Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children

Author(s):  
Jill Ehrenreich-May ◽  
Sarah M. Kennedy ◽  
Jamie A. Sherman ◽  
Emily L. Bilek ◽  
David H. Barlow

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children: Workbook (UP-C) provides evidence-based treatment strategies to assist child clients to function better in their lives. This treatment is designed for children ages 7 to 13 (although some children just outside this age range may also benefit) 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 children (with corresponding parent sessions presented later in the book) and guides them through each week of the program with education, activities, and examples that will help families to understand the role that emotions play in everyday actions. Children are taught helpful strategies for dealing with strong emotions and will receive support in making choices that will move them closer to their long-term goals. The UP-C takes a transdiagnostic approach to the treatment of emotional disorders and the skills presented are appropriate for children with a large range of emotional challenges, including anxiety, depression, obsessive-compulsive symptoms, and other related concerns.

Author(s):  
Jill Ehrenreich-May ◽  
Sarah M. Kennedy ◽  
Jamie A. Sherman ◽  
Emily L. Bilek ◽  
Brian A. Buzzella ◽  
...  

Chapter 10 introduces the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C). This is also called the “Emotion Detectives” program, which reflects the guiding treatment metaphor: teaching children to “solve the mystery of their emotions,” as detectives might. The UP-C is intended to reduce the intensity and frequency of symptoms common to youth with emotional disorders by using core evidence-based treatment strategies in a broad manner that applies to a wide range of aversive emotional experiences characteristic of youth emotional disorders (i.e., anxiety, depression, other internalizing disorders). Many anxiety, depression, adjustment, traumatic stress-related, or obsessive-compulsive or related disorders would be appropriate targets for this intervention. The UP-C is intended for children between the ages of 7 and 13, although children slightly above or below this age group may benefit from this format.


Author(s):  
Johanna Thompson-Hollands

The case of a 25-year-old male with obsessive-compulsive disorder (OCD) is presented in this chapter. The patient, “Luke,” had primary obsessions related to harm befalling his family and girlfriend, as well as fears of contamination. His primary compulsions included mental “undoing,” in his words, and repeating actions. He engaged in significant avoidance around potential contaminants. The text reviews Luke’s course of treatment with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP), including the application of each treatment module and attention to challenging issues that arose in this case. Specific attention is devoted to the use of cognitive reappraisal in the UP for OCD, managing symptom accommodation by family members, and exposure in the context of intrusive thoughts and mental rituals.


Author(s):  
Jill Ehrenreich-May ◽  
Sarah M. Kennedy ◽  
Jamie A. Sherman ◽  
Emily L. Bilek ◽  
Brian A. Buzzella ◽  
...  

The therapy manuals included in this volume—the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) and Adolescents (UP-A)—include evidence-based treatment strategies to assist child and adolescent clients to function better in their lives. The manuals include specific guidelines for treatment delivery, and they also contain information about how to introduce parent-directed strategies to help promote long-term uptake of youth-directed therapy skills. The evidence-based treatment skills presented may be applied by therapists to children and adolescents with a wide variety of emotional disorders. This treatment guide takes a transdiagnostic approach to the treatment of emotional disorders. Some of the disorders that may be targeted include anxiety disorders and depressive disorders. 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 children and adolescents presenting with multiple emotional disorders or mixed/subclinical symptoms of several emotional disorders.


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

Chapter 13 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Workbook reviews the treatment program. (1) All emotions, even the ones that feel negative or uncomfortable, provide important information that can motivate us to take action in helpful ways. (2) Staying present in the moment and taking a nonjudgmental view of emotions can help to prevent emotions from increasing in intensity. The way we think about a situation influences how we feel, and how we feel affects the way we interpret a situation. (3) Although avoiding uncomfortable emotional experiences can work well in the short-term, it isn’t an effective long-term coping strategy. The chapter helps us to evaluate our progress and revisit our treatment goals. The most effective way to maintain progress and to keep improving is to continue to practice the skills learned in this program, and therefore a practice plan is developed in this last chapter.


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

Chapter 14 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide evaluates the patient’s progress and to plan for the future. Therapists will also reinforce the skills learned in treatment, review key treatment concepts, and help patients develop strategies for preventing “relapse.” Additionally, this chapter is used to address symptom recurrence and how patients can maintain treatment gains in the long term.


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.


2020 ◽  
Vol 19 (6) ◽  
pp. 491-508 ◽  
Author(s):  
Elena Crespo-Delgado ◽  
Verónica Martínez-Borba ◽  
Jorge Osma

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.


2020 ◽  
pp. 153465012096799
Author(s):  
Brianna R. Altman ◽  
Mitch Earleywine

Psychotherapy outcome research rarely focuses on the ideographic application of treatment manuals, though some modules might prove markedly more important for a client than others. Clients in need of psychoeducation, emotion regulation skills, and changes in maladaptive patterns of thinking might balk at portions of the Unified Protocol for the Treatment of Emotional Disorders that seem irrelevant to their concerns. The current case study focused on emotion dysregulation and perfectionism given their role in anxiety, depression, obsessions, and compulsions. The Overall Anxiety Severity and Impairment Scale (OASIS), Overall Depression Severity and Impairment Scale (ODSIS), and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) confirmed qualitative reports and therapist observations of improvement. Additional sessions focused on fostering self-compassion and processing the termination of a romantic relationship rather than completing every section of the manual. This case demonstrates that flexible adaptation of a transdiagnostic treatment manual, in conjunction with a strong working alliance and other non-specifics of therapy, can produce beneficial outcomes even when other modules are not applied. These results might support ideographic application of select modules from treatment manuals and support a symptoms approach to psychotherapy.


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

Chapter 9 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Workbook looks at another part of our emotional experiences—emotional behaviors, which refer to the things we do to manage our emotions. This chapter presents skills to help us identify and evaluate our emotional behaviors by examining both the short term and long term consequences of these actions. In general, unhelpful emotional behaviors provide short term relief from strong emotions but set us up to experience even more strong emotions in the future. Lastly, we learn to counter unhelpful emotional behaviors by replacing current emotional behaviors with new, alternative behaviors, a skill called choosing an Alternative Action.


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

Chapter 6 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Workbook teaches us to put our emotional experience in context by examining what happens before and after we feel a strong emotion. First, we look for patterns in the situations or events that trigger emotions. Next, we continue to break-down our emotional response into thoughts, physical sensations, and behaviors. Finally, we look at the consequences for how we respond to our emotions, both in the short term and in the long term. The way we respond in the midst of an emotional response can have consequences for the emotions we feel in the future, and this understanding may help motivate us to make changes in the way we’re currently coping.


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