Transdiagnostic internet treatment for anxiety and depression = Tratamiento transdiagnóstico por internet de la ansiedad y la depresión

Abstract

Anxiety and depression are common, chronic, disabling and frequently comorbid, but many people experience barriers accessing treatment. Internet-delivered psychological treatments (iPT) have considerable potential to increase access, while transdiagnostic (TD) interventions, which aim to simultaneously treat multiple disorders, represent an emerging approach that may facilitate the treatment of comorbidity. The present paper describes a conceptual and pragmatic rationale for combining iPT and TD approaches. It also describes the authors' experiences in developing and evaluating TD iPT protocols for anxiety and depression. The results of 4 randomised controlled trials and one open trial (N = 572) are reviewed. The results of these trials are encouraging and indicate TD iPT can significantly reduce symptoms of both principal and comorbid disorders. However, independent replication of the existing findings is required and many outstanding questions remain. We watch with interest how further conceptual and technological developments influence the content and delivery of these interventions.Keywords: Internet-delivered psychological therapy (iPT); randomised controlled trial (RCT); anxiety; depression; transdiagnostic; treatment; internet. Tratamiento transdiagnóstico por internet de la ansiedad y la depresiónResumen: La ansiedad y la depresión son fenómenos comunes, crónicos, incapacitantes y frecuentemente comórbidos, pero muchas personas tienen dificultades para acceder a su tratamiento. Los tratamientos psicológicos administrados por internet poseen un gran potencial para incrementar el acceso de los pacientes, mientras que las intervenciones transdiagnósticas, que se dirigen a tratar simultáneamente múltiples trastornos, representan un enfoque emergente que podría facilitar el tratamiento de dicha comorbilidad. El presente trabajo describe los fundamentos conceptuales y pragmáticos para la aplicación del transdiagnóstico a través de internet. También se describe la experiencia de los autores en el desarrollo y evaluación de protocolos transdiagnósticos administrados por internet para el tratamiento de la ansiedad y la depresión. Se revisan los resultados procedentes de 4 ensayos controlados aleatorizados y un ensayo abierto (N = 572). Los resultados de estos ensayos son alentadores e indican que el transdiagnóstico administrado por internet puede reducir significativamente tanto los síntomas de los trastornos principales como de los trastornos comórbidos. Sin embargo, aparte de que existen cuestiones sin resolver, se requiere una replicación independiente de los resultados existentes. Observamos con interés la forma en que los futuros desarrollos teó-ricos y tecnológicos influyan sobre el contenido y administración de estas intervenciones.Palabras clave: Terapia psicológica por internet; ensayo controlado aleatorizado; ansiedad; depresión; transdiagnóstico; tratamiento; internet.

Internet-delivered cognitive behavioural therapy for symptoms of PTSD among public safety personnel: Initial outcomes of an open cohort preference trial of transdiagnostic and disorder-specific therapy

“…ICBT is an effective treatment that can overcome many treatment barriers ( Andersson et al, 2019 ). Transdiagnostic and disorder-specific ICBT have demonstrated similar outcomes ( Păsărelu et al, 2017 ), but transdiagnostic approaches to treatment have certain advantages ( Barlow, 2014 ; Titov et al, 2012 ). Preliminary results suggest that PSP have favorable attitudes toward tailored ICBT ( McCall et al, 2020a ; McCall et al, 2020b ) and benefit from it ( Hadjistavropoulos et al, 2021a ).…”

“…Adopting a single, transdiagnostic therapy approach to treat multiple emotional concerns has certain advantages, including increased efficiency of clinician training, simplification of dissemination efforts, and improved ability to help clients who present with comorbid emotional problems ( Barlow, 2014 ; Titov et al, 2012 ), which are extremely common, particularly among PSP ( Carleton et al, 2018 ). However, patient treatment preferences can also impact enrollment, attrition, adherence, satisfaction, and outcomes, and should be considered when selecting between transdiagnostic and disorder-specific treatment approaches ( American Psychological Association, 2006 ; Delevry and Le, 2019 ; Preference Collaborative Review Group, 2008 ).…”

Internet Interventions for Mental Health: Current State of Research, Lessons Learned and Future Directions

“…Studies have also shown that tailored and transdiagnostic treatments are valuable options for patients [56], and they have been used to provide treatment for patients with comorbidity [8]. Transdiagnostic interventions refer to interventions that target the core symptoms and underlying vulnerabilities of several disorders simultaneously [79]. Tailored interventions allow both the therapist and the patient to influence the protocol [53] and interventions can be tailored to, for example, patient characteristics [22].…”

Efficacy of Internet-Delivered Transdiagnostic Cognitive Behavior Therapy on Emotion Regulation, Repetitive Negative Thought and Social Adjustment in Adolescents with Sub- clinical Diagnosis of Emotional Disorders

“…An emerging model of service delivery via the Internet has the potential to improve access to evidence-based treatments for anxiety and depressive disorder (14). Internet-based treatments have many advantages including improved access to evidence-based treatments and cost-effectiveness compared to traditional faceto-face interventions (15).…”