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A Naturalistic Comparison of Group Transdiagnostic Behaviour Therapy (TBT) and Disorder-Specific Cognitive Behavioural Therapy Groups for the Affective Disorders

Published online by Cambridge University Press:  29 May 2018

Daniel F. Gros ,
Colleen Merrifield ,
Karen Rowa ,
Derek D. Szafranski ,
Lisa Young  and
Randi E. McCabe
Daniel F. Gros*
Affiliation:
Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA and Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
Colleen Merrifield
Affiliation:
Anxiety Treatment and Research Clinic, St Joseph's Healthcare, Hamilton, Ontario, Canada, Mood Disorders Outpatient Clinic, St Joseph's Healthcare, Hamilton, Ontario, Canada and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
Karen Rowa
Affiliation:
Anxiety Treatment and Research Clinic, St Joseph's Healthcare, Hamilton, Ontario, Canada and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
Derek D. Szafranski
Affiliation:
Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA and Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
Lisa Young
Affiliation:
Anxiety Treatment and Research Clinic, St Joseph's Healthcare, Hamilton, Ontario, Canada
Randi E. McCabe
Affiliation:
Anxiety Treatment and Research Clinic, St Joseph's Healthcare, Hamilton, Ontario, Canada and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
*
*Correspondence to Daniel F. Gros, Mental Health Service 116, Ralph H. Johnson VAMC, 109 Bee Street, Charleston, SC 29401, USA. E-mail: grosd@musc.edu
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Abstract

Background: Transdiagnostic psychotherapies are designed to apply the same underlying treatment principles across a set of psychiatric disorders, without significant tailoring to specific diagnoses. Several transdiagnostic psychotherapy protocols have been developed recently, each of which has its own strengths and weaknesses. One promising treatment is Transdiagnostic Behaviour Therapy (TBT), in that it is one of the few transdiagnostic treatments to date shown to be effective in patients with depressive and anxiety disorders. However, TBT has only been investigated via individual psychotherapy. Aims: The present study investigated the effectiveness of a group protocol for TBT, compared with disorder-specific group psychotherapies, in a naturalistic setting. Method: 109 participants with various diagnoses of affective disorders completed either group TBT (n = 37) or a disorder-specific group psychotherapy (n = 72). Measures included assessments of psychiatric symptomatology and transdiagnostic impairment at baseline and post-treatment. Results: Overall, participants in the TBT group demonstrated significant improvements across all measures. When compared with disorder-specific groups, no statistical differences were observed between groups across symptoms; however, participants in the TBT group demonstrated roughly twice the treatment effect sizes in transdiagnostic impairment compared with participants in the disorder-specific groups. In addition, when participants from the most well-represented diagnosis and disorder-specific treatment (social anxiety disorder) were investigated separately, participants in the TBT group demonstrated significantly larger improvements in comorbid depressive symptoms than participants in the disorder-specific treatment. Conclusions: Pending replication and additional comparison studies, group TBT may provide an effective group treatment option for patients with affective disorders.

Keywords

transdiagnosticcomorbidityanxiety disordersdepression
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 47 , Issue 1 , January 2019 , pp. 39 - 51
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2018 

