2 - (SYM 79) Navigating the Evolving Needs of Veterans and Servicemembers: A Case for Transdiagnostic Treatment

In recent years, researchers have published compelling efficacy and effectiveness data that supports massed delivery of evidence-based cognitive behavioral therapies (CBT), such as massed delivery of Prolonged Exposure therapy (PE). Massing active components of treatment (e.g., exposure) seems to retain effect sizes demonstrated in conventional treatment delivery in a significantly shorter time and with minimal patient dropout. Massed delivery may mitigate some barriers to treatment such as fluctuating motivation and may also help to minimize opportunities for avoidant processes that are maintaining psychopathology. Most research on massed delivery of CBT has investigated disorder-specific protocols, such as PE. However, a growing body of evidence indicates transdiagnostic CBT are effective for a range of emotional disorders, which can reduce the burden for individual providers to achieve competency in multiple disorder-specific treatments. Given that the veteran and servicemember population presents with significant diagnostic heterogeneity, massed delivery of transdiagnostic CBTs for this population could be a particularly effective means of treating a range of complex and comorbid clinical presentations. Importantly, the implementation of massed transdiagnostic CBT does not require the clinical context to eliminate or change the implementation of massed disorder-specific CBT, especially when the disorder-specific option is demonstrably effective. In fact, from an implementation science perspective, clinics that are effective in massed disorder-specific CBT (e.g., PE for PTSD) may be well suited to adopt and sustain effective delivery of massed transdiagnostic CBT to make treatment accessible to a greater portion of the population. This presentation reviews the rationale for one such transdiagnostic treatment, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) and examines outcomes of one intensive outpatient program using UP within the service member and veteran population. Findings from our sample (N = 117) indicate UP-IOP had high patient retention (94%) and had moderate effects on self-reported symptom severity (Cohen’s d = 0.76 for depression, Cohen’s d = 0.80 for trauma-related symptoms). These outcomes are presented alongside outcomes from massed delivery of PE within the same clinic. A clinical cases series will also be presented to illustrate the feasibility and potential benefit of providing a transdiagnostic treatment alongside a PTSD-focused treatment.