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Transtheoretic Transdiagnostic Psychotherapy
In my previous blog I explained how and why cognitive-behavior works. I also extended this explanation to dialectical behavior therapy. Here I introduce a broader form of treatment that I refer to as Transtheoretic Transdiagnostic Psychotherapy. I use the term Transdiagnostic to refer to the fact that Network Principle 7 Consonance and Dissonance, and Network Principle 8 Dissonance Induction / Reduction explain why Barlow et al.’s. (2011) Unified Protocol for treating a broad range of emotional disorders works. Their unified protocol consists of psycho-educational followed by therapeutic applications of dissonance induction plus tolerance and constructive dissonance reduction methods.
I use the term Transtheoretic to refer to the psychotherapy integration that results from the theoretical unification of the Big Five clinical orientations (behavioral, cognitive, cognitive-behavioral, psychodynamic & pharmacologic) that stems from the paradigm shift that I introduced to resolve the serious explanatory problems that I discuss in the first chapter of my book, Cognitive Neuroscience and Psychotherapy: Network Principles for a Unified Theory. Together they form a Transtheoretic Transdiagnostic Psychotherapy that I believe constitutes the next generation, future, of cognitive-behavior therapy. I believe that my proposal is entirely consistent with Dr. Aaron Beck’s recent Beck Institute for Cognitive Therapy workshop presentation regarding the future of psychotherapy that you can see here:
It is the ability to explain psychology and behavior, including psychopathology, using neuroscience mechanisms that have extensive support in psychological science and that are consistent with the Big Five clinical orientations mentioned above that makes my recommended approach to psychotherapy transtheoretic. This all begins with the proposed paradigm shift referred to above which is to think about psychology and behavior in physical neuroscience terms. This is not an endorsement of the medical model. While modern physicians think about disease in physical terms, neuroscientists think about both normal and abnormal behavior in physical terms. The brain is a network of neural networks. Consequently, a network approach to understanding psychology is required if we are to integrate neuroscience and psychological science in a way that will enable us to more fully understand how cognition and affect interact to produce behavior and therefore be better able to treat cognitive and emotional disorders.
My book presents four core explanatory network principles that participate in every processing cycle. It also provides eight corollary network principles that derive from the explanatory core. I added a ninth corollary network principle after my book was published. It is available on my Fordham faculty web page. These network principles, and their neuroscience bases, provide mechanism information that authorize and support a transtheoretic transdiagnostic approach to psychotherapy that clinicians have long sought.
Research in clinical psychology has focused almost exclusively on developing empirically supported treatments (ESTs) over a least the previous 25 years. Now there are far too many ESTs for students in doctoral clinical training programs and for practicing clinicians to master at the level of clinical competence. These many separate ESTs are presented as distinct treatments based on different theoretical analyses of what is wrong. This diversity implies that these therapies work for different reasons. Science is at its best when it reveals simple causal explanations for seemingly complex phenomena. My book proposes that all ESTs work for the same reason; i.e., because they involve the same mechanism. I refer to the Dissonance Induction / Reduction principle that I discuss in detail in my book and reviewed in my previous blog. The rich diversity of clinical interventions are merely different ways of implementing this single principle. Your professional identify can now become centered on scientific principles that explain psychology and behavior rather than the ways that you implement them. This is a major contribution to clinical practice.
Rosen and Davison (2003) identified a fatal flaw in certifying ESTs. They noted that a new therapy will pass all EST requirements if it is composed of an existing EST and an inert component. The authors can claim that the added inert component is what makes the treatment effective without ever having to provide evidence of incremental validity. They can then charge fees to train clinicians in this new therapy. Rosen and Davison (2003) recommend that we establish empirically supported principles (ESPs) instead of ESTs to avoid this possibility. The core and corollary principles presented by my book implements their recommendation.
Prochaska, and DiClemente (1986) presented a so-called transtheoretic model of change that was developed during a 1984 international conference on addiction held in Scotland. They strived to describe stages of change that patients with various addictions go through in response to the approximately 240 therapies that were available at that time. Their work was called transtheoretic because the stages of change that they identified pertained to the various theoretical orientations that authorized the 240 available treatments. Their work was not transtheoretic in the sense that it promoted theoretical unification nor did it explain how or why any of these therapies worked.
The core and corollary neural network principles that I present in my book constitute a Bio«Psychology Network (BPN) explanatory system that begins to explain how the brain does psychology, how psychology emerges from biology, in a way that is fully consistent with the Big Five clinical orientations mentioned above. The resulting common understanding of psychology and behavior that this theoretical unification provides enables a transtheoretic transdiagnostic psychotherapy that I refer to as having an Applied Psychological Science (APS) clinical orientation.
Warren’s book, Cognitive Neuroscience and Psychotherapy: Network Principles for a Unified Theory is available for purchase on the Elsevier Store.
Use discount code “STC215” at checkout and save up to 30% on your very own copy.
About the Author
Warren W. Tryon received his undergraduate degree from Ohio Northern University in 1966. He was enrolled in the APA approved Doctoral Program in Clinical Psychology at Kent State University from 1966 – 1970. Upon graduation from Kent State, Dr. Tryon joined the Psychology Department faculty at Fordham University in 1970 as an Assistant Professor. He was promoted to Associate Professor in 1977 and to Full Professor in 1983. Licensed as a psychologist in New York State in 1973, he joined the National Register of Health Service Providers in Psychology in 1976, became a Diplomate in Clinical Psychology from the American Board of Professional Psychology (ABPP) in 1984, was promoted to Fellow of Division 12 (Clinical) of the American Psychological Association in 1994 and a fellow of the American Association of Applied and Preventive Psychology in 1996. Also in 1996 he became a Founder of the Assembly of Behavior Analysis and Therapy.
In 2003 he joined The Academy of Clinical Psychology. He was Director of Clinical Psychology Training from 1997 to 2003, and presently is in the third and final year of phased retirement. He will become Emeritus Professor of Psychology in May 2015 after 45 years of service to Fordham University. Dr. Tryon has published 179 titles, including 3 books, 22 chapters, and 140 articles in peer reviewed journals covering statistics, neuropsychology, and clinical psychology. He has reviewed manuscripts for 45 journals and book publishers and has authored 145 papers/posters that were presented at major scientific meetings. Dr. Tryon has mentored 87 doctoral dissertations to completion. This is a record number of completed dissertations at the Fordham University Graduate School of Arts and Sciences and likely elsewhere.
His academic lineage is as follows. His mentor was V. Edwin Bixenstein who studied with O. Hobart Mowrer at the University of Illinois who studied with Knight Dunlap at Johns Hopkins University who studied with Hugo Munsterberg at Harvard University who studied with Wilhelm Wundt at the University of Leipzig.
Cognitive Neuroscience and Psychotherapy: Network Principles for a Unified Theory is Dr. Tryon’s capstone publication. It is the product of more than a quarter of a century of scholarship. Additional material added after this book was printed is available at www.fordham.edu/psychology/tryon. This includes chapter supplements, a color version of Figure 5.6, and a thirteenth “Final Evaluation” chapter. He is on LinkedIn and Facebook. His email address is email@example.com.
Researchers and clinicians in psychology work across a vast array of sub-disciplines, including applied psychology, addictions, cognitive psychology, developmental and educational psychology, experimental physiological psychology, forensic psychology, neuropsychology, and behavioral and cognitive therapy. For these professionals, and students as well, cross-disciplinary study is a given. For more than 75 years, Elsevier has cultivated portfolios of psychology books, eBooks, and journals covering current and critical issues in all of these areas. This vital content provides a sound basis of understanding for all those involved in this multi-faceted field.