TRANSACTIVA. A randomized clinical trial of Behavioral Activation, Acceptance and Commitment Therapy, and transdiagnostic Cognitive-Behavioral Therapy for emotional disorders.
The study of the usefulness of contextual and cognitive transdiagnostic therapies calls for an analysis of both their differential efficacy and their specificity when acting on the transdiagnostic conditions on which they focus. This controlled trial compares the post-treatment and 3- and 6-month follow-up effects of Behavioral Activation (BA), Acceptance and Commitment Therapy (ACT) and Cognitive-Behavioral Transdiagnostic Therapy (TD-CBT) on emotional symptomatology, and analyses the role played by Experiential Avoidance, Cognitive Fusion, Activation and Emotion Regulation in the clinical change. Hundred twenty-eight patients who fulfilled diagnostic criteria for anxiety and/or depression (intention-to-treat sample) were randomly assigned to 3 experimental group-treatment groups (BA, n=34; ACT, n=27; TD-CBT n=33) and one control group (WL, n=34). 99 completed all phases of the treatment (per-protocol sample). In the post-treatment, all therapies reduced anxiety and depression symptomatology. In the follow-ups, the greater and more prolonged the effects of the therapy were on Activation, the greater was the reduction in emotional symptomatology. Activation was the principal condition in modifying all the transdiagnostic patterns and BA was the most efficacious and specific treatment. The trial was registered at ClinicalTrials.gov NCT04117464.