The primary goal of our research is to improve psychological care in order to relieve the suffering of individuals with common mental health conditions (e.g., anxiety, depression, and related disorders) This goal is achieved via basic psychopathological research to identify the processes that drive symptom expression, along with treatment development/testing to ensure that our interventions indeed address the most potent mechanistic targets. We use a range of complementary methodological approaches (e.g., surveys, laboratory-based experiments, clinic-based treatment studies, and real-time monitoring) to better understand how common disorders develop and how to best treat them. In particular, we are interested in establishing evidence-based way to personalize treatment delivery to optimize outcomes. Across our broad research goals, explicit attention is paid to understudied and/or stigmatized conditions such as borderline personality disorder, suicidal thoughts/behaviors, and anger.

Identifying Transdiagnostic Mechanisms

Common mental health conditions are apt to co-occur. Despite high rates of comorbidity, prevailing treatment approaches have traditionally focused on a single diagnosis (e.g., panic disorder, social anxiety). Unfortunately, discrete interventions for each clinical problem do not offer comprehensive care for patients who endorse multiple areas of dysfunction, perhaps suboptimal outcomes. Additionally, the proliferation of disorder-focused manuals places a costly, time-intensive training burden on therapists, likely disincentivizing the provision of empirically-supported interventions. In response to these issues, the TIPS program seeks to identify transdiagnostic psychopathological mechanisms that drive the expression of a range of clinical targets and can become the focus of care, rather than individually addressing each symptom/problem. In this approach to understanding psychopathology, heterogeneity in the expression of symptoms/problems can be regarded as surface-level variation in the manifestation of shared core processes.

Select Publications

Bullis, J.R., Boettcher, H., Sauer-Zavala, S., & Barlow, D.H. (in press). What is an emotional disorder? A transdiagnostic mechanistic definition and implications for assessment, treatment and prevention. Clinical Psychology: Science and Practice. PDF

Sauer-Zavala, S. & Barlow, D.H. (2014). The case for borderline personality disorder as an emotional disorder: Implications for treatment. Clinical Psychology: Science and Practice, 21, 118-138. PDF

Sauer, S. E. & Baer, R.A. (2012). Mindful and ruminative self-focused attention in borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 3, 433-441. PDF

Treatment Development and Efficacy Testing

Following the identification of transdiagnostic psychopathological mechanisms, the TIPS program aims to develop and test potent interventions that directly engage these targets and can be applied across diagnostic boundaries. This research includes large-scale randomized trials comparing transdiagnostic, mechanism-based approaches to control conditions (i.e., waitlist, traditional disorder-specific approaches). Additionally, this work includes smaller scale studies aimed at ensuring that each component included in a treatment package indeed engages the core processes that drive symptoms; single-case experimental design is often utilized in this capacity.

Select Publications

Sauer-Zavala, S., Wilner, J.G., Cassiello-Robbins, C., Saraff, P., & Pagan, D.S. (in press). Opposite Action in Borderline Personality Disorder: A Laboratory-based Alternating Treatment Design. Behaviour Research and Therapy. PDF

Barlow, D. H., Farchione, T. J., Bullis, J. R., Gallagher, M. W., Latin, H., Sauer-Zavala,  S., …. Cassiello-Robbins, C. (2017).  The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders compared to diagnosis-specific protocols for anxiety disorders: A randomized clinical trial. JAMA Psychiatry, 74, 875-884. PDF

Sauer-Zavala, S., Bentley, K.H., & Wilner, J.G. (2016). Transdiagnostic treatment of borderline personality disorder and comorbid disorders: A clinical replication series. Journal of Personality Disorders, 30, 35-51. PDF

Personalizing Treatment: Increasing Potency and Efficiency

Transdiagnostic, mechanism-driven treatment is a step forward in improving care for common mental health conditions, though it may be possible to further enhance the potency and efficiency of our interventions. Given that transdiagnostic treatments often consist of multiple components designed to target the same core process, it is possible that some skills may be more or less robust at mechanism engagement for a particular patient. Thus, an important aim of the TIPS program is to identify best practices for personalizing care so that individual patients may reap the greatest benefit. Although some of this work has been conducted in our research laboratory, we strive to work with providers in community practice to increase the likelihood that our treatment innovations are feasible to implement in the real-world.

Select Publications

Sauer-Zavala, S., Ametaj, A.A., Wilner, J.W., Bentley, K.H., Marquez, S., Patrick, K., Starks, B., Shtasel, D., & Marques, L. (in press). Evaluating transdiagnostic, evidence-based mental health care in a safety-net setting serving homeless individuals. Psychotherapy. PDF

Sauer-Zavala, S., Cassiello-Robbins, C., Ametaj, A.A., Wilner, J.W., & Pagan, D.S. (in press). Transdiagnostic Treatment Personalization: Prioritizing Unified Protocol treatment skills to capitalize on strengths or compensate for weaknesses. Behavior Modification. PDF

Sauer-Zavala, S., Cassiello-Robbins, C., Conklin, L., Bullis, J.R., Thompson-Hollands, J., & Kennedy, K. (2017). Isolating the unique effects of the Unified Protocol treatment modules using single-case experimental design. Behavior Modification, 40, 286-307. PDF