Group Treatment Applications of the Unified Protocol

2017 ◽  
pp. 252-267
Author(s):  
Jacqueline R. Bullis ◽  
Kate H. Bentley ◽  
Katherine A. Kennedy
Keyword(s):  
Cost Effectiveness ◽  
Emotional Disorders ◽  
Group Treatment ◽  
Depressive Disorders ◽  
Research Priorities ◽  
Future Research ◽  
Recent Application ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Group Format

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) has demonstrated promising results among patients with heterogeneous anxiety and comorbid depressive disorders when delivered on an individual basis, but greater efficiencies may be achieved with group-based applications. This chapter will provide a rationale for utilizing a transdiagnostic approach in a group format, including cost-effectiveness and efficiency for patients and practitioners alike. It will illustrate a recent application of the UP with patients who completed 12 sessions in a group, offer guidelines on how to successfully implement the UP in a group of patients with a range of anxiety, depressive, and related disorders, and discuss the challenges that arose during treatment. We will then present data on the treatment response for each patient, as well as patients’ perceptions of the acceptability and feasibility of the UP in a group format, and conclude with our thoughts on future research priorities.

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.

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.

Introduction to the Unified Protocol

2017 ◽  
pp. 3-8
Author(s):  
David H. Barlow ◽  
Todd J. Farchione ◽  
Shannon Sauer-Zavala ◽  
Heather Murray Latin ◽  
Kristen K. Ellard ◽  
...  
Keyword(s):  
Mental Health ◽  
Eating Disorders ◽  
Emotional Disorders ◽  
Depressive Disorders ◽  
Mental Health Providers ◽  
Health Providers ◽  
Transdiagnostic Treatment ◽  
Unified Protocol

Chapter 1 of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide introduces the treatment program, which is applicable to all anxiety and unipolar depressive disorders, and potentially other disorders with strong emotional components (e.g., eating disorders, borderline personality disorder). This introductory chapter lays out the advantages of a unified, transdiagnostic approach as well as the efficacy of the Unified Protocol (UP). The chapter concludes with an explanation of the purpose of the therapist guide, which gives mental health providers guidance on administration of the UP.

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders

2017 ◽  
Author(s):  
David H. Barlow ◽  
Todd J. Farchione ◽  
Shannon Sauer-Zavala ◽  
Heather Murray Latin ◽  
Kristen K. Ellard ◽  
...  
Keyword(s):  
Emotional Disorders ◽  
Depressive Disorders ◽  
Cognitive Appraisals ◽  
Borderline Personality ◽  
Short Term ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Empirically Supported ◽  
Core Skills ◽  
Action Tendencies

The Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide is a treatment programv applicable to all anxiety and unipolar depressive disorders and potentially other disorders with strong emotional components (e.g., eating disorders, borderline personality disorder). The UP for the Transdiagnostic Treatment of Emotional Disorders addresses neuroticism by targeting the aversive, avoidant reactions to emotions that, while providing relief in the short term, increase the likelihood of future negative emotions and maintains disorder symptoms. The strategies included in this treatment are largely based on common principles found in existing empirically supported psychological treatments—namely, fostering mindful emotion awareness, reevaluating automatic cognitive appraisals, changing action tendencies associated with the disordered emotions, and utilizing emotion exposure procedures. The focus of these core skills has been adjusted to specifically address core negative responses to emotional experiences.

scholarly journals The Unified Protocol for Transdiagnostic Treatment of Perinatal Depression: A Case Study

2020 ◽  
Vol 19 (6) ◽  
pp. 491-508 ◽  
Author(s):  
Elena Crespo-Delgado ◽  
Verónica Martínez-Borba ◽  
Jorge Osma
Keyword(s):  
Emotional Disorders ◽  
Individual Treatment ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Group Format ◽  
Regulation Strategies ◽  
Anxiety Depression ◽  
Perinatal Women

This case study aims to present the application of the Unified Protocol (UP) for the Transdiagnostic Treatment of Emotional Disorders in the case of a 38-year-old pregnant woman with a peripartum onset of major depressive disorder and anxiety symptoms. The UP is a cognitive-behavioral intervention based on the shared etiological and maintenance mechanisms of emotional disorders (i.e., mood, anxiety, and related disorders). The UP helps to modify maladaptive emotion-regulation strategies and enhance tolerance of unpleasant and intense emotions (sadness, anxiety, anger, etc.). Whereas previous studies demonstrate the efficacy of the UP in different emotional disorders, to our knowledge, none of them have used the UP to treat perinatal emotional disorders. After the eight UP modules of individual treatment, a significant decrease in anxiety, depression, negative affect, and anxiety sensitivity, and also an increase in positive affect were observed. These results were maintained at the 12-month follow-up. In addition to its clinical utility and acceptance, these results indicate that the UP can be adapted and personalized for the treatment of perinatal emotional disorders. Future studies with larger samples and controlled experimental designs should be developed to demonstrate its efficacy. Furthermore, as the UP seems to be useful in a group format, future efforts should be focused on the UP with perinatal women in a group format.

scholarly journals Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in Medical Conditions: A Systematic Review

2021 ◽  
Vol 18 (10) ◽  
pp. 5077
Author(s):  
Jorge Osma ◽  
Laura Martínez-García ◽  
Alba Quilez-Orden ◽  
Óscar Peris-Baquero
Keyword(s):  
Systematic Review ◽  
Emotional Disorders ◽  
Medical Condition ◽  
Future Research ◽  
Medical Conditions ◽  
Emotional Symptoms ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Study Protocols ◽  
Research Studies

