Sudden Gains and Ambivalence in the Unified Protocol for Transdiagnostic Treatment of Emotional Disorder

Author(s):  
João Tiago Oliveira ◽  
Divo Faustino ◽  
Paulo P. P. Machado ◽  
Eugénia Ribeiro ◽  
Sónia Gonçalves ◽  
...  
Author(s):  
Hannah Boettcher ◽  
Laren R. Conklin

This chapter describes a transdiagnostic, emotion-focused approach to case formulation that facilitates individualized application of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP). We begin by highlighting the advantages of dimensional assessment and classification in the domain of emotional disorders. Next, we describe the elements of case conceptualization essential to the UP, including assessment of strong uncomfortable emotions, aversive reactions to emotional experiences, and efforts to escape or avoid these experiences. We provide examples of such processes, suggestions for how to elicit relevant information from patients, and a worksheet for conducting case formulation within the UP framework. Finally, we preview a recently developed self-report instrument that uses dimensional assessment to yield a transdiagnostic profile of emotional disorder features, which may further facilitate treatment planning.


2018 ◽  
Vol 17 (2) ◽  
pp. 59-76 ◽  
Author(s):  
Jamie A. Sherman ◽  
Niza A. Tonarely ◽  
Jill Ehrenreich-May

This article presents the use of an emotion-focused, transdiagnostic therapy approach designed for adolescents with a range of anxiety, obsessive-compulsive, depressive, and related disorders, referred to here as emotional disorders. Preliminary work suggests that emotional disorders share underlying temperament factors, such as high neuroticism and low extroversion in adults and adolescents, possibly influencing the development and maintenance of emotional disorders across the life span. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) and similar core dysfunction-focused, transdiagnostic therapy approaches may lead to successful treatment by targeting higher order factors that cut across an array of emotional disorders The utility of UP-A for adolescents experiencing a variety of emotional disorder symptoms is demonstrated here through the case illustration of Tony, a 15-year-old adolescent male with severe social and generalized anxiety and mild levels of depression. After 16 individual treatment sessions, Tony demonstrated significant reductions in anxiety and depressive symptoms, as well as an ability to respond more adaptively to a range of emotional experiences. This case study illustrates how short-term, transdiagnostic treatment using the UP-A can effectively ameliorate a wide range of emotional disorder symptoms in adolescents and may also lead to changes in core features of neuroticism, potentially preventing development of further emotional difficulties over time.


Author(s):  
Shannon Sauer-Zavala ◽  
Kate H. Bentley ◽  
Julianne G. Wilner

Borderline personality disorder (BPD) is a severe, difficult-to-treat psychiatric condition that represents a large proportion of treatment-seeking individuals. This disorder is characterized by high rates of co-occurrence with depressive and anxiety disorders, and recent explanations for this comorbidity suggest that these disorders share biological vulnerabilities and functional maintenance factors. Given the commonalities among BPD and other emotional disorders, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) was clinically applied to five individuals who met criteria for BPD and at least one comorbid emotional disorder. This chapter will highlight the theoretical rationale for considering BPD an emotional disorder, underscoring the use of the UP with this population. In addition, detailed case presentations of two individuals with BPD treated with the UP will be presented to illustrate the ways in which UP skills can be flexibly applied within this diagnostic group.


Author(s):  
David H. Barlow ◽  
Todd J. Farchione ◽  
Shannon Sauer-Zavala ◽  
Heather Murray Latin ◽  
Kristen K. Ellard ◽  
...  

Chapter 5 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide is designed to provide a review of the patient’s presenting problems and diagnoses within the context of the emotional disorder framework. This is an opportunity for the therapist to start identifying how the patient’s experience fits into a transdiagnostic model emphasizing frequent strong emotions and aversive, avoidant responses to these emotions. This first session also emphasizes the importance of cultural factors and then provides patients with an introduction to the treatment protocol.


