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).

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.

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 Clinical Utility of an Internet-Delivered Version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (iUP-A): A Pilot Open Trial

2020 ◽  
Vol 17 (22) ◽  
pp. 8306
Author(s):  
Bonifacio Sandín ◽  
Julia García-Escalera ◽  
Rosa M. Valiente ◽  
Victoria Espinosa ◽  
Paloma Chorot
Keyword(s):  
Depressive Symptoms ◽  
Panic Disorder ◽  
Emotional Disorders ◽  
Clinical Utility ◽  
Pilot Trial ◽  
Small Sample ◽  
Access To Treatment ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Improve Access

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) has been shown to be effective for reducing symptoms of anxiety and depression in adolescents with emotional disorders. Internet-delivered psychological treatments have great potential to improve access to evidence-based psychological therapy since they are associated with reduced human and economic costs and less social stigma. Recently, our group developed an online version of the UP-A (the iUP-A) for the treatment of emotional disorders in adolescents. The aim of this pilot trial was to test the clinical utility of the iUP-A in a small sample (n = 12) of adolescents with elevated anxiety and/or depressive symptoms. Intention-to-treat and completer analyses revealed pre- to post-intervention self-reported decreases of anxiety and depressive symptoms, anxiety sensitivity, emotional avoidance, panic disorder symptoms, panic disorder severity, generalized anxiety disorder symptoms, pathological worry, and major depressive disorder symptoms. We found high feasibility and acceptability of the program with all participants and responsible parents reporting an improvement in the adolescents’ ability to cope with emotions. Results suggest that the iUP-A may provide a new approach to improve access to treatment for anxious and depressive adolescents in Spain; however, further research must be conducted before firm conclusions can be drawn.

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.

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.

Treating Suicidal Thoughts and Behaviors Within an Emotional Disorders Framework: Acceptability and Feasibility of the Unified Protocol in an Inpatient Setting

2017 ◽  
Vol 41 (4) ◽  
pp. 529-557 ◽  
Author(s):  
Kate H. Bentley ◽  
Shannon Sauer-Zavala ◽  
Clair F. Cassiello-Robbins ◽  
Laren R. Conklin ◽  
Stephanie Vento ◽  
...  
Keyword(s):  
Emotional Disorders ◽  
Inpatient Setting ◽  
Suicidal Thoughts ◽  
Treatment As Usual ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Adjunctive Intervention ◽  
And Behaviors ◽  
Suicidal Thoughts And Behaviors

We provide a theoretical rationale for applying a transdiagnostic, shared mechanism treatment (the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders [UP]) to suicidal thoughts and behaviors. We also present results from a proof of concept study examining the feasibility and acceptability of adding a modified UP to treatment as usual (TAU) in an inpatient setting for individuals reporting a recent suicide attempt or active suicidal ideation. Participants ( N = 12) were randomly assigned to receive UP + TAU or TAU alone. Findings indicate good feasibility and acceptability of the adjunctive intervention. Among participants who were responsive to contact attempts postdischarge ( n = 6), there were no observable differences in suicidal thoughts or behaviors during a 6-month follow-up. This application represents a promising initial extension of a cognitive-behavioral, emotion-focused treatment to suicidal individuals within an inpatient setting. Future studies adequately powered to speak to efficacy of the modified UP intervention are warranted.

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.

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.

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