Flexible Application of Interoceptive and Situational Exposure-Based Treatment for an Outpatient With Multiple Anxiety and Mood Disorders: A Comprehensive Case Study

Cognitive-behavioral therapy (CBT) is efficacious and effective in the treatment of anxiety disorders. However, few guidelines exist on how to efficiently provide CBT when comorbidity is present. Given that anxiety disorders may share underlying mechanisms of maintenance, targeting such mechanisms may be fruitful when working with individuals who suffer from extensive anxiety-related comorbidity. The present study describes an interoceptive and situational exposure-based treatment with a 40-year-old outpatient whose presentation was complicated by multiple anxiety disorders and related difficulties. A comprehensive assessment monitored mechanisms targeted in treatment, symptoms associated with clinical diagnoses, and related impairment. Treatment gains were clinically and statistically significant. Improvements were maintained 1-month post-treatment. These results add to the growing literature focused on transdiagnostic interventions that successfully target broad-based mechanisms of maintenance for multiple types of psychopathology. Theoretical and technical issues related to this type of intervention are discussed throughout the article.