Emotional disorders are those that most commonly present comorbidly with medical conditions. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP), a cognitive-behavioral emotion-based intervention, has proven efficacy and versatility. The aim of this systematic review is to know the current (research studies) and future research interest (study protocols) in using the UP for the transdiagnostic treatment of emotional symptoms or disorders (EDs) in people with a medical condition. Using the PRISMA guidelines, a literature search was conducted in Web of Science, PubMed, Medline, and Dialnet. The nine research studies included in this review indicated that the UP is effective in treating emotional symptomatology in a population with a medical condition (effect sizes ranging from d = −3.34 to d = 2.16). The three included study protocols suggest interest in the future UP application to different medical conditions, and also in distinct application formats. Our review results are encouraging, and conducting more controlled studies is advised to recommend the UP to treat and/or prevent EDs in medical conditions, especially in children and youths.

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders

2017 ◽  
Author(s):  
David H. Barlow ◽  
Todd J. Farchione ◽  
Shannon Sauer-Zavala ◽  
Heather Murray Latin ◽  
Kristen K. Ellard ◽  
...  
Keyword(s):  
Emotional Disorders ◽  
Treatment Program ◽  
Depressive Disorders ◽  
Emotional Disorder ◽  
Psychological Treatments ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Empirically Supported ◽  
The Way

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.

scholarly journals The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Among Japanese Children: A Pilot Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Hiroko Fujisato ◽  
Noriko Kato ◽  
Hikari Namatame ◽  
Masaya Ito ◽  
Masahide Usami ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Functional Status ◽  
Emotional Disorders ◽  
Depressive Disorders ◽  
Anxiety Symptoms ◽  
Japanese Children ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Pre Treatment

At present, there is no established cognitive behavioral therapy (CBT) for treating emotional disorders in Japanese children. Therefore, we introduced the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) in Japan and adapted it to the Japanese context. We then examined its feasibility and preliminary efficacy using a single-arm pretest, posttest, follow-up design. Seventeen Japanese children aged between 8 and 12 years (female n = 11; male n = 6; M = 10.06 ± 0.97 years) with a principal diagnosis of anxiety, obsessive-compulsive, or depressive disorders, and their parents were enrolled in the study. The primary outcome was the overall severity of emotional disorders as assessed by psychiatrists using the Clinical Global Impression-Severity Scale. Secondary outcomes included child- and parent-reported anxiety symptoms, depressive symptoms, and functional status. No severe adverse events were observed. The feasibility was confirmed by the low dropout proportion (11.76%), high attendance proportion (children: 95.6%; parents: 94.6%), and sufficient participant satisfaction. Linear mixed models (LMMs) showed that the overall severity of emotional disorders and child- and parent-reported anxiety symptoms improved from pre-treatment to post-treatment, and that these treatment effects were maintained during the 3-month follow-up period. Additionally, child- and parent-reported functional status improved from pre-treatment to the 3-month follow-up. In contrast, child-reported depressive symptoms improved from pre-treatment to follow-up, but there was no significant change in parent-reported depressive symptoms between pre-treatment and other time points. These findings demonstrate the feasibility and preliminary efficacy of the Japanese version of the UP-C, suggesting that future randomized controlled trials (RCTs) are warranted (Clinical trial registration: UMIN000026911).

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents

2017 ◽  
Author(s):  
Jill Ehrenreich-May ◽  
Sarah M. Kennedy ◽  
Jamie A. Sherman ◽  
Shannon M. Bennett ◽  
David H. Barlow
Keyword(s):  
Anxiety Disorder ◽  
Depressive Disorder ◽  
Emotional Disorders ◽  
Depressive Disorders ◽  
Separation Anxiety Disorder ◽  
Tic Disorders ◽  
Evidence Based ◽  
Evidence Based Treatment ◽  
Transdiagnostic Treatment ◽  
Unified Protocol

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents: Workbook (UP-A) provides evidence-based treatment strategies to assist adolescent clients to function better in their lives. This treatment is designed for adolescents who are experiencing feelings of sadness, anxiety, worry, anger, or other emotions that get in the way of their ability to enjoy their lives and feel successful. The workbook is written for adolescents and guides them through each week of the program with education, activities, and examples that will help them to understand the role that emotions play in their behaviors every day. Adolescents are taught helpful strategies for dealing with uncomfortable emotions and will receive support in making choices that will move them closer to their long-term goals. The evidence-based treatment skills presented in the accompanying Therapist Guide may be applied by the therapist to adolescents with a wide variety of emotional disorders. The UP-A takes a transdiagnostic approach to the treatment of the emotional disorders. Some of the disorders that may be targeted include anxiety disorders (e.g., generalized anxiety disorder, social anxiety disorder, separation anxiety disorder, specific phobias, panic disorder, illness anxiety disorder, agoraphobia) and depressive disorders (e.g., persistent depressive disorder, major depressive disorder). This treatment is flexible enough for use with some trauma and stress-related disorders (including adjustment disorders), somatic symptom disorders, tic disorders, and obsessive-compulsive disorders. The transdiagnostic presentation of evidence-based intervention techniques within these treatments may be particularly useful for adolescents presenting with multiple emotional disorders or mixed/subclinical symptoms of several emotional disorders.

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