Category: Treatment - CBT


Institute 4 - Common Elements Treatment Approach: An Evidence Based CBT Transdiagnostic Approach for Low-resource Settings

Thursday, November 16
1:00 PM - 6:00 PM
Location: Indigo 202 B, Level 2, Indigo Level

Keywords: Transdiagnostic | Cross Cultural / Cultural Differences
Presentation Type: Institutes
Level of Familiarity: Moderate

The Common Elements Treatment Approach (CETA) was developed by Drs. Murray and Dorsey specifically for use in low and middle income countries (LMICs) for lay providers (Murray et al., 2013). It is a CBT-based, modular transdiagnostic psychotherapy that trains a single provider in a range of evidence-based CBT elements to treat a variety of common disorders, including symptoms of depression, anxiety, trauma, substance use and externalizing behavior.
Global mental health has seen progress over the past decade showing effectiveness of a range of evidence-based treatments (EBTs) (e.g., TF-CBT, CPT, IPT, BA). However, most of these treatments were developed for a focus on a single disorder or cluster of disorders. These single disorder-focused treatments that target one problem (e.g., depression) have been cited as a barrier to scale-up and sustainability in LMIC because they require complex referral systems, a large work force that is trained in multiple EBT, and do not teach lay providers how to deal with comorbidity. CETA focuses on training lay-community workers a transdiagnostic modular therapeutic approach to help address these barriers.
CETA, using lay providers, has been found to be effective in two randomized controlled trials for adults and one open trial with youth in Ethiopia. On the Thailand/Myanmar border, CETA effect sizes (Cohen’s d) were large for depression (d=1.16) and posttraumatic stress (d =1.19) and moderate for impaired function (d=0.63), anxiety (d=0.79), and aggression (d = 0.58) (Bolton et al., 2014). In Iraq, results showed large effect sizes for all outcomes vs. controls: trauma (d=2.38), anxiety (d=1.56) and depression (d=1.78) (Weiss et al., 2015). A youth trial in Ethiopia showed that children and their caregivers reported an average decrease of 70% and 61% respectively in children’s internalizing or emotional problems (Murray et al., in submission).
This pre-institute training will review how CETA was developed specifically for training lay providers and for use in LMIC. The presenters will discuss research on how a common elements approach could aid in the scale-up and sustainability in LMIC. The training will include both the elements in CETA, and also how we train lay providers on choosing elements, order and dose.

Earn 5 continuing education credits

Learning Objectives:

Recommended Reading: Murray LK, Dorsey S, Haroz E, Lee C, Alsiary M, Haydary A, Weiss WM, & Bolton P. A common elements treatment approach for adult mental health problems in low and middle income countries. Cognitive and Behavioral Practice. 2013, doi: 10.1016/j.cbpra.2013.06.005.
Bolton P, Lee C, Haroz EE, Murray LK, Dorsey S, Robinson C, Ugueto AM, Bass J. A transdiagnostic community based mental health treatment for comorbid disorders: Development and Outcomes of a Randomized controlled trial among Burmese Refugees in Thailand. PLoS Medicine. 2014. Nov 11; 11(11): e1001757. doi:10.1371/journal.pmed. 1001757
Weiss WM, Murray LK, Zangana GA, Mahmooth Z, Kaysen D, Dorsey S, Lindgren K, Gross A, Murray SM, Bass JK, Bolton P. Community-based mental health treatments for survivors of torture and militant attacks in Southern Iraq: a randomized control trial. BMC Psychiatry. 2015 Oct 14; 15:249. doi: 10.1186/s12888-015-0622-7.PMID:26467303.
Murray LK & Jordans MJD. Rethinking the service delivery system of psychological interventions in low and middle income countries. BMC Psychiatry (2016) 16:234. DOI 10.1186/s12888-016-0938-y
McHugh RK, Murray HW, Barlow DH (2009) Balancing fidelity and adaptation in the dissemination of empirically-supported treatments: the promise of transdiagnostic interventions. Behav Res Ther 47: 946–953.

Send Email for Laura Murray

Shannon Dorsey

Associate Professor
University of Washington


Send Email for Shannon Dorsey

Stephanie van Wyk

Research Associate
Johns Hopkins University School of Public Health


Send Email for Stephanie van Wyk

Kristie Metz

Project Director, CARES (Counseling for Academic Resilience in Every Student) Project
Harvard University


Send Email for Kristie Metz


Institute 4 - Common Elements Treatment Approach: An Evidence Based CBT Transdiagnostic Approach for Low-resource Settings

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