The Unified Protocol as an Internet-based Intervention for Emotional Disorders: Randomized Controlled Trial

Schaeuffele, Carmen; Sl, Homeyer; Perea, Laurencia; Schärf, Liesel; Schulz, Ava; Knaevelsrud, Christine; Renneberg, Babette; Boettcher, Johanna

doi:10.31234/osf.io/528tw

Cited by 8 publications

(9 citation statements)

References 54 publications

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“…Overall, these improvements in emotion regulation and symptoms are consistent with the effects reported in previous UP trials when delivered face-to-face in clinical 13 and oncological populations 14 and when internet-delivered. 15,16 These results are also consistent with the findings reported by alternate transdiagnostic, internet-delivered cognitive-behavioural interventions developed for cancer survivors. 22,23…”

Section: F I G U R Esupporting

confidence: 86%

Piloting CanCope: An internet‐delivered transdiagnostic intervention to improve mental health in cancer survivors

et al. 2021

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Objective: CanCope is an internet-delivered, cognitive-behavioural intervention adapted from the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders to improve emotion regulation and support the mental health of cancer survivors. Four separate pilot studies evaluated each of CanCope's modules for (1) feasibility and participant satisfaction, and changes in (2) module-specific outcomes, and (3) global measures of emotion dysregulation and anxiety and depressive symptoms, from pre-to-post module delivery. Methods: Eligible cancer survivors self-selected into one two-week online module designed to improve a specific aspect of emotion regulation ([1] understanding emotions, [2] mindfulness of emotions, [3] cognitive reappraisals, [4] challenging emotion-driven behaviours).Results: Across modules, post-intervention surveys were completed by 17-19 participants, (58.1%-90.5% completion rate for participants who received the intervention). Each module was feasible and participants reported high satisfaction.Moderate-to-large pre-to-post effect sizes in mean differences were observed in module-specific target outcomes (p's < 0.05). Emotion dysregulation significantly decreased across modules 1 to 3 (p's < 0.05) with a non-significant decrease for module 4 (p = 0.13). Anxiety symptoms significantly decreased across all modules (p's < 0.05). Depressive symptoms significantly decreased across modules 1 and 3 (p's < 0.05), with non-significant decreases across modules 2 (p = 0.08) and 4 (p = 0.06).Conclusions: Each CanCope module demonstrated promise in targeting emotion regulation skills and supporting the mental health of cancer survivors. Randomised controlled trials are required to test the efficacy of CanCope as an intervention in its entirety.

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Section: F I G U R Esupporting

confidence: 86%

Piloting CanCope: An internet‐delivered transdiagnostic intervention to improve mental health in cancer survivors

et al. 2021

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“…In order to ensure that participants received the proper dosage of treatment, we measured the transdiagnostic processes following the module that targeted them. But since the treatment was self-paced and the mean number of modules completed was M = 7.22 (Schaeuffele et al, 2020), this naturally meant that the assessments after completion of module 7 and 9 were limited to participants who progressed to this stage of treatment. Thus, our findings are preliminary and should be replicated with larger samples.…”

Section: Discussionmentioning

confidence: 99%

“…We collected data within a randomized controlled trial examining the efficacy of an internet-based version of the UP for anxiety, depressive, and somatic symptom disorders (Schaeuffele et al, 2020). For this purpose, treatment was compared to waitlist in a 1:1 ratio (N = 129).…”

Section: Methodsmentioning

confidence: 99%

Transdiagnostic Processes as Mediators of Change in an Internet-Delivered Intervention Based on the Unified Protocol

Schaeuffele

Buengener

et al. 2021

Cogn Ther Res

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Background Transdiagnostic treatments target shared mechanisms between disorders to facilitate change across diagnoses. The Unified Protocol (UP) aims at changing dysfunctional reactions towards emotions by increasing mindful emotion awareness and cognitive flexibility, as well as decreasing anxiety sensitivity and emotion avoidance. Method We investigated whether these transdiagnostic processes were malleable by treatment and mediated the relationship between treatment and outcome in an internet-delivered adaptation of the UP. N = 129 participants with mixed anxiety, depressive, and somatic symptom disorders were randomized to treatment or waitlist. Results The treatment yielded significant changes in all transdiagnostic processes over time in comparison to a waitlist condition. In separate mediator models, significant mediating effects were found for mindfulness, cognitive flexibility, behavioral activation, and experiential avoidance. When all mediators were combined in a multiple mediator model, the indirect effects through mindfulness and cognitive flexibility emerged as significant. Conclusion These findings add to the growing body of research on transdiagnostic processes as mediators of change and emphasize mindfulness and cognitive flexibility as a transdiagnostic treatment target. However, these results should be interpreted cautiously, as temporal precedence could not be established.

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“…For the internet-based treatment sample, data were collected within a randomized controlled trial on the efficacy of an internet-based version of the Unified Protocol (UP), a transdiagnostic intervention for internalizing disorders focused on emotion regulation processes, for patients with primary anxiety, depressive, or somatic symptom disorders (30). Participants received a 10-week therapist-guided internetdelivered intervention based on the UP, working self-paced through 10 modules with asynchronous (text-based) guidance once a week.…”

Section: Online Treatment Settingmentioning

confidence: 99%

Differential Effects of Psychological Interventions in Online and Face-to-Face Settings on DSM-5 and ICD-11 Maladaptive Trait Domains: An Exploratory Pilot Study

et al. 2021

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While mental health treatments have proven to be effective for a range of mental health problems, there is comparably little research on its effects on personality disorders or difficulty (PD). New dimensional conceptualizations of PD such as the ICD-11 PD model enable the cost- and time-effective dimensional assessment of severity and style of PD. Furthermore, they constitute a promising tool to investigate PD, not only as a treatment endpoint but also as a predictive or influencing factor for mental health treatments. In this study, we investigated the effects in two different mental health treatment settings [online (N = 38); face-to-face and blended [FTF/blended] (N = 35)] on the reduction of maladaptive personality traits as well as the interaction between maladaptive personality patterns and the response on primary endpoints (i.e., mental distress). Results indicate that both treatment settings have comparable within-group effects on the reduction of distress symptoms, while the treatment in the FTF/blended setting seems to have a stronger impact on the reduction of maladaptive traits. Further, reduction of maladaptive trait expressions was a reliable predictor of treatment response in the FTF/blended setting while explaining less variance in the online setting. Beyond the promising findings on the utility of maladaptive trait change as an outcome measure, we discuss possible applications as an information source for treatment decisions.

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The Unified Protocol as an Internet-based Intervention for Emotional Disorders: Randomized Controlled Trial

Cited by 8 publications

References 54 publications

Piloting CanCope: An internet‐delivered transdiagnostic intervention to improve mental health in cancer survivors

Piloting CanCope: An internet‐delivered transdiagnostic intervention to improve mental health in cancer survivors

Transdiagnostic Processes as Mediators of Change in an Internet-Delivered Intervention Based on the Unified Protocol

Differential Effects of Psychological Interventions in Online and Face-to-Face Settings on DSM-5 and ICD-11 Maladaptive Trait Domains: An Exploratory Pilot Study

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