Over the past decade, clinical psychology has made many advances in terms of treatment. The first is to treat psychological problems through transdiagnostic therapy.
Most commonly, therapists learn and use specific treatment for each psychopathology, however, some studies have shown that using a common approach to different disorders of the same category could be more effective and also more effective (transdiagnostic therapy).
- Transdiagnostic therapy is a therapy that tries to focus on the common core that underlies different disorders.
- For example.
- When it comes to anxiety disorders.
- Panic.
- Phobias or generalized anxiety.
- These are disorders that share a number of characteristics.
- Which can be threatening thoughts.
- Physiological overactivation or avoidance or safety behavior.
So is it appropriate to apply specific cognitive behavioral therapy to a specific disorder?According to Norton’s team at the University of Houston (Norton, Hayes and Hope, 2004, Norton and Hope, 2005), this would not be necessary.
After the first randomized clinical trial that applied cognitive behavioral diagnostic therapy in group format to a heterogeneous group of patients with various anxiety and depression disorders, they found that it not only improved anxiety, but also the secondary diagnosis of comorability that did not improve. had nothing to do with anxiety, like depression.
The combination was more effective than TCC combined with other types of treatments for anxiety disorder, such as relaxation training, according to Peter Norton, associate professor of clinical psychology and director of the Anxiety Disorders Clinic at the University of Houston. (Uh)?
The key to transdiagnostic therapy shows that the therapist is able to find the basic core shared by different anxiety disorders.
No matter if you suffer from panic, spider phobia or even obsessive-compulsive disorder, in this therapy we forget about these specific labels and say that the patient suffers anxiety, regardless of the specific manifestation of this anxiety.
This common nuclear pathology, according to Norton, is essentially determined by the structure of the tripartite model on affection, anxiety and depression (Clark and Watson, 1991).
For Clark and Watson, the tripartite model of depression and anxiety suggests that depression and anxiety have common components (generalized negative affection) and specific components (anhedonia and physiological overactivation).
Norton took these references and assumed that negative affection could be considered a fundamental psychopathological component of anxiety and depression; According to this theoretical model, the processes and components of treatment were not based on different manifestations of anxiety in terms of different disorders that may require different treatments.
The basic ingredients used in the transdiagnosis cognitive-behavioral protocol were:
Explain to patients what manifestations of anxiety generally occur, how it occurs and how it continues, in addition, following the tripartite model, they will receive information on negative conditions, common in both anxiety and depression.
They must understand that knowing how to manage this emotionality, moving away from artificial distinctions, can improve and in fact improve the comorities of each patient.
Comobility can be defined as pathologies often associated with a major problem, as anxiety and depression are an example, in fact, in most cases, they are so close together that they are indistinguishable, one way to reconcile them is to explain them based on negative affection.
We assume that in most anxious patients there are a number of threatening negative automatic thoughts. We already know that anxiety is the answer to the intuition of a potential danger.
Of course, anxiety disorders rule out their functionality: thoughts are exaggerated and lack reality. With good training in cognitive restructuring, we can make patients able to detect their thoughts on future dangers and modify them, through socratic dialogue, by tighter ones. to reality.
For example, it’s common to find thoughts like ‘I’m going to have a panic attack’, ‘I’m going to go crazy’ in a state of panic. But similar ideas can arise in a widespread anxiety disorder: “What if my daughter was raped goes out tonight?
The goal is for the patient to focus on reality, with the available data, and not predict future situations, because they have not yet occurred and, if they did, they would not be what he thinks.
It is used as a measure of exposure to dreaded stimuli. The format can be live, imaginative or interoceptive, that is, as a way to expose yourself to internal sensations that usually occur in panic disorder.
With exposure, we not only get a physiological addiction to anxiety, but also to anxiety-causing stimuli. When the patient uses response prevention, he stops performing the avoidance behaviors that may be: compulsions in obsessive-compulsive disorder, signs of generalized anxiety disorder. or taking an anxiolytic in panic disorder.
Transdiagnostic therapy works well. According to Norton, patients have improved more than standard treatment; in addition, treatment had a major impact on secondary diagnosis; two-thirds of comorities have dissipated, compared to what happens when working with specific therapy; with the latter, only 40% of patients find remission in a comorability diagnosis.
It has been proven that this is not only a more effective approach, but also more effective for the patient as a whole, as well as for the therapist, in this way you can gather a group of people with the same problem, assuming a significant time saving.
The transdiagnostic psychopathological perspective allows to understand mental disorders from a dimensional point of view, based on the convergence of different psychological processes common to disorders, treatment, in turn, is more holistic and integral.
We can also conclude, as a proposal for future revisions, that the importance of some other emotions, such as disgust, recent studies have shown how negative affection, anhedonia or fear play an important role in some anxiety-causing disorders. , particularly phobias and ODO.
Although it is not yet known to what extent the feeling of disgust is part of the general negative affectivity factor (or general anxiety factor), everything indicates that a generic transdiagnostic dimension of repugnance sensitivity may also be etiologically involved in one or more groups of mental disorders.
Logically, transdiagnostic therapy should include the construction modification mentioned in the new transdiagnostic protocols, however, so far, the results have been promising, including not only adult patients, but also children and adolescents, for whom it is even more difficult to make a specific specification. Diagnosis.