Mastering the Unified Protocol: A Transdiagnostic Approach to Emotional Disorders

CPD

Handouts

Speaker

Shannon Sauer-Zavala, PhD Related seminars and products

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Shannon Sauer-Zavala, PhD, is co-developer of the Unified Protocol and the founding director of the Unified Protocol Institute at the Center for Anxiety and Related Disorders at Boston University. She has provided training and consultation in the Unified Protocol to clinicians all over the world. In addition to over 15 years' experience as a clinical psychologist providing evidence-based treatments, Dr. Sauer-Zavala maintains a prolific research career focused on exploring emotion-focused mechanisms that maintain psychological symptoms (particularly high-risk symptoms such as suicidal thoughts and behaviors) and using this information to develop more targeted, easily disseminated intervention strategies. She is an Assistant Professor in the Department of Psychology at the University of Kentucky (UK) and is the founding director of Clinical Services at the UK Clinic for Emotional Health. Dr. Sauer-Zavala completed her doctorate in Clinical Psychology from UK, her predoctoral internship at Duke University Medical Center, and her postdoctoral fellowship at Boston University. Her research has been supported by NIMH, NIAAA, Templeton Foundation, the Center for Implementation and Improvement Sciences, and the Canadian Institute of Health Research. Dr. Sauer-Zavala has co-authored over 100 scholarly publications and three books, including workbook and therapist guides on the Unified Protocol for Oxford's Treatments That Work Series, as well as Neuroticism: A New Framework for Emotional Disorders and Their Treatment, with David Barlow.

Speaker Disclosures:
Financial: Dr. Shannon Sauer-Zavala has employment relationships with the University of Kentucky and Boston University. She receives grants from NIMH and The John Templeton Foundation. Dr. Sauer-Zavala receives royalties as a published author. She receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Shannon Sauer-Zavala a member of the North American Society for the Study of Personality Disorders, the Association for Psychological Science, the Association for Behavioral and Cognitive Therapy, and the APA Division 12.

Objectives

1. Describe the advantages and disadvantages of the current method of classifying mental disorders.
2. Construct a transdiagnostic case conceptualization for clients presenting with comorbid disorders.
3. Utilize mindfulness-based interventions to increase clients’ awareness and experience of emotions.
4. Apply cognitive restructuring techniques targeting overestimation and catastrophizing.
5. Plan behavioural experiments to promote clients’ ability to engage in intentional action.
6. Utilize situational, imaginal, and interoceptive exposures to improve clients’ tolerance of strong emotions.

Outline

Controversial issues in diagnosis

• History of mental health disorders classification
• Categorical approach: the problem of phenotypic overlap
• Comorbidity – when only the content of worries distinguishes diagnosis
• Ill-fitting diagnostic boxes: unspecified and subthreshold presentations

Rationale for transdiagnostic treatment and a return to lumping disorders

• Conventional approaches: the burden of one diagnosis = one treatment
• Personality/temperamental factors supporting a transdiagnostic approach
• Neurobiological evidence for going deeper than symptom level

The two vulnerabilities to developing emotional disorders

• Experiencing strong emotions and having strong negative reactions to intense emotions
• Transdiagnostic case conceptualisation – when avoidance backfires
• Unified Protocol: core strategies to increase clients’ willingness to experience strong emotions

Starting out: Understanding what gets clients going and what keeps them stuck

• Conducting assessments and getting clients on board with UP treatment
• Harnessing and maintaining motivation
• Exercise: Goal setting and decisional balance
• Case study

Developing a better understanding of emotional experience

• Teaching clients the adaptive function of their uncomfortable feelings
• “Just relax” - understanding the interacting components of thoughts, physical sensations, and emotions
• Break out of the vacuum – recognising the ARC (antecedents, response, consequence)
• Exercise: Cultivating mindful attention and Mindful mood induction
• Case study

Shining a light on how thinking generates and maintains distress

• Dismantling thinking traps: the role of automatic, habitual cognitive appraisals
• Targeting specific types of cognitive inflexibility: overestimation and catastrophising
• What to do when cognitive work falls flat with your clients
• Exercise: Ambiguous picture

Understanding and countering avoidance strategies

• The five categories of emotional behaviours that reinforce symptoms
• Deciding on alternative action experiments
• Exercise: Paradox of suppression
• Case study

Fostering more accurate appraisals of body sensations

• Shaking clients’ conviction that they cannot handle situations and emotions
• Interoceptive exposures – de-triggering your clients’ physical experience
• Exercise: Playground metaphor and generating exposure ideas
• Case study

Climbing the ladder of emotion exposures

• Situational, imaginal, interoceptive!
• Creating strong emotion to show clients they can cope
• Exposure preparation and debriefing
• Exercise: Create a hierarchy
• Case study

Maintaining gains and preventing relapse

• Treatment consolidation and relapse prevention
• Tips for teaching clients to be their own therapist
• Exercise: Distinguish symptom relief goals from well-being goals

Limitations of the research and potential risks

Target Audience

• Psychologists
• Psychiatrists
• Counselors
• Social Workers
• Psychotherapists
• Case Managers
• Marriage and Family Therapists
• Addiction Counselors
• Other Mental Health Professionals