Transdiagnostic Assessment and Case Formulation

2017 ◽  
pp. 17-37
Author(s):  
Hannah Boettcher ◽  
Laren R. Conklin
Keyword(s):  
Emotional Disorders ◽  
Relevant Information ◽  
Emotional Disorder ◽  
Self Report ◽  
Case Formulation ◽  
Case Conceptualization ◽  
Emotional Experiences ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Dimensional Assessment

This chapter describes a transdiagnostic, emotion-focused approach to case formulation that facilitates individualized application of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP). We begin by highlighting the advantages of dimensional assessment and classification in the domain of emotional disorders. Next, we describe the elements of case conceptualization essential to the UP, including assessment of strong uncomfortable emotions, aversive reactions to emotional experiences, and efforts to escape or avoid these experiences. We provide examples of such processes, suggestions for how to elicit relevant information from patients, and a worksheet for conducting case formulation within the UP framework. Finally, we preview a recently developed self-report instrument that uses dimensional assessment to yield a transdiagnostic profile of emotional disorder features, which may further facilitate treatment planning.

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders

2010 ◽  
Author(s):  
David H. Barlow ◽  
Kristen K. Ellard ◽  
Christopher P. Fairholme ◽  
Todd J. Farchione ◽  
Christina L. Boisseau ◽  
...  
Keyword(s):  
Emotion Regulation ◽  
Emotional Disorders ◽  
Emotional Experience ◽  
Dissociative Disorders ◽  
Emotional Experiences ◽  
Transdiagnostic Treatment ◽  
Situational Cues ◽  
Unified Protocol ◽  
The Common ◽  
Evidenced Based

This online patient workbook is a radical departure from disorder-specific treatments of various emotional disorders, and is designed to be applicable to all anxiety and unipolar mood disorders, as well as other disorders with strong emotional components, such as many somatoform and dissociative disorders. It covers the Unified Protocol (UP), which capitalizes on the contributions made by cognitive-behavioral theorists by distilling and incorporating the common principles of CBT present in all evidenced based protocols for specific emotional disorders, as well as drawing on the field of emotion science for insights into deficits in emotion regulation. It discusses the seven modules of UP, and focuses on four core strategies: becoming mindfully aware of emotional experience; reappraising rigid emotion laden attributions; identifying and preventing behavioral and emotional avoidance; and facilitating exposure to both interoceptive and situational cues associated with emotional experiences.

Moving UP from Here

2017 ◽  
pp. 149-160
Author(s):  
David H. Barlow ◽  
Shannon Sauer-Zavala ◽  
Todd J. Farchione ◽  
Heather Murray Latin ◽  
Kristen K. Ellard ◽  
...  
Keyword(s):  
Emotional Disorders ◽  
Treatment Program ◽  
Treatment Goals ◽  
Emotional Experiences ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Practice Plan ◽  
The Moment ◽  
The Way

Chapter 13 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Workbook reviews the treatment program. (1) All emotions, even the ones that feel negative or uncomfortable, provide important information that can motivate us to take action in helpful ways. (2) Staying present in the moment and taking a nonjudgmental view of emotions can help to prevent emotions from increasing in intensity. The way we think about a situation influences how we feel, and how we feel affects the way we interpret a situation. (3) Although avoiding uncomfortable emotional experiences can work well in the short-term, it isn’t an effective long-term coping strategy. The chapter helps us to evaluate our progress and revisit our treatment goals. The most effective way to maintain progress and to keep improving is to continue to practice the skills learned in this program, and therefore a practice plan is developed in this last chapter.

Mindful Emotion Awareness

2017 ◽  
pp. 61-76
Author(s):  
David H. Barlow ◽  
Shannon Sauer-Zavala ◽  
Todd J. Farchione ◽  
Heather Murray Latin ◽  
Kristen K. Ellard ◽  
...  
Keyword(s):  
Emotional Disorders ◽  
Mood Induction ◽  
Daily Life ◽  
Emotional Experiences ◽  
Transdiagnostic Treatment ◽  
Mindful Awareness ◽  
Unified Protocol ◽  
Meditation Exercise

Chapter 7 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Workbook presents the benefits of applying mindful awareness, a nonjudgmental present-focused stance, to emotional experiences. Mindful awareness is first practiced through a formal meditation exercise that introduces readers to applying this quality of attention to their emotions. Next, readers are encouraged to continue practicing mindful emotion awareness though the use of a Mindful Mood Induction exercise. Finally, the chapter continues by focusing on the Anchoring in the Present skill, which allows us to apply the concept of mindful emotion awareness to emotional experiences as they are coming up in daily life.

