Fostering Engagement in Early Sessions of Transdiagnostic Cognitive-Behavioral Therapy

This article describes the early sessions of a transdiagnostic cognitive-behavioral treatment for emotional disorders that is designed to target temperamental characteristics, particularly neuroticism and resulting emotion dysregulation, underlying all anxiety, depressive, and related disorders. The...

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Bibliographic Details
Published in:Psychotherapy (Chicago, Ill.) Ill.), 2019-03, Vol.56 (1), p.41-47
Main Authors: Curreri, Andrew J, Farchione, Todd J, Wang, Mengxing
Format: Article
Language:English
Subjects:
Anxiety
Client Participation
Cognitive Behavior Therapy
Collaboration
Emotional Disturbances
Human
Neuroticism
Psychological Engagement
Therapeutic Alliance
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Summary:This article describes the early sessions of a transdiagnostic cognitive-behavioral treatment for emotional disorders that is designed to target temperamental characteristics, particularly neuroticism and resulting emotion dysregulation, underlying all anxiety, depressive, and related disorders. These sessions facilitate clinical improvement by setting realistic expectations, fostering a collaborative therapeutic alliance, and improving motivation for change. Addressing these common factors in early sessions strengthens patient engagement, which is necessary for patients to benefit most greatly from subsequent treatment elements. We begin with a brief description of the treatment protocol and theoretical model. Next, we describe how the early sessions, specifically, are used to help facilitate application of later treatment skills that target specific psychopathological mechanisms. Finally, we present a clinical case example and utilize clinical vignettes from the early sessions to illustrate the therapy process. Specific clinical exchanges are highlighted to offer advice on how therapists can most effectively implement these procedures. Clinical Impact Statement Question: What therapeutic techniques can therapists use in early sessions of transdiagnostic cognitive-behavioral therapy to strengthen their patients' engagement with treatment skills? Findings: Therapists using the Unified Protocol use discussions and activities in early sessions to help patients set realistic treatment expectations, cultivate a collaborative alliance, and enhance motivation for change. Meaning: Incorporating these discussions and activities early in treatment may allow for stronger engagement with specific treatment mechanisms later in treatment. Next Steps: Future empirical studies should seek to investigate the relationship between common factors, specific treatment mechanism engagement, and outcomes.
ISSN:0033-3204
1939-1536
DOI:10.1037/pst0000207