Integrating psychotherapy with the hierarchical taxonomy of psychopathology (HiTOP).

Abstract

In this paper we present the Hierarchical Taxonomy of Psychopathology (HiTOP), an evidencebased alternative to the categorical approach to diagnostic classification with considerable promise for integrative psychotherapy research and practice. We first review issues associated with the categorical approach that may have constrained advances in psychotherapy. We next describe how the HiTOP model addresses some of these issues. We then offer suggestions regarding potentially mutual benefits of integrating HiTOP with treatment principles from the common factors literature as well as the cognitive-behavioral and relational psychotherapy traditions. We conclude by enumerating principles for psychotherapy research and practice based on the HiTOP model, which are illustrated with a case example.

CBT at the Crossroads: The Rise of Transdiagnostic Treatments

“…The transdiagnostic process perspective-that has gained popularity thanks to the rise of shared mechanism unified treatments-has merit for the further development of treatments and clinical decision tools. A necessary next step is to identify relevant processes across diagnoses and derive therapeutic approaches that target these processes (Hofmann and Hayes 2019;Hopwood et al 2019). From our point of view, this implementation can only be achieved in individualized approaches.…”

“…Embracing these systems might help to advance psychotherapy research and practice. A similar approach to HiTOP could be adopted within psychotherapy research to create an empirically based hierarchical conceptualization of psychotherapy, where techniques of different approaches are integrated and distinguished based on quantitative data (Hopwood et al 2019). While the development of a hierarchical organization of psychotherapeutic techniques would be a highly complex endeavor, it would have a revolutionary impact on empirical clinical decision-making.…”

Revealing what is distinct by recognising what is common: distinguishing between complex PTSD and Borderline Personality Disorder symptoms using bifactor modelling

“…It has been hypothesised that 'P' may reflect a biological vulnerability or processes inherent to many forms of psychopathology, such as neuroticism or negative emotionality, deficits with emotion regulation, and/or disordered thought processes (Caspi & Moffitt, 2018). One of the most radical implications of 'P' is that clinicians may potentially provide the same treatment to all clients regardless of presenting problems, this may explain why transdiagnostic therapies which were initially developed for one disorder have been successful in treating a range of disorders (Hopwood et al, 2019;Ruggero et al, 2019). However, if there are features unique to a specific syndrome or broader dimensions of psychopathology then more specific treatment considerations may be required (Hopwood et al, 2019;Ruggero et al, 2019).…”

Retiring Categorical Systems and the Biomedical Model of Mental Illness: The Why and the How—A Clinician’s Perspective

“…Finally, further support for using the "p" factor, relates to how researchers highlight that cognitive processing, attachment, interpersonal, psychodynamic, and evolutionary approaches have strikingly similar ways to conceptualize and treat personality disorders (Huprich, 2015). Based on the above, the HiTOP system offers an evidence-based alternative to traditional categorical diagnostic classification approaches, and a promising future for research and practice of integrative psychotherapy (Hopwood et al, 2019). This relates directly to clinical practice.…”