A Randomized Controlled Trial Comparing Transdiagnostic Behavior Therapy and Disorder-Specific Psychotherapies in...

Transdiagnostic psychotherapies have been gaining in popularity due in part to their hypothesized ability to address multiple emotional disorders via a single protocol. However, to date, most randomized clinical trials of these treatments have focused on patients with anxiety disorders, or in mixed samples, limiting their use in other diagnoses. The present study compared Transdiagnostic Behavior Therapy (TBT) to disorder-specific therapies (DSTs) in 304 veterans with principal diagnoses of major depressive disorder (MDD), posttraumatic stress disorder (PTSD), or panic disorder. Disorder-specific symptom outcomes and overall impairment were assessed at baseline, mid-treatment, and posttreatment. Structural equation modeling was used to evaluate changes in outcomes over time via latent growth curve models. Support for noninferiority between TBT and the matching DSTs was found in participants with PTSD and panic disorder for the disorder-specific symptom scales and for overall impairment scores across diagnoses. Similar effect sizes were obtained for MDD, although noninferiority could not be concluded because confidence intervals were wide. Similar scores for patient satisfaction and treatment completion also were observed across TBT and the comparison DSTs. Together, these findings suggest that TBT demonstrates comparable efficacy to the established DSTs in addressing symptoms of depressive disorders (MDD), trauma and stressor-related disorders (PTSD), and the anxiety disorders (panic disorder). Thus, ongoing dissemination and implementation efforts for TBT should be considered for a wider range of diagnoses, easing provider training burden and expanding treatment coverage in clinical settings.