Targeting Comorbid Anxiety and Depression Using the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents

2018 ◽  
Vol 17 (2) ◽  
pp. 59-76 ◽  
Author(s):  
Jamie A. Sherman ◽  
Niza A. Tonarely ◽  
Jill Ehrenreich-May
Keyword(s):  
Emotional Disorders ◽  
Emotional Disorder ◽  
Adolescent Male ◽  
Individual Treatment ◽  
Obsessive Compulsive ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Wide Range ◽  
Core Features

This article presents the use of an emotion-focused, transdiagnostic therapy approach designed for adolescents with a range of anxiety, obsessive-compulsive, depressive, and related disorders, referred to here as emotional disorders. Preliminary work suggests that emotional disorders share underlying temperament factors, such as high neuroticism and low extroversion in adults and adolescents, possibly influencing the development and maintenance of emotional disorders across the life span. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) and similar core dysfunction-focused, transdiagnostic therapy approaches may lead to successful treatment by targeting higher order factors that cut across an array of emotional disorders The utility of UP-A for adolescents experiencing a variety of emotional disorder symptoms is demonstrated here through the case illustration of Tony, a 15-year-old adolescent male with severe social and generalized anxiety and mild levels of depression. After 16 individual treatment sessions, Tony demonstrated significant reductions in anxiety and depressive symptoms, as well as an ability to respond more adaptively to a range of emotional experiences. This case study illustrates how short-term, transdiagnostic treatment using the UP-A can effectively ameliorate a wide range of emotional disorder symptoms in adolescents and may also lead to changes in core features of neuroticism, potentially preventing development of further emotional difficulties over time.

Introduction to the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C)

2017 ◽  
pp. 171-180
Author(s):  
Jill Ehrenreich-May ◽  
Sarah M. Kennedy ◽  
Jamie A. Sherman ◽  
Emily L. Bilek ◽  
Brian A. Buzzella ◽  
...  
Keyword(s):  
Emotional Disorders ◽  
Treatment Strategies ◽  
Evidence Based ◽  
Age Group ◽  
Emotional Experiences ◽  
Obsessive Compulsive ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Wide Range ◽  
Anxiety Depression

Chapter 10 introduces the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C). This is also called the “Emotion Detectives” program, which reflects the guiding treatment metaphor: teaching children to “solve the mystery of their emotions,” as detectives might. The UP-C is intended to reduce the intensity and frequency of symptoms common to youth with emotional disorders by using core evidence-based treatment strategies in a broad manner that applies to a wide range of aversive emotional experiences characteristic of youth emotional disorders (i.e., anxiety, depression, other internalizing disorders). Many anxiety, depression, adjustment, traumatic stress-related, or obsessive-compulsive or related disorders would be appropriate targets for this intervention. The UP-C is intended for children between the ages of 7 and 13, although children slightly above or below this age group may benefit from this format.

Module 3: Mindful Emotion Awareness

2017 ◽  
pp. 81-96
Author(s):  
David H. Barlow ◽  
Todd J. Farchione ◽  
Shannon Sauer-Zavala ◽  
Heather Murray Latin ◽  
Kristen K. Ellard ◽  
...  
Keyword(s):  
Emotional Disorders ◽  
Open Approach ◽  
Emotional Experiences ◽  
Transdiagnostic Treatment ◽  
Mindful Awareness ◽  
Unified Protocol ◽  
Over Time

Chapter 8 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide introduces patients to cultivating a nonjudgmental, present-focused stance toward their emotional experiences. The previous module asked patients to monitor to how their emotions unfold over time. This module builds on that work by encouraging patients to incorporate mindful awareness that moves beyond simply paying attention to these experiences. The principles of mindfulness are very consistent with the overall goal of the UP—to develop a more open, approach-oriented relationship with emotions.

