Transdiagnosis approach in therapy: characteristics and functioning

There are various approaches within psychotherapy to address mental disorders, starting from ones that focus on symptoms or more specific disorders, even others that try to cover a set of mental disorders, as is the case of the approach transdiagnosis.

The transdiagnosis 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 to 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 to that can be approached from a transdiagnostic approach that allows understanding the factors they have in common, as well as the singularities of each of the them.

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What is the transdiagnostic approach to therapy?

The transdiagnostic approach in psychological therapy has represented a new paradigm when it comes to approaching and understanding mental health disorders, since instead of focusing on the specifics of each of the disorders mental,

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 makes it possible to more efficiently treat various disorders of the mental health, such as depressives, 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 an approach with greater efficiency, in such a way that it helps to improve the quality of life of the patient.

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Contributions of the transdiagnostic approach in therapy

Next 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 suffering from such a disorder, such as anorexia nervosa, shared symptoms and characteristics with other eating disorders, such as bulimia nervous; Furthermore, all of them presented common psychopathological processes.

These researchers found that there could be a transdiagnostic evolution from one of these eating disorders to another of them (p. g., suffer from anorexia and begin to develop bulimia or vice versa).

Then, the transdiagnostic approach that they developed allowed a treatment that could cover the different eating disorders, even in those cases in which there was a transition from one of them to other.

Years later, other transdiagnostic approaches were developed that could treat those cases in which there were psychopathological comorbidity, such as those cases in which there were symptoms of anxiety and depressive time.

The transdiagnosis approach It also allows addressing psychological constructs that are present in various mental disorders, for example, "intolerance of uncertainty", which consists of a negative predisposition towards situations that are experienced as uncertain. This characteristic, which some patients present, is present in various mood-related mental disorders.

Another transdiagnosis construct is the one developed by Egan, Wade and Shafran, known as "dysfunctional perfectionism". For this, they started from the basis that dysfunctional perfectionism could be conceptualized as a trait of personality, as a psychopathological symptom or also as a group of cognitive characteristics and behavioral

These authors understand dysfunctional perfectionism as a cognitive-behavioral process that influences the development and maintenance of various psychological disorderssuch as eating disorders, depressive disorders, anxiety disorders, or obsessive-compulsive disorders.

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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 some rivalry between categorical and dimensional approaches to behavior abnormal, coming out triumphant, in most cases, the categorical approach by having certain advantages over the approach dimensional.

1. Categorical approach

One of those advantages of the categorical approach is that it is more striking and pragmatic, although this approach is not without limitations, for example, the high growth of syndromes as new editions of the DSM come out and the high comorbidity between mental health disorders, causing the same person to be diagnosed simultaneously with more than one of them.

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 fully justified, such as anxiety and depressive disorders.

According to some experts, it should be mentioned that sometimes, due to the high comorbidity that they present from the categorical approach, it can be difficult to distinguish between some disorders, as may be the case of the social phobia regarding avoidant personality disorder.

In favor of the categorical approach to the diagnosis is the advantage it has when it comes to adjusting to the requirements of the health institutions and the facility it has at the time of sharing diagnoses between different health professionals, among other.

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2. Dimensional approach

This approach It is not based only on the presence or absence of a symptom, but also focuses on the intensity and frequency of the same. 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 one, of reducing the number of categories diagnostic by establishing a group of basic dimensions and placing greater emphasis on the severity of the disorder mental.

3. Transdiagnosis approach

This approach could be a more consistent alternative in the field of psychopathology with respect to those previously mentioned. The transdiagnosis 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 is intended 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 base, it accepts the use of a diagnostic and categorical system.

Most used transdiagnostic therapies in mental health

Therapies that follow a transdiagnostic approach in psychotherapy have proliferated, highlighting those of a cognitive-behavioral nature. Let's see how they are.

Albert ellis he was a pioneer using a transdiagnostic approach in therapy, as designed a transdiagnostic cognitive-behavioral therapy to work with patients in a group way.

Aaron T. Beck developed a cognitive therapy to treat depression which ended up becoming a transdiagnostic therapy by demonstrating the great utility it also had to treat anxiety disorders, as well as other mental disorders.

Cognitive behavioral therapy (CBT) has had a great progression from the specific approach of some specific mental disorders. Nevertheless, CBT has also successfully evolved with a transdiagnostic approach, which has a perspective of psychopathology that allows the approach of various disorders psychological and also psychopathological constructs that are present in different mental disorders.

For this reason, transdiagnostic CBT is carried out using a unified or integrative protocol that allows treating a group of disorders (p. g., being able to address all emotional disorders).

A cognitive-behavioral transdiagnosis approach widely used among mental health professionals is the "Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders" (PU), developed by Barlow and her team, in order to address anxiety disorders, affective disorders and those with 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 of regulatory skills of their emotions, so the objective of this treatment is to take those skills to a 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, only Norton's focuses on the format group therapy, in order to treat as a group patients with anxiety disorders and depression.

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 was useful for unify both disorders based on a series of common symptoms that occurred in both and that are under the general dimension known as "affectivity negative".

As can be seen, given the number of symptoms that depression disorders have in common and those of anxiety, its approach from a transdiagnostic approach in therapy is very useful psychological.