Table Of ContentUnifi ed Protocol for Transdiagnostic Treatment
of Emotional Disorders
editor-in-chief
David H. Barlow, PhD
scientific
advisory board
Anne Marie Albano, PhD
Gillian Butler, PhD
David M. Clark, PhD
Edna B. Foa, PhD
Paul J. Frick, PhD
Jack M. Gorman, MD
Kirk Heilbrun, PhD
Robert J. McMahon, PhD
Peter E. Nathan, PhD
Christine Maguth Nezu, PhD
Matthew K. Nock, PhD
Paul Salkovskis, PhD
Bonnie Spring, PhD
Gail Steketee, PhD
John R. Weisz, PhD
G. Terence Wilson, PhD
Unifi ed Protocol for
Transdiagnostic
Treatment of
Emotional Disorders
W o r k b o o k
David H. Barlow • Kristen K. Ellard • Christopher P. Fairholme
T odd J. Farchione • Christina L. Boisseau • Laura B. Allen
Jill T. Ehrenreich-May
1
2011
1
Oxford University Press, Inc., publishes works that further
Oxford University’s objective of excellence
in research, scholarship, and education.
Oxford New York
Auckland Cape Town Dar es Salaam Hong Kong Karachi
Kuala Lumpur Madrid Melbourne Mexico City Nairobi
New Delhi Shanghai Taipei Toronto
With offi ces in
Argentina Austria Brazil Chile Czech Republic France Greece
Guatemala Hungary Italy Japan Poland Portugal Singapore
South Korea Switzerland Thailand Turkey Ukraine Vietnam
Copyright © 2011 by Oxford University Press, Inc.
Published by Oxford University Press, Inc.
198 Madison Avenue, New York, New York 10016
www.oup.com
Oxford is a registered trademark of Oxford University Press
All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted, in any form or by any means,
electronic, mechanical, photocopying, recording, or otherwise,
without the prior permission of Oxford University Press.
____________________________________________
ISBN-13 978-0-19-977267-4 Paper
____________________________________________
9 8 7 6 5 4 3 2 1
Printed in the United States of America
on acid-free paper
About Unifi ed Transdiagnostic TreatmentsT hatWork™
O ne of the most diffi cult problems confronting patients with various
disorders and diseases is fi nding the best help available. Everyone is
aware of friends or family who have sought treatment from a seem-
ingly reputable practitioner, only to fi nd out later from another doctor
that the original diagnosis was wrong, or the treatments recom-
mended were inappropriate or perhaps even harmful. Most patients,
or family members, address this problem by reading everything they
can about their symptoms, seeking out information on the Internet,
or aggressively “asking around” to tap knowledge from friends and
acquaintances. Governments and healthcare policymakers are also
aware that people in need don’t always get the best treatments—
something they refer to as “variability in healthcare practices.”
N ow, healthcare systems around the world are attempting to correct
this variability by introducing “evidence-based practice.” This simply
means that it is in everyone’s interest that patients get the most
up-to-date and effective care for a particular problem. Healthcare
policymakers have also recognized that it is very useful to give con-
sumers of healthcare as much information as possible, so that they
can make intelligent decisions in a collaborative effort to improve
health and mental health. This series, Treatments That Work™ is
designed to accomplish just that. Only the latest and most effective
interventions for particular problems are described in user-friendly
language. To be included in this series, each treatment program must
pass the highest standards of evidence available, as determined by a
scientifi c advisory board. Thus, when individuals suffering from
these problems or their family members seek out an expert clinician
who is familiar with these interventions and decides that they are
appropriate, they will have confi dence that they are receiving the
best care available.
The latest development in evidence-based treatment programs,
based on the most up-to-date research and clinical evaluation, is
v
found in unifi ed, transdiagnostic interventions for disorders that
share common features and respond to common therapeutic proce-
dures. Deepening understanding of the nature of psychological dis-
orders reveals that many groups of related disorders share important
causes, and look very similar in terms of behavioral problems and
brain function. Thinking of these disorders or problems as related,
or on a “spectrum,” is the approach now taken by leading therapists
and researchers as well as by committees writing the next version
of the diagnostic manual for psychological disorders, the DSM-5.
This is because most people with one disorder or problem also have
another problem or disorder (referred to as c omorbidity) . If someone
has panic disorder, they may also have social anxiety as well as depres-
sion; these are all emotional disorders. If someone abuses drugs, they
may also abuse alcohol or cigarettes; these are all addictive disorders.
Treatment programs in this series are “unifi ed” because they share a
common, unifi ed set of therapeutic procedures that are effective
with a whole class of disorders, such as emotional disorders or addic-
tive disorders. Treatment programs are “transdiagnostic” because
they are designed to be effective with all of the disorders in that class
(emotional or addictive or eating disorders) that somebody might
have, rather than just one disorder. Working with one set of thera-
peutic principles makes it easier and more effi cient for you and your
therapist, and should address all of the problems you may have in a
more comprehensive and effective way.
This particular workbook is designed for your use as you work
together with a therapist to address your emotional disorders.
Generally, this group of disorders includes all of the anxiety and
mood (depressive) disorders such as panic disorder with or without
agoraphobia, social anxiety disorder, generalized anxiety disorder,
post-traumatic stress disorder, obsessive-compulsive disorder, and
depression. The program is also designed to address closely related
emotional disorders such as hypochondriasis, and other problems
associated with excessive anxiety focused on health concerns, as well
as problems with experiencing dissociation (feelings of unreality).
What all of these disorders have in common is excessive or inappro-
priate emotional responding that is interfering with your ability to
lead a happy and normal life—such as excessive anxiety or fear about
certain situations or people, or feelings of depression that take all the
vi
fun out of life and keep you from doing the things you want. This
program is not generally recommended for a specifi c phobia, if that
is the only problem you are experiencing at this time. Other books
in this series can deal more effi ciently with that problem (visit www.
oup.com/us/ttw for a list of books). Only your healthcare profes-
sional can tell you for sure which disorders you have and which you
may not have; and only your healthcare professional can decide on
the most appropriate treatments for you.
David H. Barlow, Editor-in-Chief
Unifi ed Transdiagnostic TreatmentsT hatWork™
Boston, MA
vii
This page intentionally left blank
Contents
Chapter 1 What are Emotional Disorders? 1
Chapter 2 Is This Treatment Right for You? 15
Chapter 3 Learning to Record Your Experiences 21
Chapter 4 Maintaining Motivation and Setting
Goals for Treatment 35
Chapter 5 Understanding Your Emotions 53
Chapter 6 Recognizing and Tracking Your Emotional
Responses 67
Chapter 7 Learning to Observe Your Emotions and
Your Reactions to Your Emotions 81
Chapter 8 Understanding Thoughts: Thinking the Worst
and Overestimating the Risk 1 07
Chapter 9 Understanding Behaviors 1: Avoiding
Your Emotions 135
Chapter 10 Understanding Behaviors 2: Emotion-Driven
Behaviors 145
Chapter 11 Understanding and Confronting Physical
Sensations 159
Chapter 12 Putting It into Practice: Facing Your Emotions in
the Situations in which They Occur 171
Chapter 13 Medications for Anxiety, Depression, and
Related Emotional Disorders 1 87
Chapter 14 Moving On From Here: Recognizing
Your Accomplishments and Looking
to Your Future 197
Appendix Self-Assessment Answers 207
ix
Description:Emerging conceptualizations of major emotional disorders emphasize their commonalities rather than their differences, including considerable overlap in disorder phenomenology, a common set of vulnerabilities to development of emotional disorders, and generalization of treatment response across disor
