Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A)

Note: The UP-A program was not responsive to the CEBC's inquiry. The following information was obtained from publicly available sources.

About This Program

Target Population: Not Specified

Program Overview

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) is a flexible, 8-module intervention for adolescents ages 12-17. The UP-A frames treatment strategies in the general language of strong or intense emotions so that it can be flexibly applied across a range of youth emotional concerns, including anxiety, depression, obsessive-compulsive disorder, and other problem areas related to strong emotions. Specifically, the goal of the UP-A is to reduce the intensity and frequency of negative emotions by extinguishing the distress and anxiety these emotions produce. The UP-A is designed to accomplish this goal through emotion-focused education, awareness techniques, cognitive strategies, problem-solving and an array of behavioral strategies, including a full-range of exposure and activation techniques. A caregiver module can be flexibly incorporated as needed to address caregiver behaviors that may contribute to emotional concerns in youth, including overprotection/accommodation, inconsistency, criticism, and modeling of strong emotions.

Logic Model

The program representative did not provide information about a Logic Model for Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A).

Manuals and Training

Publicly available information indicates there is a manual that describes how to deliver this program, and there is some training available for this program.
See contact info below.

Relevant Published, Peer-Reviewed Research

Child Welfare Outcome: Child/Family Well-Being

Queen, A. H., Barlow, D. H., & Ehrenreich-May, J. (2014). The trajectories of adolescent anxiety and depressive symptoms over the course of a transdiagnostic treatment. Journal of Anxiety Disorders, 28(6), 511–521. https://doi.org/10.1016/j.janxdis.2014.05.007

Type of Study: Other quasi-experimental
Number of Participants: 59

Population:

  • Age — 12–17 years (Mean=15.42 years)
  • Race/Ethnicity — 44% White, Non-Hispanic, 44% Hispanic/Latino, 7% Other, 3% Black/African American, and 2% Asian American
  • Gender — 58% Female
  • Status — Participants were adolescents having a primary diagnosis of any DSM-IV anxiety and/or unipolar depressive disorder.

Location/Institution: Two large urban treatment sites in Northeastern and Southeastern United States

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the separate trajectories of adolescent anxiety and depressive symptoms over the course of a transdiagnostic intervention, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescence (UP-A). Participants were randomly assigned to either UP-A or a waitlist condition after an open trial. Measures utilized include the Anxiety Disorders Interview Schedule for DSM-IV-Child/Parent version (ADIS-IV-C/P), the Revised Children’s Anxiety and Depression Scale (RCADS), and the Revised Children’s Anxiety and Depression Scale - Parent version (RCADS-P). Results indicate that adolescent self-rated anxiety and depressive symptoms showed similar rates of improvement during treatment, but while anxiety symptoms continued to improve during follow-up, depressive symptoms showed nonsignificant improvement after treatment. Parent-rated symptoms also showed similar rates of improvement for anxiety and depression during the UP-A to those observed for adolescent self-report, but little improvement after treatment across either anxiety or depressive symptoms. Limitations include small sample size, most subjects had a principal anxiety disorder diagnosis, and the majority of subjects came from families of middle to upper-middle class socioeconomic status.

Length of postintervention follow-up: 3 and 6 months.

Ehrenreich-May, J., Rosenfield, D., Queen, A. H., Kennedy, S. M., Remmes, C. S., & Barlow, D. H. (2017). An initial waitlist-controlled trial of the unified protocol for the treatment of emotional disorders in adolescents. Journal of Anxiety Disorders, 46, 46–55. https://doi.org/10.1016/j.janxdis.2016.10.006

Type of Study: Randomized controlled trial
Number of Participants: 51

Population:

  • Age — 12–17 years
  • Race/Ethnicity — 59% Hispanic/Latino, 24% Non-Hispanic White, 8% African American, 8% Other, and 2% Asian American
  • Gender — 57% Female
  • Status — Participants were adolescents with a primary diagnosis of any DSM-IV anxiety disorder (including obsessive compulsive disorder) and/or depression diagnosis

Location/Institution: Not specified

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine initial outcomes of a randomized, waitlist-controlled trial of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A). Participants were randomly assigned to UP-A or a waitlist control group. Measures utilized include the Anxiety Disorders Interview Schedule for the DSM-IV, Child and Parent Reports (ADIS-IV-C/P), the Clinical Global Impression–Severity (CCGI-S), the Clinical Global Impression–Improvement (CGI-I), the Revised Children’s Anxiety and Depression Scale, Youth and Parent Versions (RCADS/RCADS-P), and the Adolescent Life Interference Scale (ALIS). Results indicate the UP-A outperformed waitlist at mid-treatment with respect to disorder severity and functional impairment, and there was a significant treatment effect in favor of the UP-A on all outcome measures at posttreatment. Within-subjects analyses collapsing across participants revealed significant improvements on outcome measures over time. Limitations include small sample size, the majority of participants presented with a principal DSM-IV anxiety disorder, and the use of a waitlist control rather than an active comparison condition.

Length of postintervention follow-up: 3 and 6 months

Additional References

No reference materials are currently available for Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A).

Contact Information

Jill Ehrenreich-May, PhD
Website: camat.psy.miami.edu/up-c-and-up-a-training/index.html
Email:
Phone: (305) 284-9852

Date Research Evidence Last Reviewed by CEBC: July 2021

Date Program Content Last Reviewed by Program Staff: November 2021

Date Program Originally Loaded onto CEBC: December 2021