Consistent with the transdiagnostic hypothesis, RNT was associated with a range of anxiety disorders and depression and with comorbidity for those with a principal depressive disorder, supporting recent evidence that RNT is a transdiagnostic process. The presence of RNT, specifically worry and rumination, should be assessed and treated regardless of diagnostic profile. Future research may show that both pure and comorbid depressed or anxious patients receive incremental benefit from transdiagnostic protocols developed to treat core pathological processes of RNT traditionally associated with separate disorders.

Theory and evidence relating to biological and psychological vulnerabilities, comorbidity, latent structure, cognitive and behavioral maintaining factors, and treatment outcome suggest that commonalities across emotional disorders may outweigh the differences. Thus, researchers have recently begun evaluating transdiagnostic (or unified) treatment protocols, which target common maintaining factors, by applying them to individuals with multiple disorders or to mixeddiagnosis groups. The aim of this article is to review the efficacy of unified protocols for anxiety and mood disorders. Evidence suggests that unified treatments are associated with symptom improvement, generally perform better than wait-list controls, are associated with improvements in comorbid disorders, and may compare well to diagnosis-specific treatments. Unified protocols are also associated with high client satisfaction, therapeutic alliance, group cohesion, and positive treatment expectations. However, these conclusions are tempered by the small number of studies and methodological limitations. We propose directions for future research.

Researchers have recently suggested that the commonalities across the emotional disorders outweigh the differences, and thus similar treatment principles could be applied in unified interventions. In this study, the authors used a benchmarking strategy to investigate the transportability of cognitive-behavioral therapy (CBT) for anxiety and depression to mixed-diagnosis groups. Patients (N = 143) attended 10 2-hour sessions of group CBT plus a 1-month follow-up. Changes in anxiety and depression were indexed by effect sizes, reliable change, and clinically significant change and then benchmarked to previous efficacy and effectiveness studies. Symptoms of depression and anxiety significantly improved, and mixed-diagnosis groups compared favorably with diagnosis-specific CBT, suggesting that unified treatments are an effective, efficient, and practical method of treatment delivery.

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Many studies have examined factors influencing or associated with the outcome of bipolar disorder. However, little is known about bipolar patients' subjective experiences of their illness and the issues that are of significance to them. The use of a client-focused approach in identifying these issues is important for planning treatment and clinical medical management to address patients' specific needs. Focus group discussions and individual interviews were conducted with 18 bipolar patients and transcribed verbatim. The data were then analyzed and interpreted according to the phenomenological approach to qualitative research. The data were interpreted in terms of how patients view themselves, their lives and community, and their future. Implications for treatment and future research are discussed.

Homework or between-session learning has long been considered an essential aspect of effective cognitive behaviour therapy. However, it has received relatively less empirical attention than other components of cognitive behaviour therapy. In general, studies have found that homework completion is predictive of outcome in psychotherapy. However, the amount of homework completed by a patient represents only one aspect of this important therapeutic component. This study investigated both the quantity and the quality of homework completed during a 10-week group cognitive and behavioural treatment program for anxious and depressed patients. It explored the relationship between various aspects of homework completion and outcomes on several different variables. A total of 94 patients were included in the analysis. It was found that both quantity and quality of homework completed predicted outcome on measures of depression, anxiety and quality of life at post-treatment and at 1-month follow-up. The results were strongest for the amount of homework completed, suggesting that clinicians should encourage patients to complete homework even if the homework content is not entirely accurate. The results of this study highlight the importance of homework as a central part of effective cognitive and behavioural treatment.

Early change in treatment is encouraged to achieve the best possible prognosis in CBT-E. Those who did not achieve rapid response still had an overall significant improvement in symptoms from pretreatment to post-treatment, but a lower rate of full remission. Nonrapid responders are an important group of patients to study because they offer researchers an opportunity to improve clinical decision-making and treatment outcomes for patients who are at risk of suboptimal response.

Mindfulness training has been proposed as a potentially important new approach for the treatment of generalized anxiety disorder (GAD). However, to date only a few studies have investigated mindfulness training for GAD. The aim of this study was to further investigate symptom change and recovery in pathological worry after mindfulness-based cognitive therapy (MBCT) using an uncontrolled pre-post design. Twenty-three adults with a primary diagnosis of GAD participated in the study. The MBCT program involved 9 weekly 2-hour group sessions, a post-treatment assessment session, and 6-week and 3-month follow-up sessions. Intent-to-treat analysis revealed significant improvements in pathological worry, stress, quality of life, and a number of other symptoms at post-treatment, which were maintained at follow-up. Attrition was also low, and MBCT was perceived as a credible and acceptable intervention. However, when applying standardized recovery criteria to pathological worry scores, the rate of recovery at post-treatment was very small, although improved at follow-up. Overall, the findings suggest MBCT is definitely worthy of further investigation as a treatment option for GAD, but falls well short of outcomes achieved by past research. Possible reasons for the poor rate of recovery, implications, and limitations are briefly outlined.