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.

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.

A pilot trial of a transdiagnostic treatment for emotional disorders—a locally adapted variant of group Unified Protocol (UP) for Chinese adults

2020 ◽  
Author(s):  
Candice L Y M Powell ◽  
Todd J Farchione ◽  
David H Barlow ◽  
Patrick W L Leung
Keyword(s):  
Hong Kong ◽  
Mental Disorders ◽  
Positive Affect ◽  
Emotional Disorders ◽  
Common Mental Disorders ◽  
Pilot Trial ◽  
Effect Sizes ◽  
Chinese Adults ◽  
Transdiagnostic Treatment ◽  
Unified Protocol

Abstract There has been increasing interest in transdiagnostic cognitive-behavioral therapy (CBT), which is more cost efficient yet yields similar effect sizes when compared to disorder-specific CBT. The Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders was adapted for Hong Kong Chinese adults with common mental disorders, such as depression and anxiety. It was piloted in community settings and delivered in a group format. Thirty-one Chinese adults (female = 93.5%, mean age = 44 years) with heterogeneous anxiety and depressive disorders were recruited from a number of public-funded community mental health centers in Hong Kong to participate in a pilot trial of a locally adapted variant of UP. Treatment consisted of 14 group sessions plus one individual session. Each group included six to nine participants. The diagnostic and outcome measures included Anxiety Disorders Interview Schedule for DSM-IV, The Chinese versions of Beck Depression Inventory-Revised (C-BDI-II), Beck Anxiety Inventory (C-BAI), Positive Affect subscale of Positive and Negative Affect Scale, and Work and Social Adjustment Scale. Results indicate significant improvement across a number of outcome measures, with moderate-to-large effect sizes for measures of depression (d = 1.11), anxiety (d = 0.67), positive affect (d = 0.54), and work and social functioning (d = 0.49). Furthermore, 45.2% and 29.0% of the participants scored within the normal range of C-BDI-II and C-BAI at posttreatment, respectively, compared to 3.2% and 6.5% at pretreatment. This pilot, uncontrolled trial demonstrated potential effectiveness of a locally adapted variant of group UP for Chinese adults with common mental disorders. It achieved comparable effect sizes to those observed in western populations.

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).

A Randomized Controlled Pilot Trial of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children

2018 ◽  
Vol 43 (3) ◽  
pp. 330-360 ◽  
Author(s):  
Sarah M. Kennedy ◽  
Emily L. Bilek ◽  
Jill Ehrenreich-May
Keyword(s):  
Emotional Disorders ◽  
Emotional Reactivity ◽  
Negative Emotion ◽  
Pilot Trial ◽  
Specific Treatment ◽  
Control Treatment ◽  
Depression Symptoms ◽  
Transdiagnostic Treatment ◽  
Randomized Controlled ◽  
Unified Protocol

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) is an intervention for children aged 7 to 13 targeting high negative emotion, emotional reactivity, and emotion regulation deficits common across emotional disorders. Our objective was to collect pilot randomized controlled trial (RCT) data on the efficacy of the UP-C, comparing UP-C with an active, anxiety-focused intervention. Participants were 47 children with at least one primary anxiety disorder; approximately one half had elevated depression symptoms. Participants received either UP-C or the anxiety-focused control treatment. No condition-related differences were found with respect to diagnostic remission and anxiety symptoms. However, differences in favor of UP-C were observed with respect to treatment response at follow-up, depression symptoms, sadness dysregulation, and cognitive reappraisal. Results provide preliminary evidence that the UP-C may be at least as efficacious in treating anxiety as well-supported anxiety-specific treatment protocols and may produce greater gains in certain emotion reactivity and regulation variables.

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.

Culturally and Linguistically Sensitive Applications in Other Countries

2021 ◽  
pp. 180-194
Author(s):  
Hiroko Fujisato ◽  
Noriko Kato ◽  
Dominique Phillips ◽  
Estefany Sáez-Clarke
Keyword(s):  
Children And Adolescents ◽  
Emotional Disorders ◽  
Cultural Context ◽  
Japanese Culture ◽  
Cultural Groups ◽  
Cultural Adaptations ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Intervention Protocol

Cultural adaptation can help maintain a balance between scientifically rigorous interventions and culturally sensitive, effective practice. When introducing the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A) into a new cultural context, translating the treatment may be sufficient in some countries and regions, while others may require more systematic modification. This chapter discusses specific steps that were taken for adapting the UP-C/A in the context of Japanese culture and presents a case study in Japan. When introducing the UP-C/A into the Japanese context, modifications were made to increase the treatment’s acceptability and comprehension, but there were no significant modifications in the content of the intervention protocol. In the future, as the UP-C/A is introduced into other cultures, its effectiveness will be further evaluated and the cultural adaptations needed to accommodate new cultural groups will become increasingly apparent.

Introduction

2021 ◽  
pp. 3-36
Author(s):  
Heather Thompson-Brenner ◽  
Melanie Smith ◽  
Gayle Brooks ◽  
Rebecca Berman ◽  
Angela Kaloudis ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Negative Affect ◽  
Emotional Disorders ◽  
Emotional Functioning ◽  
Transdiagnostic Treatment ◽  
Unified Protocol

The Renfrew Unified Treatment for Eating Disorders and Co-occurring Emotional Disorders (UT) is an integrative, transdiagnostic, principle-based approach to address patterns of emotion avoidance, emotion sensitivity, and negative affect that produce and maintain the symptoms of eating disorders and co-occurring emotional disorders. The UT model was developed through an extensive process of adapting the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) for use with patients with severe and diverse eating disorders. The modules of the UT are distinct from other approaches due to their cohesive (internal and collective) focus on how each module addresses these shared maintaining mechanisms. There is extensive evidence that eating disorders typically co-occur with other emotional disorders. There is also extensive evidence that eating disorders and other emotional disorders share common maintaining mechanisms, reflecting aspects of emotional functioning.

Basic Principles Underlying Treatment and Outline of the Treatment Procedures

2017 ◽  
pp. 9-20
Author(s):  
David H. Barlow ◽  
Todd J. Farchione ◽  
Shannon Sauer-Zavala ◽  
Heather Murray Latin ◽  
Kristen K. Ellard ◽  
...  
Keyword(s):  
Emotional Disorders ◽  
Automatic Thoughts ◽  
Transdiagnostic Treatment ◽  
Psychological Mechanisms ◽  
External Threats ◽  
Unified Protocol ◽  
Core Skills ◽  
Emotional Processes ◽  
Treatment Procedures ◽  
Action Tendencies

Chapter 2 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide notes that the Unified Protocol (UP) is based on traditional cognitive-behavioral principles, but the particular emphasis on the way individuals experience and respond to their emotions is unique in that it brings emotional processes to the forefront, making them available to fundamental psychological mechanisms of change. Core skills of the UP are introduced. These include mindful emotion awareness, which involves the practice of nonjudgmental, present-focused attention toward emotional experiences; challenging automatic thoughts related to external threats and internal threats and increasing cognitive flexibility; identifying and modifying problematic action tendencies, or emotional behaviors; increasing awareness and tolerance of physical sensations through interoceptive exposures; and engagement in emotion exercises. The chapter concludes with a description of the treatment modules.

Sign in / Sign up

Export Citation Format

Share Document