Prospective cohort feasibility study of a transdiagnostic group intervention for common mental health problems: The <scp>T</scp>ake <scp>C</scp>ontrol <scp>C</scp>ourse

Morris, Lydia; Mansell, Warren; Emsley, Richard; Bates, Rachel; Comiskey, Jody; Pistorius, Emma; McEvoy, Phil

doi:10.1111/papt.12070

Cited by 10 publications

(17 citation statements)

References 113 publications

(95 reference statements)

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“…A substantial proportion (27%) of studies did not acknowledge using any psychometric interview to establish their gold standard diagnoses. Several studies (16%) did not refer to a gold standard diagnostic manual, but speculated on comparative benefits of the transdiagnostic approach over specific diagnoses.…”

Section: Resultsmentioning

confidence: 99%

“…One interventional study stated that the participants were not diagnosed at all. The study addressed this issue by simply noting that “it would have been informative to know client diagnoses”, raising concerns about unnecessary or excessive treatments in this sample.…”

Section: Resultsmentioning

confidence: 99%

“…An interventional study which did not use cut‐offs to define post‐traumatic stress disorder concluded that treating distress was better than treating the categorical disorder. Another interventional study which measured symptoms but not disorders tautologically concluded that the potential advantage of transdiagnostic interventions was a reduced need for disorder‐based assessments. Some studies did apply cut‐offs but eventually did not use them for their main analyses.…”

Section: Resultsmentioning

confidence: 99%

“…Frequently, studies did not specify the exact ICD/DSM types of mental disorders that were investigated, but only referred to the general domains of psychotic disorders, substance induced disorders, anxiety disorders, mood disorders, or mood and anxiety disorders. The specific ICD/DSM diagnostic codes were hardly ever reported.…”

Section: Resultsmentioning

confidence: 99%

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Transdiagnostic psychiatry: a systematic review

et al. 2019

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The usefulness of current psychiatric classification, which is based on ICD/DSM categorical diagnoses, remains questionable. A promising alternative has been put forward as the "transdiagnostic" approach. This is expected to cut across existing categorical diagnoses and go beyond them, to improve the way we classify and treat mental disorders. This systematic review explores whether self-defining transdiagnostic research meets such high expectations. A multi-step Web of Science literature search was performed according to an a priori protocol, to identify all studies that used the word "transdiagnostic" in their title, up to May 5, 2018. Empirical variables which indexed core characteristics were extracted, complemented by a bibliometric and conceptual analysis. A total of 111 studies were included. Most studies were investigating interventions, followed by cognition and psychological processes, and neuroscientific topics. Their samples ranged from 15 to 91,199 (median 148) participants, with a mean age from 10 to more than 60 (median 33) years. There were several methodological inconsistencies relating to the definition of the gold standard (DSM/ICD diagnoses), of the outcome measures and of the transdiagnostic approach. The quality of the studies was generally low and only a few findings were externally replicated. The majority of studies tested transdiagnostic features cutting across different diagnoses, and only a few tested new classification systems beyond the existing diagnoses. About one fifth of the studies were not transdiagnostic at all, because they investigated symptoms and not disorders, a single disorder, or because there was no diagnostic information. The bibliometric analysis revealed that transdiagnostic research largely restricted its focus to anxiety and depressive disorders. The conceptual analysis showed that transdiagnostic research is grounded more on rediscoveries than on true innovations, and that it is affected by some conceptual biases. To date, transdiagnostic approaches have not delivered a credible paradigm shift that can impact classification and clinical care. Practical "TRANSD"iagnostic recommendations are proposed here to guide future research in this field.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Transdiagnostic psychiatry: a systematic review

et al. 2019

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“…However, it is also possible that flexibility could be offered in other ways. For example, three participants said that they would have liked more TCC sessions, and this corresponds to increasing evidence that psychological change does not occur within a predictable time frame and that psychological interventions can be offered that respond to differences in “change trajectory” (Carey & Spratt, 2009; Morris, Mansell, Emsley, et al, 2016). Although TCC sessions cover a range of topics and will be sufficient for many clients, for others, more (or less) therapy may be required.…”

Section: Discussionmentioning

confidence: 97%

Experiences of a transdiagnostic group, the Take Control Course, for clients with common mental health problems: A qualitative study

Morris

Mansell

Amos

et al. 2018

Clin Psychology and Psychoth

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ObjectivesDespite the promising effectiveness findings for transdiagnostic groups, studies have not explored clients' experiences. There is a risk that clients could perceive that the content of transdiagnostic groups is not sufficiently tailored to their specific problems. Our aims were to examine whether a brief transdiagnostic group, the Take Control Course (TCC), was acceptable to participants and to explore participants' perceptions of psychological change.MethodsQualitative data were collected via 12 semistructured, in‐depth interviews. Data collection and thematic analysis were concurrent and iterative.ResultsThree superordinate themes were identified: “Style and format,” “Control and flexibility,” and “Change.” The flexible group format was appreciated, as participants felt able to engage at their own pace and adapt relevant aspects. Greater clarity regarding what was within participants' control reduced distress and enabled effective pursuit of valued goals. Participants described significant (predominantly gradual) changes, including substantial improvements within relationships.ConclusionsThe transdiagnostic format did not prevent participants experiencing the TCC as individually relevant. The flexibility and consistent theoretical framework seemed to contribute to this. The results indicated that greater consideration of control and mindfulness allowed greater cognitive flexibility, an ability to reprioritize and let go of unhelpful habits, which better enabled participants to meet their goals. Implications for group therapy include (a) clearly explaining the format of such groups to clients and (b) providing flexibility in the way the group is delivered where possible. Additional qualitative studies of transdiagnostic groups are required to establish if themes generalize to other transdiagnostic groups.

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