Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders: Protocol Development and Initial Outcome Data
Section snippets
Development of the Unified Transdiagnostic Treatment for Emotional Disorders
In response to these advances, we developed the Unified Protocol for the Treatment of Emotional Disorders (UP), a transdiagnostic, emotion-focused cognitive-behavioral treatment (CBT) (Barlow, Boisseau, Ellard, Fairholme, & Farchione, 2008). The UP was developed to be applicable across anxiety and mood disorders, as well as other disorders in which anxiety and emotion dysregulation play a significant role, such as many somatoform and dissociative disorders. The focus in the UP on common
Study 1: Pilot-Test of Initial Version of the UP
The initial version of the UP was pilot-tested in a sample of patients whose principal diagnoses spanned the anxiety disorders, including GAD, OCD, SAD, PTSD, and PDA, as well as major depressive disorder (MDD) and dysthymia. Consistent with epidemiological accounts (Kessler et al., 2005), and prior research (Brown, Campbell, Lehman, Grisham, & Mancill, 2001), the sample evidenced high rates of comorbidity (see below). We hypothesized that treatment using the UP would result in reductions in
Study 2: Pilot-Test of the Revised UP
Following the initial pilot-test presented in Study 1, and prior to advancing to a more complex randomized controlled trial (RCT), the UP manual underwent several modifications in an effort to improve upon these initial promising results. As suggested by Rounsaville, Carroll, and Onken (2001), this additional treatment manual development phase and further pilot testing allows for thorough testing of the theoretical rationale behind treatment components, and allows for important modifications
Key Modifications to the UP
The revised version of the UP treatment manual was modified to anchor treatment concepts more explicitly within the three-component, modal model of emotion (see Fairholme, Boisseau, Ellard, Ehrenreich, & Barlow, 2009), and to place a greater emphasis upon increasing patient awareness of the interaction of each of these components within the context of present-moment experience. As the treatment proceeds in the revised manual, the domains of thoughts, feelings, and behaviors are each explored in
Discussion
In this article, we present preliminary data on outcomes from the UP, a transdiagnostic treatment designed to be applicable across anxiety and mood disorders. Results from a pilot-study of the initial version of the treatment manual, represented in Study 1, provided preliminary support for the efficacy (albeit modest) of the UP in the treatment of a range of anxiety and mood disorders including GAD, SAD, PDA, OCD, PTSD, and depression. After further manual development and modifications to
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