Transdiagnostic Approach In Therapy: Characteristics And Operation
There are various approaches within psychotherapy to address mental disorders, starting from some that focus on more specific symptoms or disorders, to others that try to cover a set of mental disorders, as is the case of the transdiagnostic approach.
The transdiagnostic approach in therapy serves to treat the most relevant emotional, psychological and behavioral mechanisms that underlie mental disorders. in order to make the therapeutic process more flexible and be able to cover the entire set of symptoms that the patient may suffer.
The development and exhaustive analysis of psychological constructs, which are present in various mental health disorders, has led to the need for them to be addressed from a transdiagnostic approach that allows us to understand the factors they have in common, as well as the singularities of each one of them.
What does the transdiagnostic approach in therapy consist of?
The transdiagnostic approach in psychological therapy has represented a new paradigm when it comes to addressing and understanding mental health disorders, given that instead of focusing on the specifics of each of the mental disorders, chooses to focus on common aspects of various disorders that influence the origin or maintenance of mental disorders.
This approach to clinical psychology and psychotherapy allows various mental health disorders to be treated more efficiently, such as depression, anxiety, addictions, eating disorders, etc.
In the field of psychotherapy, the transdiagnostic approach has helped to focus on the common psychopathological factors in various disorders or in those levels of the patient’s functioning that could be affected and also being related to other more specific aspects, allows the psychotherapist to approach it more effectively, in a way that helps improve the patient’s quality of life.
Contributions of the transdiagnostic approach in therapy
Below we will see a compendium of research in the field of psychology that allowed the development of the transdiagnostic approach.
Fairburn and his collaborators began to use the transdiagnostic approach in therapy within the field of eating disorders. because patients who suffered from a disorder of this type, such as anorexia nervosa, shared symptoms and characteristics with other eating disorders, such as bulimia nervosa; Furthermore, all of them presented common psychopathological processes.
These researchers discovered that There could be a transdiagnostic evolution from one of these eating disorders to another of them (e.g., suffering from anorexia and beginning to develop bulimia or vice versa).
Therefore, the transdiagnostic approach they developed allowed for a treatment that could encompass the different eating disorders, even in those cases in which there was a transition from one of them to another.
Years later, other transdiagnostic approaches were developed that could treat cases in which there was psychopathological comorbidity, such as those cases in which there were anxiety and depressive symptoms at the same time.
The transdiagnostic approach It also allows us to address psychological constructs that are present in various mental disorders. , such as, for example, “intolerance of uncertainty”, which consists of the negative predisposition towards situations that are experienced as uncertain. This characteristic, which some patients present, is present in various mental disorders related to mood.
Another transdiagnostic construct is the one developed by Egan, Wade and Shafran, known as “dysfunctional perfectionism.” To do this, they started from the basis that dysfunctional perfectionism could be conceptualized as a personality trait, as a psychopathological symptom or also as a group of cognitive and behavioral characteristics.
These authors They understand dysfunctional perfectionism as a cognitive-behavioral process that influences the development and maintenance of various psychological disorders. such as eating disorders, depressive disorders, anxiety disorders or obsessive-compulsive disorders.
Diagnostic approaches
There are various diagnostic approaches within clinical psychology and it is for this reason that some of them are mentioned below.
Since the dawn of psychopathology there has been a certain rivalry between the categorical and dimensional approaches with respect to abnormal behavior, with the categorical approach coming out triumphant in most cases as it has certain advantages over the dimensional approach.
1. Categorical approach
One of these advantages of the categorical approach is that it is more striking and pragmatic, although this approach is not without limitations such as, for example, the high growth in syndromes as new editions of the DSM come out and the high comorbidity between mental health disorders, leading to the same person being diagnosed with more than one of them simultaneously.
That is why, based on a categorical criterion, it is highly probable that there is comorbidity between two or more mental disorders, although it is true that There are many mental disorders that have several common symptoms and this classification is totally justified, as are anxiety and depressive disorders.
According to some experts, it is worth mentioning that sometimes, due to the high comorbidity they present from the categorical approach, It can be difficult to distinguish between some disorders as may be the case with social phobia with respect to avoidant personality disorder.
In favor of the categorical approach to diagnosis is the advantage it has when adjusting to the demands of health institutions and the ease it has when sharing diagnoses between different health professionals, among others.
2. Dimensional approach
This approach It is not based only on the presence or absence of a symptom, but also focuses on its intensity and frequency. In this way, more importance is given to the description of the symptoms than to the mere fact of making a classification.
The dimensional approach has the advantage, with respect to the categorical approach, of reducing the number of diagnostic categories by establishing a group of basic dimensions and placing greater emphasis on the severity of the mental disorder.
3. Transdiagnostic approach
This approach could provide a more consistent alternative in the field of psychopathology with respect to those previously mentioned. The transdiagnostic approach understands mental health disorders fundamentally from a range of cognitive and behavioral processes that contribute to generating and/or maintaining mental disorders or a group of them.
This model, despite being based on a dimensional perspective of mental disorder, is rather a union of both approaches, the categorical and the dimensional.
The transdiagnostic approach aims to understand, classify and unite the various symptoms and diagnoses from dimensions that are to a greater or lesser extent general or similar. This highlights that, Despite using a dimensional approach as a basis, it accepts the use of a diagnostic and categorical system.
Transdiagnostic therapies most used in mental health
Therapies that follow a transdiagnostic approach in psychotherapy have proliferated, highlighting those of a cognitive-behavioral nature. Let’s see what they are like.
Albert Ellis was a pioneer using a transdiagnostic approach in therapy, as designed a transdiagnostic cognitive-behavioral therapy to work with patients in a group manner.
Aaron T. Beck developed a cognitive therapy to treat depression that ended up becoming a transdiagnostic therapy when he demonstrated its great usefulness in treating anxiety disorders, as well as other mental disorders.
Cognitive-behavioral therapy (CBT) has made great progress from the specific approach to some specific mental disorders. However, CBT has also successfully evolved with a transdiagnostic approach which has a perspective on psychopathology that allows the approach to various psychological disorders and also psychopathological constructs that are present in different mental disorders.
Therefore, transdiagnostic CBT is carried out through a unified or integrative protocol that allows a set of disorders to be treated (e.g., being able to address all emotional disorders).
A cognitive-behavioral transdiagnostic approach widely used among mental health professionals is the “Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders” (PU), developed by Barlow and his team, in order to address anxiety disorders, affective disorders and those that have a strong emotional component, such as dissociative and somatoform disorders.
This approach is based on the fact that all these disorders have a common factor and that is the fact that patients have a deficit in the regulation of their emotions, so the objective of this treatment is to bring these skills to a better level. more adaptive level and with greater functionality for the patient.
Among the cognitive-behavioral transdiagnostic treatments is Norton’s which was designed along the same lines as Barlow’s, except that Norton’s focuses on the group therapy format, in order to treat patients who have anxiety and depression disorders as a group.
Another of the most popular models, within transdiagnostic approaches, is the “tripartite model” of anxiety and depression developed by psychologists Clark and Watson. Paradoxically, this model was created to explain the differences between anxiety and depression, but in the end it served to unify both disorders based on a series of common symptoms that were presented in both and that are found under the general dimension. known as “negative affectivity”.
As can be seen, given the number of symptoms that depression and anxiety disorders have in common, their approach from a transdiagnostic approach in psychological therapy is very useful.
