Treating Anxiety and Depression with "Transdiagnostic" Methods
At Front Range Treatment Center, we often use the Unified Protocol when treating clients with mixed depression and anxiety. The UP is a transdiagnostic treatment. What does this mean?
There is an ongoing debate amongst mental health researchers whether it is better to focus on developing ever more precise distinctions between disorders and disorder sub-types, or to focus on diagnostic groupings and emphasize common underlying processes that cut across multiple diagnoses and diagnostic categories (Norton & Paulus, 2016). The widespread use of the DSM encourages clinicians to make fine diagnostic distinctions, and thereby encourages the use of highly focused and diagnosis-specific treatments. However, some clinicians and researchers argue in favor of a diagnostic and treatment philosophy grounded in commonalities rather than distinctions. This debate of “splitting” versus “lumping” is especially lively amongst those who treat and research the mood disorders, with a growing number of persons emphasizing the consistent similarities amongst those with anxiety and depressive disorders.
One of the most popular transdiagnostic interventions is the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP). The UP was designed to address vulnerabilities common to persons with anxiety and depressive disorders, such as negative affect, negative attribution bias, and avoidant tendencies (Barlow et al., 2017). The UP has been found effective in reducing the symptoms of PTSD, as well as generalized anxiety disorder, panic disorder, phobias, major depressive disorder, borderline personality disorder, eating disorders, and substance abuse. The UP has been shown to reduce symptoms severity, improve affect, and improve daily functioning (Farchione et al., 2012).
There is also some evidence the UP has a lower attrition rate than single-diagnosis treatments. Barlow (2017) compared the efficacy of the Unified Protocol with diagnosis specific, single-disorder protocols (SDPs). They discovered the UP and SDPs were statistically equivalent in their efficacy. However, the UP group was significantly more likely to complete treatment than the SDP group.