Implications for a unified treatment approach. Clinical Child and Family Psychology Review, 12(3): 234-254.
  • 99. Tulbure BT, Rusu A, Sava FA, Sălăgean N, Farchione TJ (2018) A web-based transdiagnostic intervention for affective and mood disorders: randomized controlled trial. JMIR mental health, 5(2): e36. doi: 10.2196/mental.8901.
  • 100. van Loo HM, Romeijn JW (2015) Psychiatric comorbidity: Fact or artifact? Theoretical Medicine and Bioethics, 36: 41–60.
  • 101. Varkovitzky RL, Sherrill AM, Reger GM (2018) Effectiveness of the unified protocol for Transdiagnostic treatment of emotional disorders among veterans with posttraumatic stress disorder: a pilot study. Behavior modification, 42(2): 210-230.
  • 102. Wegner DM, Schneider DJ, Carter SR, White TL (1987) The paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53: 5–13.
  • 103. Wells A (2011) Metacognitive therapy for anxiety and depression. Guilford press.
  • 104. Wittchen HU, Nocon A, Beesdo K, Pine DS, Hofler M, Lieb R, Gloster AT (2008) Agoraphobia and panic. Prospective longitudinal relations suggest a rethinking of diagnostic concepts. Psychotherapy and Psychosomatics, 77: 147–157.
  • 105. World Health Organization (‎1992)‎ The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. World Health Organization.
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Details

Primary Language English
Subjects Psychiatry
Journal Section Review
Authors

Sedat Batmaz 0000-0003-0585-2184

Early Pub Date March 31, 2023
Publication Date March 31, 2023
Acceptance Date May 26, 2022
Published in Issue Year 2023 Volume: 15 Issue: 1

Cite

AMA Batmaz S. Transdiagnostic Cognitive Behavioral Psychotherapy: Unified Protocol as an Example. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. March 2023;15(1):12-28. doi:10.18863/pgy.1064590

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