CBT at the Crossroads: The Rise of Transdiagnostic Treatments
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CBT at the Crossroads: The Rise of Transdiagnostic Treatments Carmen Schaeuffele 1 & Ava Schulz 2 & Christine Knaevelsrud 3 & Babette Renneberg 1 & Johanna Boettcher 1,4 Accepted: 27 October 2020/ # The Author(s) 2020
Abstract Transdiagnostic treatments span a heterogeneous group of interventions that target a wider range of disorders and can be applied to treat several disorders simultaneously. Several meta-analyses have highlighted the evidence base of these novel therapies. However, these meta-analyses adopt different definitions of transdiagnostic treatments, and the growing field of transdiagnostic therapies has become increasingly difficult to grasp. The current narrative review proposes a distinction of “one size fits all” unified and “my size fits me” individualized approaches within transdiagnostic therapies. Unified treatments are applied as “broadband” interventions to a range of disorders without tailoring to the individual, while individualized treatments are tailored to the specific problem presentation of the individual, e.g., by selecting modules within modular treatments. The underlying theoretical foundation and relevant empirical evidence for these different transdiagnostic approaches are examined. Advantages and limitations of the transdiagnostic treatments as well as future developments are discussed. Keywords Transdiagnostic . Unified . Individualized . Tailored . Cognitive behavioral
therapy
* Carmen Schaeuffele carmen.schaeuffele@fu–berlin.de
1
Clinical Psychology and Psychotherapy, Freie Universität Berlin, Habelschwerdter Allee 45, 14195 Berlin, Germany
2
Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zürich, Switzerland
3
Clinical-Psychological Intervention, Freie Universität Berlin, Berlin, Germany
4
Clinical Psychology and Psychotherapy, Psychologische Hochschule Berlin, Berlin, Germany
International Journal of Cognitive Therapy
In its early stages, cognitive behavioral therapy (CBT) comprised a collection of general techniques like cognitive restructuring, which were applied to several disorders (Beck and Haigh 2014). Over the years, research advanced and identified an increasing number of characteristics of specific disorders, followed by increasingly narrow definitions of diagnoses (American Psychiatric Association 1980, 2000, 2013). This disorder-specific approach was successful: Effective disorderspecific treatments were developed and resulted in a rise of evidence-based treatments for specific diagnoses (see Hofmann et al. 2012 for a review of metaanalyses). The focus on disorder-specifics is, however, in stark contrast to high comorbidity between disorders with 40% of patients reporting more than one diagnosis (Jacobi et al. 2014). High comorbidity rates are likely not a simple co-occurrence of disorders but a result of a shared common underlying basis between disorders, as increasing evidence suggests (e.g., Caspi et al. 2014; Lahey et al. 2017a, 2017b). Instead of unique processes responsible for the onset and maintenance of sing
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