Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-25T22:05:39.181Z Has data issue: false hasContentIssue false

Transdiagnostic CBT versus counselling sessions: a naturalistic trial from Saudi Arabia

Published online by Cambridge University Press:  20 January 2021

Yousra Alatiq*
Affiliation:
King Abdulaziz Medical City-Riyadh (KAMC-R) Clinical Psychology Section, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Saudi Arabia
*
Corresponding author. Email: [email protected]; [email protected]

Abstract

In a previous feasibility trial, we found that transdiagnostic cognitive behavioural therapy (T-CBT) showed promising results in improving emotional disorders in adults from Saudi Arabia. The primary aim of this study was to replicate these findings and compare T-CBT results with results for counselling sessions. The overall sample consisted of 276 patients (175 in the T-CBT group and 101 in the counselling group). Of the overall sample, 110 patients (39.9%) completed the treatment plan, and 166 (60.1%) disengaged from treatment. The pre- and post-assessments of the clients who completed the treatment showed large effect sizes for almost all outcome measures for both the T-CBT and counselling groups. For patients who decided to disengage from therapy, T-CBT had medium effect sizes for all three measures (depression, anxiety and function), while counselling sessions had medium effect size for the anxiety measure only. This study provides additional evidence that T-CBT is suitable for patients from Saudi Arabia with emotional disorders. The study also provides information regarding when and why T-CBT or counselling was applied in a real clinical setting. Implications and recommendations are discussed.

Key learning aims

  1. (1) To confirm a previous feasibility trial on the effect of T-CBT in Saudi Arabia.

  2. (2) To explore the effect of T-CBT compared with counselling in a real clinical setting.

  3. (3) To identify variables related to the choice of interventions.

Type
Original Research
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Further reading

Harvey, A. G., Watkins, E., & Mansell, W. (2004) Cognitive Behavioural Processes across Psychological Disorders: A Transdiagnostic Approach to Research and Treatment. Oxford, UK: Oxford University Press.CrossRefGoogle Scholar

