A Unified Protocol for the Transdiagnostic Psychodynamic Treatment of Anxiety Disorders: An Evidence-Based Approach

被引:47
作者
Leichsenring, Falk [1 ]
Salzer, Simone [2 ]
机构
[1] Univ Giessen, Clin Psychosomat & Psychotherapy, D-35392 Giessen, Germany
[2] Univ Gottingen, Univ Med, Clin Psychosomat Med & Psychotherapy, D-37073 Gottingen, Germany
关键词
anxiety disorder; empirically supported treatments; unified protocol; transdiagnostic; COGNITIVE-BEHAVIORAL THERAPY; RANDOMIZED CONTROLLED-TRIAL; TERM DYNAMIC PSYCHOTHERAPY; SOCIAL ANXIETY; TRANSFERENCE INTERPRETATIONS; CLINICAL-TRIAL; PANIC DISORDER; ALLIANCE; DEFENSE; MECHANISMS;
D O I
10.1037/a0033815
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Although there is evidence for the efficacy of psychodynamic therapy (PDT) in anxiety disorders, results are not yet satisfactory, for example, if rates of remission and response are considered. To address this problem, a unified psychodynamic protocol for anxiety disorders (UPP-ANXIETY) is proposed that integrates the treatment principles of those methods of PDT that have proven to be efficacious in anxiety disorders. In addition, this protocol is transdiagnostic, implying that is it is applicable to various forms of anxiety disorders and related disorders (generalized anxiety disorder, social phobia, panic disorders, avoidant personality disorder). Based on supportive-expressive therapy, the UPP-ANXIETY represents an integrated form of psychodynamic therapy that allows for a flexible use of empirically supported treatment principles. UPP-ANXIETY encompasses the following 9 treatment principles (modules): (1) socializing the patient for psychotherapy, (2) motivating and setting treatment goals, (3) establishing a secure helping alliance, (4) identifying the core conflict underlying anxiety, (5) focusing on the warded-off wish/affect, (6) modifying underlying internalized object relations, (7) changing underlying defenses and avoidance, (8) modifying underlying response of self, and (9) termination and relapse prevention. Some principles are regarded as core components to be used in every treatment (principles 3-8). A unified protocol for the psychodynamic treatment of anxiety disorders has several advantages, that is (1) integrating the most effective treatment principles of empirically supported psychodynamic treatments for anxiety disorders can be expected to further improve the efficacy of PDT; (2) using a unified protocol in efficacy studies has the potential to enhance the evidence-based status of PDT by aggregating the evidence; (3) a unified protocol will facilitate both training in PDT and transfer of research to clinical practice; and (4) thus, a unified protocol can be expected to have a significant impact on the health care system. We are planning to test the UPP-ANXIETY in a multicenter randomized controlled trial.
引用
收藏
页码:224 / 245
页数:22
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