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I’m reading a book that came out last year – “The Transdiagnostic Road Map to Case Formulation and Treatment Planning” by Rochelle Frank and Joan Davidson (239 pages – not too long). Basically, the authors point out the limits of EST (Empirically Supported Treatment) protocols, and also the limitations of DSM diagnostic categorizations. The authors point out that “dual diagnosis” is more the rule than the exception in clinical reality, and that “Transdiagnostic Mechanism” (TDM) can contribute to different “disorders.” TDMs come in two main flavors – “Vulnerability Mechanisms” (e.g. anxiety sensitivity) and “Response Mechanisms” (e.g. rumination). Books like this are cool because they nudge the field away from thinking about people in terms of DSM diagnostic categories, which don’t ultimately seem to help all that much; in my clinical experience (albeit brief), it seems rare to see a “textbook example” of a “disorder.” Perhaps in the future, psychological assessment and diagnosis would identify TDMs in clients such as “difficulty in emotional regulation” and “past problematic conditioned responses” rather than “borderline personality disorder,” for example. This book is likely of interest to anyone with an interest in clinical psychology. If you’ve read this book, or have others to share, feel free to add. Clark |
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