The Unified Protocol for Anxiety Disorders

2017 ◽  
pp. 38-52 ◽  
Author(s):  
Laren R. Conklin ◽  
Todd J. Farchione ◽  
Steven Dufour
Keyword(s):  
Anxiety Disorders ◽  
Emotional Disorders ◽  
Clinical Case ◽  
The United States ◽  
Transdiagnostic Treatment ◽  
Diagnostic And Statistical Manual ◽  
Unified Protocol ◽  
Clinical Case Studies ◽  
Individual Module ◽  
Manualized Protocol

Of any cluster of illnesses outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), none is more prevalent, likely to serve as a comorbid diagnosis, or costly in the United States than anxiety disorders. This chapter outlines the applications of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) for the treatment of such disorders. First, we briefly review the background research that provides context for the use of transdiagnostic treatment for anxiety disorders. The UP, with its intent to target comorbidity, is an approach that can be especially helpful for therapists who want to use an evidence-based treatment, prefer the structure of a manualized protocol, and value the benefits that a workbook can bring to patients. We then present two clinical case studies to demonstrate how each individual module of the UP maps onto typical cases of principal and comorbid anxiety. Recommendations for specific methods of protocol implementation are also described.

The Unified Protocol for Comorbid Alcohol Use and Anxiety Disorders

2017 ◽  
pp. 127-149 ◽  
Author(s):  
Todd J. Farchione ◽  
Tracie M. Goodness ◽  
Katelyn M. E. Williams
Keyword(s):  
Alcohol Use ◽  
Anxiety Disorders ◽  
Emotional Disorders ◽  
Negative Impact ◽  
The United States ◽  
Problematic Drinking ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Impact On Treatment ◽  
Dsm Iv

Alcohol use disorders (AUDs) are highly prevalent in the United States. Further, they have significant comorbidity with anxiety disorders (AXDs). The presence of AUD and AXD comorbidity is of concern because it appears to have a negative impact on treatment outcome for either disorder alone. Increasingly, researchers and clinicians have been moving toward transdiagnostic treatments that can address AUD/AXD comorbidity in a more comprehensive fashion that is ultimately more helpful for patients than the traditional delivery of parallel treatments for individual disorders. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) has shown preliminary results for reducing problematic drinking in patients with AUD/AXD comorbidity compared to medications or other treatments. This chapter offers a rationale for using the UP to address AUD/AXD comorbidity and presents a case illustrating application of this protocol in a patient presenting with DSM-IV alcohol dependence and additional AXDs.

The Unified Protocol for Eating Disorders

2017 ◽  
pp. 150-163
Author(s):  
Christina L. Boisseau ◽  
James F. Boswell
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Emotional Disorders ◽  
Clinical Case ◽  
Case Examples ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Outpatient Settings

This chapter describes the application of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) to eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder, and other specified feeding or eating disorders. We focus on the five core treatment modules, highlighting aspects of each one that are particularly relevant to eating disorders and discuss the evidence supporting their use. Next, using clinical case examples from both residential and outpatient settings, we illustrate how each of these core modules can be applied to the treatment of eating disorders. Finally, we provide recommendations for future applications of the UP in this population.

The Unified Protocol for Major Depressive Disorder

2017 ◽  
pp. 67-85
Author(s):  
James F. Boswell ◽  
Laren R. Conklin ◽  
Jennifer M. Oswald ◽  
Matteo Bugatti
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Emotional Disorders ◽  
Clinical Case ◽  
Depressive Disorders ◽  
Major Depressive ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
High Level ◽  
Future Work

Major depressive disorder (MDD) can be a chronic, debilitating condition that for many individuals waxes and wanes over time. In addition, MDD and other unipolar depressive disorders demonstrate a high level of comorbidity with anxiety disorders. This chapter describes the application of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) to MDD and other unipolar depressive disorders. We first review research supporting the association between depression and higher-order constructs such as neuroticism. Next, we present a clinical case that, combined with module-specific recommendations, further illustrates how UP principles and strategies are implemented in the treatment of primary depression. Finally, we offer recommendations for future work involving the UP for major depression and other depressive disorders.

