From fragmentation to transtheoretical models of psychological therapy

In psychological therapy, clinical training and practice is usually based on one or several of the traditional theoretical treatment orientations' subvariants and varies considerably from country to country. However, no traditional clinical theory provides a fully defined and tested causal network between concepts of disorders and clinical interventions that includes tests of alternative explanations. Adhering to the traditional orientations also bears the risk of hindering innovation and the dynamic exchange of ideas. As a consequence, therapists decide which theory to follow based on their country's specific regulations and their personal taste. In this position paper, we recommend that the field moves toward evidence- and practice-based, personalized treatment planning and interventions that focus on patients' specific problem patterns and actual treatment progress, instead of prioritizing one theoretical framework. We present an open framework for evidence-based, transtheoretical, and transdiagnostic psychological therapy. This framework could stimulate progress in research as well as future developments in competence-based clinical training and practice.