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Abstract
Considerable work and attention has supported the use of behavioral activation (BA) strategies in the treatment of depressive disorders. Although not often recognized, BA, both implicitly and explicitly, appears to be conceptually and empirically relevant to the treatment of diverse problem areas, including the anxiety disorders. This article addresses the role of BA strategies in transdiagnostic cognitive–behavioral therapy (CBT) for anxiety and related disorders, including in cases without comorbid depression. Following a brief introduction to a transdiagnostic CBT model of anxiety and related disorders, this article will: (a) provide a rationale for the integration of BA strategies as a potentially potent facilitator of therapeutic change; (b) identify relevant treatment targets of BA in anxiety disorders; and (c) illustrate the implementation and impacts of these strategies using a clinical case example. Finally, suggestions for future research and implications for training and practice will be noted.
It may be possible through detachment, to gain knowledge that is “useful”; but only through participation is it possible to gain the knowledge that is helpful.
–Harry Stack Sullivan
Transdiagnostic cognitive–behavioral therapies (CBTs), such as The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP; Barlow et al., 2011) have been developed to address the spectrum of anxiety and other “emotional disorders” (Barlow et al., 2011). Such developments are, in part, informed by high rates of comorbidity among emotional disorders (Brown, Campbell, Lehman, Grisham, & Mancill, 2001). Research findings suggest that the distinguishing symptoms of emotional disorders may be manifestations of common underlying factors. Such underlying factors include the core temperamental dimensions of neuroticism and associated features such as cognitive and behavioral inflexibility and affect avoidance (Brown, Chorpita, & Barlow, 1998; Kasch, Rottenberg, Arnow, & Gotlib, 2002; Watson, Clark, & Carey, 1988). In addition, common CBT strategies in multicomponent treatments targeting specific disorders can lead to improvements in comorbid disorders (Brown, Antony, & Barlow, 1995; Tsao, Lewin, & Craske, 1998; Tsao, Mystkowski, Zucker, & Craske,...