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Transdiagnostic Processes

A ‘transdiagnostic process’ is the label given to a mechanism which is present across disorders, and which is either a risk factor or a maintaining factor for the disorder. The Transdiagnostic Processes worksheet is designed to help clinicians and their clients to understand core processes which are operating to prolong distress.

Rather than thinking of mental health diagnoses as separate ‘disease entities’ there is increasing awareness that common ‘processes’ or ‘mechanisms’, which underpin or act to maintain client problems, operate across disorders (Harvey et al, 2004). A ‘transdiagnostic process’ is the label given to a mechanism which is present across disorders, and which is either a risk factor or a maintaining factor for the disorder. Transdiagnostic processes are found in the domains of attention, memory/imagery, thinking, reasoning, and behavior. They can helpfully be thought of a the ‘building blocks’ which underpin disorders.

Examples of transdiagnostic processes include: the experience of ‘intrusive memories’ which are common to diverse conditions including depression, anxiety, PTSD, and eating disorders (Brewin et al, 2010); or ‘repetitive negative thinking’ which is a feature of generalized anxiety disorder (GAD) in the form of worry and depression in the form of ruminative thinking.

Empirically supported therapies all include interventions which target the processes maintaining a disorder: for example treatment for panic targets catastrophic misinterpretations of body sensations, and treatment for PTSD targets the experience of involuntary memory. However, there there is a recognized need for clinicians to better understand the processes underlying dysfunction, and treatment strategies that target these processes (Hayes & Hoffman, 2018). The Transdiagnostic Processes worksheet is designed to help clinicians and their clients to understand core processes which are operating to prolong distress.

This is a Psychology Tools information handout. Suggested uses include:

  • Client handout – use as a psychoeducation resource
  • Discussion point – use to provoke a discussion and explore client beliefs
  • Therapist learning tool – improve your familiarity with a psychological construct
  • Teaching resource – use as a learning tool during training
  • Brewin, C. R., Gregory, J. D., Lipton, M., & Burgess, N. (2010). Intrusive images in psychological disorders: characteristics, neural mechanisms, and treatment implications. Psychological review, 117(1), 210.
  • Harvey, A. G., Watkins, E., & Mansell, W., Shafran, R. (2004). Cognitive behavioural processes across psychological disorders: A transdiagnostic approach to research and treatment. Oxford University Press, USA.
  • Hayes, S. C., & Hofmann, S. G. (Eds.). (2018). Process-based CBT: the science and core clinical competencies of cognitive behavioral therapy. New Harbinger Publications.

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