References

Alatiq, Y., & Al Modayfer, O. (2019). Transdiagnostic CBT for adult emotional disorders: a feasibility open trial from Saudi Arabia. the Cognitive Behaviour Therapist, 12.CrossRefGoogle Scholar
Albuhairi, A. A. (2005). SCL-90_R Arabic version. Asuod, Eyget: Counseling & Educational Center.Google Scholar
Andersen, P., Toner, P., Bland, M., & McMillan, D. (2016). Effectiveness of transdiagnostic cognitive behaviour therapy for anxiety and depression in adults: a systematic review and meta-analysis. Behavioural and Cognitive Psychotherapy, 44, 673690.CrossRefGoogle ScholarPubMed
Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35, 205230.CrossRefGoogle Scholar
Barlow, D. H., Farchione, T. J., Bullis, J. R., Gallagher, M. W., Murray-Latin, H., Sauer-Zavala, S., … & Ametaj, A. (2017). The unified protocol for transdiagnostic treatment of emotional disorders compared with diagnosis-specific protocols for anxiety disorders: a randomized clinical trial. AMA Psychiatry, 74, 875884.Google ScholarPubMed
Barlow, D. H., Farchione, T. J., Sauer-Zavala, S., Latin, H. M., Ellard, K. K., Bullis, J. R., Bentley, K. H., Boettcher, H. T., & Cassiello-Robbins, C. (2011). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide. New York, USA: Oxford University Press.Google Scholar
Bentall, R. P. (2003). Madness Explained: Psychosis and Human Nature. Penguin UK.Google Scholar
Binnie, J., & Boden, Z. (2016). Non-attendance at psychological therapy appointments. Mental Health Review Journal, 21, 231248.CrossRefGoogle Scholar
Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clinical Psychology Review, 26, 1731.CrossRefGoogle ScholarPubMed
Clark, D. A., & Taylor, S. (2009). The transdiagnostic perspective on cognitive-behavioral therapy for anxiety and depression: new wine for old wineskins? Journal of Cognitive Psychotherapy, 23, 6066.CrossRefGoogle Scholar
Derogatis, L. R. (1977). SCL-90-R Administration, Scoring and Procedures Manual. Baltimore, MD, USA: Clinical Psychometric Research.Google Scholar
Erickson, D. H., Janeck, A. S., & Tallman, K. (2007). A cognitive-behavioral group for patients with various anxiety disorders. Psychiatric Services, 58, 12051211.CrossRefGoogle Scholar
Erickson, D. H., Janeck, A. S., & Tallman, K. (2009). Transdiagnostic group CBT for anxiety: clinical experience and practical advice. Journal of Cognitive Psychotherapy, 23, 3443.CrossRefGoogle Scholar
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: a ‘transdiagnostic’ theory and treatment. Behaviour Research and Therapy, 41, 509528.CrossRefGoogle ScholarPubMed
Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Thompson-Hollands, J., Carl, J. R., … & Barlow, D. H. (2012). Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behavior Therapy, 43, 666678.CrossRefGoogle ScholarPubMed
Ferrans, C. E., & Powers, M. J. (1985). Quality of life index: development and psychometric properties. Advances in Nursing Science, 8, 1524.CrossRefGoogle ScholarPubMed
García-Escalera, J., Chorot, P., Valiente, R. M., Reales, J. M., & Sandín, B. (2017). Eficacia de la terapia cognitivo conductual transdiagnóstica en el tratamiento de la ansiedad y la depresión en adultos, niños y adolescentes: un meta-análisis. Revista de Psicopatología y Psicología Clínica, 21, 147175.CrossRefGoogle Scholar
Grencavage, L. M., & Norcross, J. C. (1990). Where are the commonalities among the therapeutic common factors? Professional Psychology: Research and Practice, 21, 372.CrossRefGoogle Scholar
Harvey, A., Watkins, E., Mansell, W., & Shafran, R. (2004) Cognitive Behavioural Processes across Psychological Disorders: A Transdiagnostic Approach to Research and Treatment. USA: Oxford University Press.CrossRefGoogle Scholar
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. New York, USA: Guilford Press.Google Scholar
Hill, C. E. (2014). Helping Skills: Facilitating, Exploration, Insight, and Action, (4th edn). American Psychological Association.CrossRefGoogle Scholar
Hyer, L., Kramer, D., & Sohnle, S. (2004). CBT with older people: alterations and the value of the therapeutic alliance. Psychotherapy: Theory, Research, Practice, Training, 41, 276.CrossRefGoogle Scholar
Ingram, R. E. (1990). Self-focused attention in clinical disorders: review and a conceptual model. Psychological Bulletin, 107, 156.CrossRefGoogle Scholar
Johnston, L., Titov, N., Andrews, G., Spence, J., & Dear, B. F. (2011). A RCT of a transdiagnostic internet-delivered treatment for three anxiety disorders: examination of support roles and disorder-specific outcomes. PloS One, 6, e28079.CrossRefGoogle ScholarPubMed
Kabat-Zinn, J., Maisson, A. O., Kristeller, J., Peterson, L. G., Fletcher, K. E., Pbert, L., Lenderking, W. R., & Santorelli, S. F. (1992). Effectiveness of a meditation based stress reduction program in the treatment of anxiety disorders. American Journal of Psychiatry, 149, 936943.Google ScholarPubMed
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606613.CrossRefGoogle ScholarPubMed
Mansell, W. (2005). Control theory and psychopathology: an integrative approach. Psychology and Psychotherapy: Theory, Research and Practice, 78, 141178.CrossRefGoogle Scholar
Mansell, W., Carey, T. A., & Tai, S. (2012). A Transdiagnostic Approach to CBT Using Method of Levels Therapy: Distinctive Features. Routledge.CrossRefGoogle Scholar
Mansell, W., Harvey, A., Watkins, E., & Shafran, R. (2009). Conceptual foundations of the transdiagnostic approach to CBT. Journal of Cognitive Psychotherapy, 23, 619.CrossRefGoogle Scholar
Mansell, W., Morrison, A. P., Reid, G., Lowens, I., & Tai, S. (2007). The interpretation of, and responses to, changes in internal states: an integrative cognitive model of mood swings and bipolar disorders. Behavioural and Cognitive Psychotherapy, 35, 515539.Google Scholar
Morrison, A. P. (2001). The interpretation of intrusions in psychosis: an integrative cognitive approach to hallucinations and delusions. Behavioural and Cognitive Psychotherapy, 29, 257276.CrossRefGoogle Scholar
Neal, R. D., Hussain-Gambles, M., Allgar, V. L., Lawlor, D. A., & Dempsey, O. (2005). Reasons for and consequences of missed appointments in general practice in the UK: questionnaire survey and prospective review of medical records. BMC Family Practice, 6, 47.CrossRefGoogle ScholarPubMed
Newby, J. M., McKinnon, A., Kuyken, W., Gilbody, S., & Dalgleish, T. (2015). Systematic review and meta-analysis of transdiagnostic psychological treatment for anxiety and depressive disorders in adulthood. Clinical Psychology Review, 40, 91110.CrossRefGoogle ScholarPubMed
Norton, P. J. (2012). Transdiagnostic group CBT for anxiety disorder: efficacy, acceptability, and beyond. Spanish Journal of Clinical Psychology, 17, 205217.Google Scholar
Norton, P. J., & Barrera, T. L. (2012). Transdiagnostic versus diagnosis-specific CBT for anxiety disorders: a preliminary randomized controlled noninferiority trial. Depression and Anxiety, 29, 874882.CrossRefGoogle ScholarPubMed
Norton, P. J., & Hope, D. A. (2005). Preliminary evaluation of a broad-spectrum cognitive-behavioral group therapy for anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 36, 7997.CrossRefGoogle ScholarPubMed
Persons, J. B. (1986). The advantages of studying psychological phenomena rather than psychiatric diagnoses. American Psychologist, 41, 1252.CrossRefGoogle ScholarPubMed
Pybis, J., Saxon, D., Hill, A., & Barkham, M. (2017). The comparative effectiveness and efficiency of cognitive behaviour therapy and generic counselling in the treatment of depression: evidence from the 2nd UK National Audit of psychological therapies. BMC Psychiatry, 17, 215.CrossRefGoogle Scholar
Rosenzweig, S. (1936). Some implicit common factors in diverse methods of psychotherapy. American Journal of Orthopsychiatry, 6, 412415.CrossRefGoogle Scholar
Sheehan, V. (1983). Sheehan Disability Scale – overview. Available at: http://memorialparkpsychiatry.com/doc/sheehan_disability_scale.pdf Google Scholar
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166, 10921097.CrossRefGoogle ScholarPubMed
Ward, E., King, M., Lloyd, M., Bower, P., Sibbald, B., Farrelly, S., … & Addington-Hall, J. (2000). Randomised controlled trial of non-directive counselling, cognitive-behaviour therapy, and usual general practitioner care for patients with depression. I: Clinical effectiveness. BMJ, 321, 13831388.CrossRefGoogle ScholarPubMed
Wierzbicki, M., & Pekarik, G. (1993). A meta-analysis of psychotherapy dropout. Professional Psychology: Research and Practice, 24, 190.CrossRefGoogle Scholar
Young, J., & Beck, A. T. (1980). Cognitive Therapy Scale: Rating Manual. Unpublished manuscript.Google Scholar
Submit a response

Comments

No Comments have been published for this article.