The utilization of unified protocols in behavioral cognitive therapy in transdiagnostic group subjects: A clinical trial

Maia, Ana Claudia C. de Ornelas; Nardi, Antônio Egídio; Cardoso, Adriana

doi:10.1016/j.jad.2014.09.023

Cited by 37 publications

(16 citation statements)

References 24 publications

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“…This study aimed to address the UP in a group format for individuals with comorbid anxiety symptoms. Consistent with prior work in group settings, significant decreases were found in general anxiety symptoms (Bullis et al, 2015;de Ornelas Maia et al, 2013;de Ornelas Maia et al, 2015). In addition to replicating these findings, the current study furthered the extant literature to also show significant decreases in the group setting in anxiety disorderspecific symptoms, including worry, social anxiety, and panic symptoms.…”

Section: Discussionsupporting

confidence: 89%

Unified Protocol Transdiagnostic Treatment in Group Format

et al. 2016

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Barlow et al. published the unified protocol (UP) for transdiagnostic treatment of emotional disorders, focusing on common pathological factors across a variety of diagnoses. The limited UP research to date suggests that this treatment may be particularly useful for anxiety disorders. However, it has largely been evaluated only in individual treatment format. The current study examined the effectiveness of the UP treatment in a group format, with individuals with comorbid anxiety disorder symptoms. Twenty-six individuals with clinically significant anxiety symptoms in at least two of the following areas, social anxiety, worry, or panic, participated in a 14-week manualized group treatment using the UP. Significant decreases were found on general anxiety, worry, social anxiety, panic, depression, and negative affect, and increases on positive affect. The UP may hold promise for a transdiagnostic group treatment of comorbid anxiety symptoms, but further examination of this treatment is warranted.

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Section: Discussionsupporting

confidence: 89%

Unified Protocol Transdiagnostic Treatment in Group Format

et al. 2016

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“…Less evidence exists for the effect of UP on depressive disorders, but data from the anxiety trials suggest improvement in comorbid conditions [18]. Limited, but promising, data, including our own naturalistic study suggest that the UP can be delivered in groups with pre-post effect sizes in the medium to large range [19–22]. This is important, as the group format is an efficacious and cost-effective way of delivering treatment [23], which is regularly used in Danish MHS.…”

Section: Introductionmentioning

confidence: 99%

Transdiagnostic group CBT vs. standard group CBT for depression, social anxiety disorder and agoraphobia/panic disorder: Study protocol for a pragmatic, multicenter non-inferiority randomized controlled trial

et al. 2017

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BackgroundTransdiagnostic Cognitive Behavior Therapy (TCBT) manuals delivered in individual format have been reported to be just as effective as traditional diagnosis specific CBT manuals. We have translated and modified the “The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders” (UP-CBT) for group delivery in Mental Health Service (MHS), and shown effects comparable to traditional CBT in a naturalistic study. As the use of one manual instead of several diagnosis-specific manuals could simplify logistics, reduce waiting time, and increase therapist expertise compared to diagnosis specific CBT, we aim to test the relative efficacy of group UP-CBT and diagnosis specific group CBT.Methods/designThe study is a partially blinded, pragmatic, non-inferiority, parallel, multi-center randomized controlled trial (RCT) of UP-CBT vs diagnosis specific CBT for Unipolar Depression, Social Anxiety Disorder and Agoraphobia/Panic Disorder. In total, 248 patients are recruited from three regional MHS centers across Denmark and included in two intervention arms.The primary outcome is patient-ratings of well-being (WHO Well-being Index, WHO-5), secondary outcomes include level of depressive and anxious symptoms, personality variables, emotion regulation, reflective functioning, and social adjustment. Assessments are conducted before and after therapy and at 6 months follow-up. Weekly patient-rated outcomes and group evaluations are collected for every session. Outcome assessors, blind to treatment allocation, will perform the observer-based symptom ratings, and fidelity assessors will monitor manual adherence.DiscussionThe current study will be the first RCT investigating the dissemination of the UP in a MHS setting, the UP delivered in groups, and with depressive patients included. Hence the results are expected to add substantially to the evidence base for rational group psychotherapy in MHS. The planned moderator and mediator analyses could spur new hypotheses about mechanisms of change in psychotherapy and the association between patient characteristics and treatment effect.Trial registrationClinicaltrials.gov NCT02954731. Registered 25 October 2016Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-1175-0) contains supplementary material, which is available to authorized users.

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“…Evidence relating to individual UP has been reported in various forms: theoretical paper [ 11 , 13 ], case report [ 36 ], pilot clinical trial [ 37 ], and RCT with waiting-list [ 38 ]. Moreover, the feasibility of UP has been extended to individual and group formats for depressive and anxiety disorders [ 39 ], individual format for bipolar disorder [ 40 ], borderline personality disorder [ 41 ], and emotional disorders in adolescents [ 42 ].…”

Section: Introductionmentioning

confidence: 99%

“…The existing evidence, however, should be regarded as preliminary at best [ 12 ]. Findings by RCT to date are limited to one trial each for individual- and group-format UP, with small sample sizes [ 38 , 39 ]. Further, there is clear lack of evidence regarding UP efficacy for depressive disorders and for Asian populations.…”

Section: Introductionmentioning

confidence: 99%

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Japan Unified Protocol Clinical Trial for Depressive and Anxiety Disorders (JUNP study): study protocol for a randomized controlled trial

et al. 2016

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BackgroundThe unified protocol for the transdiagnostic treatment of emotional disorders is a promising treatment approach that could be applicable to a broad range of mental disorders, including depressive, anxiety, trauma-related, and obsessive-compulsive disorders. However, no randomized controlled trial has been conducted to verify the efficacy of the unified protocol on the heterogeneous clinical population with depressive and anxiety disorders.Methods/designThe trial was designed as a single-center, assessor-blinded, randomized, 20-week, parallel-group superiority study in order to compare the efficacy of the combination of unified protocol and treatment-as-usual versus waiting-list with treatment-as-usual for patients with depressive and/or anxiety disorders. The primary outcome was depression at 21 weeks, assessed by the 17-item version of the GRID-Hamilton Rating Scale for Depression. Estimated minimum sample size was 27 participants in each group. We will also examine the treatment mechanisms, treatment processes, and neuropsychological correlates.DiscussionThe results of this study will clarify the efficacy of the unified protocol for depressive and anxiety disorders, and the treatment mechanism, process, and neurological correlates for the effectiveness of the unified protocol. If its efficacy can be confirmed, the unified protocol may be of high clinical value for Japan, a country in which cognitive behavioral treatment has not yet been widely adopted.Trial RegistrationClinicalTrials.gov NCT02003261 (registered on December 2, 2013)

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The utilization of unified protocols in behavioral cognitive therapy in transdiagnostic group subjects: A clinical trial

Cited by 37 publications

References 24 publications

Unified Protocol Transdiagnostic Treatment in Group Format

Unified Protocol Transdiagnostic Treatment in Group Format

Transdiagnostic group CBT vs. standard group CBT for depression, social anxiety disorder and agoraphobia/panic disorder: Study protocol for a pragmatic, multicenter non-inferiority randomized controlled trial

Japan Unified Protocol Clinical Trial for Depressive and Anxiety Disorders (JUNP study): study protocol for a randomized controlled trial

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