A Review of Transdiagnostic Mechanisms in Cognitive Behavior Therapy.

Cognitive behavior therapies (CBTs) are the gold standard treatment for many psychiatric conditions. However, relatively little is known about how CBTs work. By characterizing these mechanisms, researchers can ensure CBTs retain their potency across diagnoses and delivery contexts. We review 3 classes of putative mechanisms: CBT-specific skills (eg, cognitive restructuring, behavioral activation), transtheoretical mechanisms (eg, therapeutic alliance, treatment expectancies, self-efficacy beliefs), and psychopathological mechanisms (aversive reactivity, positive affect, attachment style). We point to future research within each class and emphasize the need for more intensive longitudinal designs to capture how each class of mechanisms interacts with the others to improve outcomes.

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Disclosure S. Sauer-Zavala receives royalties from the Oxford University Press in her role as an author of the Unified Protocol. M.W. Southward’s efforts on this paper were partially supported by the National Institute of Mental Health, United States under award number K23MH126211. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institute of Health.