Author(s):  
David H. Barlow ◽  
Todd J. Farchione ◽  
Shannon Sauer-Zavala ◽  
Heather Murray Latin ◽  
Kristen K. Ellard ◽  
...  

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Workbook was developed to help people who are struggling with intense emotions like anxiety, sadness, anger, and guilt. A person may have an emotional disorder when his or her emotions are so overwhelming that they get in the way of moving forward in life. Although emotions affect our lives in different ways, there are three features that often occur across emotional disorders. These are (a) frequent, strong emotions; (b) negative reactions to emotions; and (c) avoidance of emotions. The goal of this workbook is to change the way that people with emotional disorders respond to their emotions when they occur. This treatment program is applicable to all anxiety and unipolar depressive disorders and potentially other disorders with strong emotional components. The strategies included in this treatment are largely based on common principles found in existing empirically supported psychological treatments.


2021 ◽  
Author(s):  
Shannon Sauer-Zavala ◽  
Anthony J. Rosellini ◽  
Kate H. Bentley ◽  
Amantia A. Ametaj ◽  
James F. Boswell ◽  
...  

2012 ◽  
Vol 36 (4) ◽  
pp. 482-508 ◽  
Author(s):  
K. K. Ellard ◽  
T. Deckersbach ◽  
L. G. Sylvia ◽  
A. A. Nierenberg ◽  
D. H. Barlow

2020 ◽  
pp. 014544552098256
Author(s):  
Sara Rodriguez-Moreno ◽  
Todd J. Farchione ◽  
Pablo Roca ◽  
Carolina Marín ◽  
Ana I. Guillén ◽  
...  

The purpose of this study is to evaluate the effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders adapted for homeless women (UPHW). Eighty-one homeless women participated in this single-blinded quasi-experimental clinical trial, involving up to 12 sessions of group treatment, and 3-and 6-month follow-ups. The participants received either immediate treatment with the UPHW ( n = 46) or delayed treatment, following a 12-week wait-list control period (WLC; n = 35). Primary outcomes included depression and anxiety. Secondary measures comprised positive and negative affect, psychological well-being, health perception, and social support. The UPHW resulted in significant improvement on measures of anxiety, depression and negative affect. Improvements in anxiety and depression were maintained over a 3-month follow-up period, but not at 6-month. The reliability of the clinical changes showed significant differences between UPHW and WLC for depression. Moreover, the inter-session assessment in the UPHW group showed a linear trend reduction for depression and anxiety scores along the 12 sessions. The clinical implications on the UPHW in social settings are also discussed.


2017 ◽  
Vol 42 (2) ◽  
pp. 210-230 ◽  
Author(s):  
Ruth L. Varkovitzky ◽  
Andrew M. Sherrill ◽  
Greg M. Reger

Effective treatment options are needed for veterans who do not participate in trauma-focused psychotherapy. Research has yet to examine the effectiveness of transdiagnostic psychotherapy in veterans with posttraumatic stress disorder (PTSD) and co-occurring psychological disorders. This pilot study examined the effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) delivered in a 16-week group format. We examined treatment outcomes in male and female veterans ( n = 52) in an outpatient specialty PTSD clinic at a large Veterans Affairs (VA) medical center. We hypothesized significant decreases in emotion regulation difficulty (Difficulties in Emotion Regulation Scale), PTSD symptom severity (PTSD Checklist for DSM-5), and depressive symptom severity (Patient Health Questionnaire–9). In addition, we hypothesized that reductions in emotion regulation difficulty across treatment would negatively predict PTSD and depressive symptoms at posttreatment. PTSD symptoms, depressive symptoms, and emotion regulation difficulty all evidenced significant improvements at the end of treatment relative to baseline ( ps < .001). In addition, reductions in emotion regulation across treatment were associated with lower PTSD and depressive symptoms at posttreatment ( ps < .001). This pilot study provides preliminary evidence supporting use of UP among veterans with PTSD and co-occurring disorders. Well-designed clinical trials evaluating efficacy of UP among veterans are needed.


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