Table 2.

Case examples of transdiagnostic interventions for dyads early after NDD diagnoses

Component	Case 1	Case 2
Contextual Factors	Spousal dyads comprising of a cisgendered White female partner (age 67) recently diagnosed with AD and a cisgendered White female partner (age 64). Both partners reported good premorbid health and relationship functioning prior to diagnosis and experience the diagnosis as “overwhelming.”	Parent-child dyad comprising of a White Hispanic father (age 72) diagnosed with PD and White Hispanic daughter (age 45). Person with PD had a medical history significant for Type II diabetes prior to PD onset. Dyad’s relationship was strained due to substantial life stressors (recent loss of spouse/mother one year prior to diagnosis).
Early Symptoms	Prominent AD symptoms include memory loss, changes in attentional abilities, and some changes in emotional expression (empathy, humor).	Prominent PD symptoms include resting tremors, difficulty moving/ walking (speed, transitions), sleep disturbance, changes in speech (speed, inflection), decreased energy and motivation for daily activities.
Significant Early Stressors	Dyad’s most substantial stressors include decisions about person with AD’s ability to safely drive, different understandings of impact of AD on long-term plans (e.g., retirement, advanced care plans), and different attributions of behaviors to symptoms or person (e.g., forgetting location of things, changes in empathic responding from person with AD during difficult conversations).	Dyad’s most substantial stressors include person with PD’s depression symptoms (e.g., low motivation, fatigue, hopelessness), communicating about person with PD’s medical care and health behaviors (diet, physical activity, sleep), transition to role as care-partners, communicating amid negative/overwhelming emotions (grief, anger, anxiety).
Clinician Tailoring of Content for Dyad: To address Illness-related factors and External Resources, Symptom Progression and Transition Points	Presentation of skills in multiple modalities (e.g., in-session, online with audio, video, and written information), use of accessible language Emphasis on home practice of skills and tailoring to address dyads’ barriers to skills use (e.g., time, setting reminders to minimize impact of memory deficits, practicing skills together) Identification of resources for dyad to navigate transitions to higher levels of care	Presentation of skills in multiple modalities (e.g., in-session, online with audio, video, and written information), use of accessible language Emphasis on home practice of skills and tailoring to address dyads’ barriers to skills use (e.g., planning time for each person to practice skills separately and together Identification of support groups and activities for person with PD and care-partner; resources for dyad to navigate transitions to higher level of care.
Dyadic Biopsychosocial Outcomes: Primary Intervention Targets (based on dyad’s prominent stressors)	• AD symptoms (e.g., cognitive functioning) • Relationship functioning (conflict, intimacy) • Quality of life	• Self-care and health management behaviors (e.g., physical activity, diet, stress management) • Relationship functioning (conflict, intimacy) • Quality of life