The Unified Protocol for Borderline Personality Disorder

2017 ◽  
pp. 200-214
Author(s):  
Shannon Sauer-Zavala ◽  
Kate H. Bentley ◽  
Julianne G. Wilner
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotional Disorders ◽  
Borderline Personality ◽  
Diagnostic Group ◽  
Emotional Disorder ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Maintenance Factors ◽  
Case Presentations

Borderline personality disorder (BPD) is a severe, difficult-to-treat psychiatric condition that represents a large proportion of treatment-seeking individuals. This disorder is characterized by high rates of co-occurrence with depressive and anxiety disorders, and recent explanations for this comorbidity suggest that these disorders share biological vulnerabilities and functional maintenance factors. Given the commonalities among BPD and other emotional disorders, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) was clinically applied to five individuals who met criteria for BPD and at least one comorbid emotional disorder. This chapter will highlight the theoretical rationale for considering BPD an emotional disorder, underscoring the use of the UP with this population. In addition, detailed case presentations of two individuals with BPD treated with the UP will be presented to illustrate the ways in which UP skills can be flexibly applied within this diagnostic group.

Countering Emotional Behaviors

2017 ◽  
pp. 95-110
Author(s):  
David H. Barlow ◽  
Shannon Sauer-Zavala ◽  
Todd J. Farchione ◽  
Heather Murray Latin ◽  
Kristen K. Ellard ◽  
...  
Keyword(s):  
Emotional Disorders ◽  
Emotional Experiences ◽  
Short Term ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Alternative Action ◽  
The Future ◽  
Alternative Behaviors ◽  
Long Term Consequences

Chapter 9 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Workbook looks at another part of our emotional experiences—emotional behaviors, which refer to the things we do to manage our emotions. This chapter presents skills to help us identify and evaluate our emotional behaviors by examining both the short term and long term consequences of these actions. In general, unhelpful emotional behaviors provide short term relief from strong emotions but set us up to experience even more strong emotions in the future. Lastly, we learn to counter unhelpful emotional behaviors by replacing current emotional behaviors with new, alternative behaviors, a skill called choosing an Alternative Action.

Cognitive Flexibility

2017 ◽  
pp. 77-94
Author(s):  
David H. Barlow ◽  
Shannon Sauer-Zavala ◽  
Todd J. Farchione ◽  
Heather Murray Latin ◽  
Kristen K. Ellard ◽  
...  
Keyword(s):  
Emotional Disorders ◽  
Cognitive Flexibility ◽  
Emotional Experiences ◽  
Transdiagnostic Treatment ◽  
Negative Thinking ◽  
Jumping To Conclusions ◽  
Unified Protocol

Chapter 8 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Workbook looks at one part of our emotional experiences—our thoughts—and describes how thoughts are very important for influencing how we feel. The chapter describes our tendency to get stuck in automatic patterns of thinking, which we refer to as thinking traps. This treatment describes two specific types of thinking traps: jumping to conclusions and thinking the worst. Next, readers are encouraged to identify their own patterns of negative thinking to generate alternative interpretations. The overall goal is to be more flexible in our thinking, referred to as cognitive flexibility.

Understanding Your Emotions—What Is an Emotion?

2017 ◽  
pp. 41-52
Author(s):  
David H. Barlow ◽  
Shannon Sauer-Zavala ◽  
Todd J. Farchione ◽  
Heather Murray Latin ◽  
Kristen K. Ellard ◽  
...  
Keyword(s):  
Emotional Disorders ◽  
Positive Emotions ◽  
Negative Emotions ◽  
Emotional Experiences ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
And Behaviors

Chapter 5 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Workbook teaches that emotions are necessary and helpful in our day-to-day lives and explains why we wouldn’t actually want to get rid of all “bad” feelings. Instead of getting rid of negative emotions, the goal of this treatment is to help people respond differently when these emotions come up. The chapter looks at how emotions (such as fear, sadness, anxiety, and anger, as well as positive emotions, like happiness, excitement, and pride) can go from providing useful input to feeling totally overwhelming. Emotional experiences are made less overwhelming by breaking them down into more manageable parts—thoughts, physical sensations, and behaviors.

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