scholarly journals The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Compared With Diagnosis-Specific Protocols for Anxiety Disorders

2017 ◽  
Vol 74 (9) ◽  
pp. 875 ◽  
Author(s):  
David H. Barlow ◽  
Todd J. Farchione ◽  
Jacqueline R. Bullis ◽  
Matthew W. Gallagher ◽  
Heather Murray-Latin ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Emotional Disorders ◽  
Transdiagnostic Treatment ◽  
Unified Protocol

Community Mental Health Delivery

2021 ◽  
pp. 162-179
Author(s):  
Ashley M. Shaw ◽  
Renee L. Brown ◽  
Vanesa A. Mora Ringle ◽  
Vanessa E. Cobham
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Emotional Disorders ◽  
The United States ◽  
Transdiagnostic Treatment ◽  
Health Delivery ◽  
Intervention Level ◽  
Unified Protocol ◽  
Mental Health Settings ◽  
Community Mental Health Settings

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) is a modular, flexible intervention that has been applied in various community mental health settings by community clinicians to diverse adolescents across the United States and Australia. This chapter summarizes key adaptations that were commonly used by community clinicians across two effectiveness trials. For example, clinicians flexibly abbreviated the UP-A when they only had limited time with an adolescent. Many clinicians also referred to “module summary” outlines during their sessions to ensure they covered key take-home points. Lastly, the chapter summarizes intervention-level, clinician-level, and patient-level barriers for UP-A implementation in community settings and provides recommendations for clinicians, supervisors, and consultants about how to troubleshoot these barriers. Furthermore, the chapter describes the case of a community clinician who initially worried about deviating too far from UP-A content but was later able to flexibly apply the UP-A to her cases.

The Unified Protocol for Nonsuicidal and Suicidal Self-Injurious Thoughts and Behaviors

2017 ◽  
pp. 179-199
Author(s):  
Kate H. Bentley ◽  
Shannon Sauer-Zavala ◽  
Clair Cassiello-Robbins ◽  
Stephanie Vento
Keyword(s):  
Mood Disorders ◽  
Emotional Disorders ◽  
Clinical Case ◽  
Full Range ◽  
Cognitive Behavioral Intervention ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Self Injury ◽  
And Behaviors ◽  
Case Presentations

Nonsuicidal self-injury (NSSI) and suicidal behavior are extremely common phenomena, with devastating consequences for individuals, families, and communities. Although interventions for NSSI and suicidal self-injurious thoughts and behaviors exist, there remains an urgent need to establish the most highly effective, efficient, and easily disseminable treatments for the full range of self-injuring individuals. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) is a cognitive-behavioral intervention recently developed to be applicable across the range of anxiety and mood disorders, as well as other disorders with strong emotional components. The aim of this chapter is to provide a rationale for using the UP, or its components, to address nonsuicidal and suicidal self-injurious thoughts and behaviors, as well as to discuss recent applications of the UP treatment to two self-injuring individuals through clinical case presentations.

scholarly journals Initial Effectiveness Evaluation of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders for Homeless Women

2020 ◽  
pp. 014544552098256
Author(s):  
Sara Rodriguez-Moreno ◽  
Todd J. Farchione ◽  
Pablo Roca ◽  
Carolina Marín ◽  
Ana I. Guillén ◽  
...  
Keyword(s):  
Negative Affect ◽  
Emotional Disorders ◽  
Group Treatment ◽  
Linear Trend ◽  
Control Period ◽  
Well Being ◽  
Homeless Women ◽  
Depression And Anxiety ◽  
Transdiagnostic Treatment ◽  
Unified Protocol

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.

Effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Among Veterans With Posttraumatic Stress Disorder: A Pilot Study

2017 ◽  
Vol 42 (2) ◽  
pp. 210-230 ◽  
Author(s):  
Ruth L. Varkovitzky ◽  
Andrew M. Sherrill ◽  
Greg M. Reger
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Emotion Regulation ◽  
Depressive Symptoms ◽  
Pilot Study ◽  
Posttraumatic Stress ◽  
Emotional Disorders ◽  
Symptom Severity ◽  
Stress Disorder ◽  
Transdiagnostic Treatment ◽  
Unified Protocol

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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