The article written by Dozois, Seeds, and Collins (2009) focused on transdiagnostic approaches to preventing both depression and anxiety. Specifically, these researchers asserted that most treatment options that are used within clinical and counseling psychology have been developed with populations in which there was depression present or anxiety present, and this fact has neglected a large portion of the population in which both conditions are simultaneously present. Furthermore, they argued that their research was needed because both depression and anxiety share symptoms, and because the conditions tend to have similar risk factors for development. What follows is a review of their article along with a commentary regarding the overall impact of the paper and future directions and questions.
1. Purpose of the Article
The article by Dozois and colleagues (2009) was quite different from other empirical studies in that it was a review article without an empirical meta-analysis or systematic review. As such, the overall purpose was to present a theoretical point of view based on the fact that anxiety and depression have overlapping risks and symptoms. This paper seems to be a call to action for more transdiagnostic approaches to be taken to treat these two conditions.
2. Disability and Population Studied
As mentioned, this is not a typical empirically based paper, and as such, the population that is studied are those who have co-occurring anxiety and depressive disorders. Therefore, the main disability factor within this work is the notion of mental illness as a disability, and the population is an abstract, and not empirically-defined group.
The researchers did not conduct a systematic review of the literature of a meta-analysis, but they did conduct a literature review in order to inform their proposition of having more transdiagnostic approaches to the treatment of anxiety and depressive disorders. They article may have been strengthened had they completed a systematic review; however, because this appears to be a novel concept with transdiagnostic approaches, it makes sense that this is not feasible.
The authors (Dozois et al., 2009) focused on four main strategies for preventing anxiety and depression so that future research could approach these conditions from a transdiagnostic perspective. Namely, they examined negative cognitive content and processes, familial psychopathology and parenting practices, stress levels and coping, and behavioral tendencies towards inhibition and avoidance. They concluded that a transdiagnostic approach would be helpful in preventing these conditions and they argue that focusing on these four modifiable risk factors would be helpful.
Overall, this article can be applied to the field of mental health counseling because it highlights similarities and overlaps between anxiety disorders and depressive disorders. Furthermore, it provides a call for researchers and clinicians to focus on transdiagnostic approaches to improve efficiency in clinical work and possibly to improve clinical outcomes. While I do believe that this is an important area of study, I was not fully impressed by the quality of the article. Specifically, I would have liked to have seen a more empirically-based study. For instance, the researchers may have done well to test out their transdiagnostic perspective in a treatment-as-usual situation compared to a transdiagnostic situation. This would have improved the credibility and generalizability of the research. At present, this study is seemingly a call for action based on a theoretical perspective that is not supported by much empirical evidence. I question what these new treatment approaches would look like and whether or not they would eventually be manualized. I am aware that there are protocols for treatment of anxiety and depression (as opposed to prevention) that are unified and transdiagnostic that are available, and I wonder why these were not mentioned in the article.
- Dozois, D.J., Seeds, P.M., & Collins, K. (2009). Transdiagnostic approaches to the prevention of depression and anxiety. Journal of Cognitive Psychotherapy, 23, 44-59.