Is Activation the Active Ingredient of Transdiagnostic Therapies? A Randomized Clinical Trial of Behavioral Activation, Acceptance and Commitment Therapy, and Transdiagnostic Cognitive-Behavioral Therapy for Emotional Disorders

Abstract

Studying the usefulness of contextual and cognitive transdiagnostic therapies calls for an analysis of both their differential efficacy and their specificity when acting on the transdiagnostic conditions on which they focus. This controlled trial compares the post-treatment and 3- and 6-month follow-up effects of Behavioral Activation (BA), Acceptance and Commitment Therapy (ACT) and Cognitive-Behavioral Transdiagnostic Therapy (TD-CBT) on emotional symptomatology, and analyses the role played by Experiential Avoidance, Cognitive Fusion, Activation and Emotion Regulation in the clinical change. One hundred twenty-eight patients who fulfilled diagnostic criteria for anxiety and/or depression (intention-to-treat sample) were randomly assigned to three experimental group-treatment conditions (BA, n = 34; ACT, n = 27; TD-CBT n = 33) and one control group (WL, n = 34). Ninety-nine (77.34%) completed the treatment (per-protocol sample). In the post-treatment, all therapies reduced anxiety and depression symptomatology. In the follow-ups, the reduction in emotional symptomatology was greater in the condition which produced greater and more prolonged effects on Activation. Activation appears to be the principal condition in modifying all the transdiagnostic patterns and BA was the most efficacious and specific treatment. The trial was registered at ClinicalTrials.gov NCT04117464. Raw data are available online http://dx.doi.org/10.17632/krj3w2hfsj.1 .

The Impact of a Creativity Camp Intervention on Depression and Well-Being in Adolescents

“…Unlike some arts programs that are focused on skill building, the goal here was to promote a creative mind set and foster self-exploration. One possible mechanism here may be related to behavioral activation (known to be effective for depression; (Dimidjian et al, 2006;Fernández-Rodríguez et al, 2023)). A central aspect of Creativity Camp involves inviting patients to engage in activities, finding new opportunities to reach for valued goals (taking an approach-oriented stance towards pursuing activities that one deeply cares about (DeYoung & Tiberius, 2023;Koutstaal & Binks, 2015).)…”

“…A central aspect of Creativity Camp involves inviting patients to engage in activities, finding new opportunities to reach for valued goals (taking an approach-oriented stance towards pursuing activities that one deeply cares about (DeYoung & Tiberius, 2023;Koutstaal & Binks, 2015).) Approaching and engaging in valued activities despite risks and fears contrasts with engaging in avoidance, rumination or behavioral inactivity that may engender and maintain depression (Fernández-Rodríguez et al, 2023;Manos et al, 2010). The high levels of continued participation across the eight days of the camp suggest that the camp was markedly successful from this "behavioral activation" perspective.…”

The Kvetch

“…Behavior change methods include behavioral activation, where patients are encouraged and nudged to take specific actions that may directly or indirectly improve their situations (Fernández-Rodríguez et al, 2023).…”

Integrating mindfulness into the extended process model of emotion regulation: The dual-mode model of mindful emotion regulation.

“…Regulation may be effective in that it achieves hedonic goals (typically, greater positive emotion and less negative emotion) but maladaptive in that it impairs functioning or contributes to psychiatric symptoms (Aldao & Christensen, 2015; Aldao et al, 2010, 2016; Hu et al, 2014). This exact phenomenon (emotion regulation being effective and maladaptive) is applied in models of psychopathology which attribute symptoms partly to the habitual use of avoidance (a form of situation selection or modification; including experiential avoidance; Ellard et al, 2010; Fernández-Rodríguez et al, 2023; Hayes et al, 2006; Keane et al, 2006). While extensive research has been conducted on the effectiveness of emotion regulation strategies in clinical and nonclinical populations (Dodd et al, 2019; Dryman & Heimberg, 2018; Güney et al, 2019; Picó-Pérez et al, 2017; Webb, Miles, & Sheeran, 2012), it is nonetheless vital to also consider the short- and long-term adaptiveness of different strategies (Aldao & Christensen, 2015; Aldao et al, 2010, 2016; Eisma & Stroebe, 2021; Hu et al, 2014; Ludwig et al, 2019; Miles et al, 2013; Sloan et al, 2017; Troy et al, 2023; Wilson & Gentzler, 2021).…”