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References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Arlington, VA: American Psychiatric Publishing.Google Scholar
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. Arlington, VA: American Psychiatric Publishing.Google Scholar
Andersen, P., Toner, P., Bland, M. and 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, 673–690.Google Scholar
Barlow, D. H. (2014). Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual. New York, NY: Guilford.Google Scholar
Barlow, D. H., Allen, L. B. and Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35, 205–230.Google Scholar
Barlow, D. H., Farchione, T. J., Bullis, J. R., Gallagher, M. W., Murray-Latin, H., Sauer-Zavala, S. et al. (2017). The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders compared with diagnosis-specific protocols for anxiety disorders. JAMA Psychiatry, 74, 875–884.Google Scholar
Barlow, D. H., Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Allen, L. B. et al. (2011). The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide. New York, NY: Oxford University Press.Google Scholar
Devins, G. M. (2010). Using the Illness Intrusiveness Ratings Scale to understand health-related quality of life in chronic disease. Journal of Psychosomatic Research, 68, 591–602.Google Scholar
Devins, G. M., Binik, Y. M., Hutchinson, T. A., Hollomby, D. J., Barré, P. E. and Guttmann, R. D. (1983). The emotional impact of end-stage renal disease: importance of patients’ perceptions of intrusiveness and control. International Journal of Psychiatry in Medicine, 13, 327–343.Google Scholar
Devins, G. M., Dion, R., Pelletier, L. G., Shapiro, C. M., Abbey, S., Raiz, L. R. et al. (2001). Structure of lifestyle disruptions in chronic disease: a confirmatory factor analysis of the Illness Intrusiveness Ratings Scale. Medical Care, 39, 1097–1104.Google Scholar
Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Thompson-Hollands, J., Carl, J. R. et al. (2012). Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behavior Therapy, 43, 666–678.Google Scholar
First, M. B., Spitzer, R. L., Gibbon, M. and Williams, J. B. W. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders – clinician version ( SCID-I/P, version 2.0). New York Psychiatric Institute, Biometrics Research Department, New York.Google Scholar
Gros, D. F. (2014). Development and initial evaluation of Transdiagnostic Behavior Therapy (TBT) for veterans with affective disorders. Psychiatry Research, 220, 275–282.Google Scholar
Gros, D. F. (2015). Design challenges in transdiagnostic psychotherapy research: comparing Transdiagnostic Behavior Therapy (TBT) to existing evidence-based psychotherapy in veterans with affective disorders. Contemporary Clinical Trials, 43, 114–119.Google Scholar
Gros, D. F., Allan, N. P. and Szafranski, D. D. (2016). The movement towards transdiagnostic psychotherapeutic practices for the affective disorders. Evidence Based Mental Health, 19, e10–e12.Google Scholar
Gros, D. F., Antony, M. M., Simms, L. J. and McCabe, R. E. (2007). Psychometric properties of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA): comparison to the State-Trait Anxiety Inventory (STAI). Psychological Assessment, 19, 369–381.Google Scholar
Gros, D. F., Szafranski, D. D. and Shead, S. D. (2017). A real world dissemination and implementation of Transdiagnostic Behavior Therapy (TBT) for veterans with affective disorders. Journal of Anxiety Disorders, 46, 72–77.Google Scholar
Judah, M. R., Lancaster, C. L. and Gros, D. F. (2017). Transdiagnostic Treatments: History and Potential for Treating PTSD/SUD. In Back, S. E. and Vujanovic, A. A. ( eds), Posttraumatic Stress and Substance Use Disorders: A Comprehensive Clinical Handbook. New York, NY: Routledge ( in press).Google Scholar
Laposa, J. M., Mancuso, E., Abraham, G. and Loli-Dano, L. (2017). Unified protocol transdiagnostic treatment in group format: a preliminary investigation with anxious individuals. Behavior Modification, 41, 253–268.Google Scholar
Lovibond, S. H. and Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales (2nd edn). Sydney, Australia: Psychology Foundation of Australia.Google Scholar
McEvoy, P. M., Nathan, P. and Norton, P. J. (2009). Efficacy of transdiagnostic treatments: a review of published outcome studies and future research directions. Journal of Cognitive Psychotherapy: An International Quarterly, 23, 20–33.Google Scholar
Newby, J. M., McKinnon, A., Kuyken, W., Gilbody, S. and 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.Google Scholar
Norton, P. J. (2012a). Group Cognitive-Behavioral Therapy of Anxiety: A Transdiagnostic Treatment Manual. New York, NY: Guilford Press.Google Scholar
Norton, P. J. (2012b). A randomized clinical trial of transdiagnostic cognitive-behavioral treatments for anxiety disorder by comparison to relaxation training. Behavior Therapy, 43, 506–517.Google Scholar
Norton, P. J. and Barrera, T. L. (2012). Transdiagnostic versus diagnosis-specific CBT for anxiety disorders: a preliminary randomized controlled noninferiority trial. Depression and Anxiety, 29, 874–882.Google Scholar
Norton, P. J. and Hope, D. A. (2005). Preliminary evaluation of a broad-spectrum cognitive-behavioral group therapy for anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 36, 79–97.Google Scholar
Norton, P. J. and Paulus, D. J. (2017). Transdiagnostic models of anxiety disorders: theoretical and empirical underpinnings. Clinical Psychology Review, 56, 122–137.Google Scholar
Pearl, S. B. and Norton, P. J. (2017). Transdiagnostic versus diagnosis specific cognitive behavioural therapies for anxiety: a meta-analysis. Journal of Anxiety Disorders, 46, 11–24.Google Scholar
Ree, M. J., French, D., MacLeod, C. and Locke, V. (2008). Distinguishing cognitive and somatic dimensions of state and trait anxiety: development and validation of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA). Behavioural and Cognitive Psychotherapy, 36, 313–332.Google Scholar
Reinholt, N. and 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, 171–184.Google Scholar
Riccardi, C. J., Korte, K. J. and Schmidt, N. B. (2017). False Safety Behavior Elimination Therapy: a randomized study of a brief individual transdiagnostic treatment for anxiety disorders. Journal of Anxiety Disorders, 46, 35–45.Google Scholar
Schmidt, N. B., Buckner, J. D., Pusser, A., Woolaway-Bickel, K., Preston, J. L. and Norr, A. (2012). Randomized controlled trial of false safety behavior elimination therapy: a unified cognitive behavioral treatment for anxiety psychopathology. Behavior Therapy, 43, 518–532.Google Scholar
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., Hergueta, T., Baker, R. and Dunbar, G. C. (1998). The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22–33.Google Scholar
Williams, J. B. W., Gibbon, M., First, M. B., Spitzer, R. L., Davies, M., Borus, J. et al. (1992). The Structured Clinical Interview for DSM-III-R (SCID): II. Multisite test–retest reliability. Archives of General Psychiatry, 49, 630–636.Google Scholar
Zemestani, M., Imani, M. and Ottaviani, C. (2017). A preliminary investigation on the effectiveness of unified and transdiagnostic cognitive behavior therapy for patients with comorbid depression and anxiety. International Journal of Cognitive Therapy, 10, 175–185.Google Scholar
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