Transdiagnostic Cognitive Behavioral Psychotherapy: Unified Protocol as an Example

Abstract

The fact that there are many limitations of the current classification systems led to the emergence of transdiagnostic approaches (TA) that focus on the common psychopathological processes underlying disorders rather than categorical diagnoses. TA focuses on the underlying common psychopathological processes in the emergence and persistence of mental disorders. Thus, even if the disorders are categorically diagnosed differently, it can be determined how they overlap or separate with each other. TA aims to treat mental disorders using these aspects. TA has a flexible and modular structure that can be easily integrated into cognitive behavioral therapies. The rest of this review will focus on the Unified Protocol (UP), one of the most popular TA examples. The main purpose of the UP is to enable patients to recognize their feelings and give more adaptive reactions to their negative emotions. Accordingly, UP consists of eight modules. The modules can usually be completed in a total of 11 - 17 weeks. Each 50 to 60-minute individual session is held once a week. If necessary, changes can be made to the number or the frequency of sessions allocated to modules. The goals of each module of the UP and the treatment approaches towards these goals allow a very clearly defined approach. For this reason, there is a need for a detailed evaluation, conceptualization and treatment plan before the UP is put into practice. We hope that mental health professionals from Turkey will contribute to the developments in the UP.

Keywords

• cognitive behavioral therapy
• modular approach
• transdiagnostic approach
• Unified Protocol

Ötetanısal (Transdiyagnostik) Bilişsel Davranışçı Psikoterapi: Bütünleşik Protokol Örneği

Öz

Kategorik sınıflandırmaya imkân veren yaklaşımların pek çok kısıtlılığının olması, tanılardan ziyade tanıların altında yatan ortak psikopatolojik süreçlere odaklanan ve kesitsel yerine boylamsal (uzunlamasına) değerlendirmeyi vurgulayan ötetanısal (transdiyagnostik, tanılarötesi) yaklaşımların (ÖY) öne çıkmasına yol açmıştır. ÖY ruhsal bozuklukların ortaya çıkmasında ve sürmesinde altta yatan ortak psikopatolojik süreçlere odaklanır. Böylelikle kategorik açıdan bozukluklar farklı şekilde tanı alsa dahi birbirleriyle ne açıdan örtüştükleri ya da ayrıştıkları tespit edilebilir. ÖY, bu yönleri kullanarak ruhsal bozuklukları tedavi etmeyi amaçlar. ÖY, bilişsel davranışçı terapilerin işleyişine kolaylıkla entegre edilebilecek esnek ve modüler bir yapıya sahiptir. Bu gözden geçirme yazısının geri kalan kısmında en popüler ÖY örneklerinden biri olan Bütünleşik Protokol (BP) üzerinde durulacaktır. BP’de temel amaç hastaların duygularını tanımaları ve olumsuz nitelikteki duygularına daha işlevsel tepkiler vermelerini sağlamaktır. Bu doğrultuda BP sekiz modülden oluşur. Modüller genellikle haftada bir sıklıkta, her biri 50 – 60 dakika süren bireysel görüşmeler ile toplam 11 – 17 hafta içerisinde tamamlanabilir. Gereklilik olması halinde modüllere ayrılan oturum sayılarında veya oturumların sıklığında değişiklik yapılabilir. BP’nin her bir modülü hedefleri ve bu hedeflere dönük tedavi yaklaşımları son derece net bir şekilde belirlenmiş bir yaklaşıma imkân verir. Bu nedenle BP’nin uygulamaya geçirilmesinden önce detaylı bir değerlendirme, olgu kavramsallaştırması ve tedavi planı ortaya çıkarma gereği vardır. BP konusundaki gelişmelere Türkiye’den ruh sağlığı ve hastalıkları uzmanları ve çalışanlarının da katkı yapması ümit edilmektedir.

Anahtar Kelimeler

• bilişsel davranışçı terapi
• Bütünleşik Protokol
• modüler yaklaşım
• ötetanısal yaklaşım

Kaynakça

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