Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C)

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

About This Program

Target Population: Children diagnosed with anxiety disorders, obsessive-compulsive, depression, and related emotional disorders

Program Overview

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) is a 15-week group program for children ages 6-12 and families that can be easily adapted for individual therapy. The UP-C 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 disorders, and other problem areas related to strong emotions. Specifically, the goal of the UP-C is to reduce the intensity and frequency of negative emotions by extinguishing the distress and anxiety these emotions produce. The UP-C is designed to accomplish this 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. Caregiver materials focus on recognizing and shifting caregiver behaviors that 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 Transdiagnostic Treatment of Emotional Disorders in Children (UP-C).

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

Kennedy, S. M., Bilek, E. L., & Ehrenreich-May, J. (2019). A randomized controlled pilot trial of the unified protocol for transdiagnostic treatment of emotional disorders in children. Behavior Modification, 43(3), 330–360. https://doi.org/10.1177/0145445517753940

Type of Study: Randomized controlled trial
Number of Participants: 47

Population:

  • Age — 6–12 years (Mean=9.31 years)
  • Race/Ethnicity — 57% White Hispanic, 36% White Non-Hispanic, 2% Black or African American, 2% Asian or Pacific Islander, and 2% Other
  • Gender — 55% Female
  • Status — Participants were children with at least one primary anxiety disorder.

Location/Institution: Not specified

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to collect data on the efficacy of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C), comparing UP-C with an active, anxiety-focused intervention. Participants were randomly assigned to UP-C or the other anxiety-focused control treatment (Cool Kids—CK). Measures utilized include the Anxiety Disorders Interview Schedule for the DSM-IV–Child and Parent Reports ADIS-IV-C/P, the Clinician Global Impression–Improvement Scale (CGI-I), the Screen for Child Anxiety-Related Emotional Disorders–Child and Parent Reports (SCARED), the Children’s Depression Inventory–Child and Parent Reports (CDI), the Children’s Emotion Management Scales (CEMS), and the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA). Results indicate 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. Limitations include small sample size, significant drop-off at follow-up, most measures were confined to rating scales, and possible allegiance effects.

Length of postintervention follow-up: 6 months.

Ebrahimi, L. S., Isfeedvajani, M. S., Mohammadi, A., Ghasemzadeh, S., Arani, A. M., & Saadat, S. H. (2019). Comparison of the effectiveness of Unified Transdiagnostic Therapy (UP-C) with Cognitive Behavioral Therapy (CBT) on depression anxiety symptoms in child workers: “Child labour.” Journal of Research in Medical and Dental Science, 7(2), 122–130. https://eprints.bmsu.ac.ir/2824/

Type of Study: Randomized controlled trial
Number of Participants: 45

Population:

  • Age — 8–11 years
  • Race/Ethnicity — Not specified
  • Gender — 100% Female
  • Status — Participants were child workers with a principal anxiety disorder and depression.

Location/Institution: Tehran, Iran

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to investigate the efficacy and rationale of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders for Children (UP-C) for providing a transdiagnostic based therapeutic strategy as a comparison with cognitive-behavioral therapy (CBT). Participants were randomly assigned to one of three groups: UP-C, CBT, or a control group that did not receive any formal intervention. Measures utilized include the Kiddie Schedule for Affective Disorders and Schizophrenia, lifetime version (K-SADS-PL) and the Revised Children’s Anxiety and Depression Scale (R-CADS). Results indicate that the effect of kind of group on depression anxiety was remarkably significant, depression and anxiety were changed significantly in different stages of pretreatment, posttreatment, and follow-up. Moreover, a significant difference was found between the pretreatment and the posttreatment in the CBT and UP-C group. Additionally, the results indicate the decreasing trend of depression anxiety in the two intervention groups (CBT and UP-C). The decrease in both depression anxieties in the UP-C group were found to be greater when comparing with the CBT group, but these trends were significantly greater in UP-C group. Limitations include small sample size, length of follow-up, and high attrition rate.

Length of postintervention follow-up: 3 months.

Kennedy, S. M., Tonarely, N. A., Sherman, J. A., & Ehrenreich-May, J. (2018). Predictors of treatment outcome for the unified protocol for transdiagnostic treatment of emotional disorders in children (UP-C). Journal of Anxiety Disorders, 57, 66–75. https://doi.org/10.1016/j.janxdis.2018.05.004

Type of Study: Other quasi-experimental
Number of Participants: 79

Population:

  • Age — 6–13 years (Mean=9.47 years)
  • Race/Ethnicity — 57% White Hispanic, 30% White Non-Hispanic, 8% Other, 3% Black or African American, and 2% Asian or Pacific Islander
  • Gender — 53% Female
  • Status — Participants were children with a primary anxiety diagnosis (with or without comorbid depression).

Location/Institution: Not specified

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to investigate potential predictors of outcome following administration of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C). Participants were enrolled in one of three UP-C group treatments: an open trial, a randomized controlled trial, or a naturalistic UP-C group treatment. Measures utilized include the Anxiety Disorders Interview Schedule for the DSM-IV-Child and Parent Reports (ADIS-IV-C/P), the Clinician Global Impression-Severity Scale (CGI-S), the Screen for Child Anxiety Related Emotional Disorders—Child and Parent Reports (SCARED), the Depression, Anxiety, and Stress Scales (DASS), and the Penn State Worry Questionnaire (PSWQ). Results indicate consistent with prior literature on CBT for anxiety, social anxiety emerged as a consistent predictor of poorer response to the UP-C. Inconsistent with prior literature, depression, symptom severity, parent psychopathology, and child age were not significant predictors of poor outcome. Limitations include a relatively small sample size primarily consisting of anxious children, the exploratory nature of the study, and length of follow-up.

Length of postintervention follow-up: Within 4 weeks of completing intervention.

Additional References

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

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