Applications Of The Unified Protocols For Transdiagnostic Treatment Of Emotional Disorders In Children And Adolescents

"The Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/UP-A; Ehrenreich-May et al., 2018) are transdiagnostic interventions designed to address multiple diagnoses, diagnostic categories, and/or problem types within a single treatment protocol. It might be said that modern transdiagnostic interventions originated within the early years of the twenty-first century with theoretical and empirical work by Barlow and colleagues conceptualizing a "unified approach" to understanding and treating emotional disorders (e.g., Barlow, Allen, & Choate, 2004) and, subsequently, the initial publication of the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders (Barlow et al., 2011). However, up until the mid-twentieth century, psychotherapeutic approaches were nothing if not transdiagnostic, in that they addressed underlying psychodynamic and interpersonal processes theorized to lead to the development of broad psychological neuroses. This approach changed during the second half of the twentieth century, in accordance with two parallel and mutually informative developments. First, with each new iteration of the American Psychiatric Association's Diagnostic and Statistical Manual Mental Disorders (DSM) from the publication of the original DSM in 1952 to DSM-IV in 1994, the number of diagnoses proliferated, and diagnostic criteria became increasingly fine-grained. During the same historical period, new treatments for these highly specified diagnoses were developed based on new empirical and theoretical evidence (e.g., exposure for phobias), and more rigorous outcomes research on cognitive-behavioral therapy (CBT) and other interventions began to emerge (Barlow et al., 2004). Psychotherapy research was conducted using newly-developed treatment manuals addressing symptoms of highly specific diagnoses (e.g., panic disorder, specific phobias) to help ensure scientific rigor and replicability. The turn back toward transdiagnostic models of psychopathology and treatment at the turn of the twenty-first century was based on growing recognition of the commonalities among psychiatric diagnoses, the shared features of psychotherapeutic interventions for distinct diagnoses, and the beneficial effects of treatments for one diagnosis on other diagnoses, which will be further discussed below"--

The Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents suggest that there may a simple and efficient method of utilizing effective treatment strategies, such as those commonly included in CBT, in a manner that addresses the broad array of emotional disorder symptoms in children and adolescents. The Unified Protocol for children and adolescents comprises a Therapist Guide, as well as two Workbooks, one for children, and one for adolescents.

The Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) and Adolescents (UP-A) are evidence-based interventions originally designed to target core dysfunctions underlying emotional disorders, such as anxiety and depressive disorders, in children and adolescents. However, the UP-C and UP-A re increasingly being used to address other diagnostic clusters and problem areas that share these same core dysfunctions in a diverse range of delivery settings and cultural contexts. Applications of the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents is a practical guide for clinicians and researchers on applying the core principles of the UP-C and UP-A to treat children and adolescents with a broad range of emotion disturbance across settings in which youth typically receive care, including community mental health settings, pediatric primary care, and telehealth. In addition to providing an overview of the rationale for using UP-C and/or UP-A with each presenting problem or within each delivery setting, chapters provide detailed, step-by-step guidance on adapting and applying the UP-C and UP-A for their particular problem area, delivery setting, or cultural context. Chapters include case examples, suggestions for overcoming potential barriers in clinical delivery, and practical "tip sheets" for clinicians. When used in conjunction with the UP-C and UP-A Therapist Guide and Workbooks, this volume is an essential resource for clinicians using transdiagnostic interventions to treat diverse, complex, and comorbid clients in real-world therapy settings.

The Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents suggest that there may a simple and efficient method of utilizing effective treatment strategies, such as those commonly included in CBT, in a manner that addresses the broad array of emotional disorder symptoms in children and adolescents. The Unified Protocol for children and adolescents comprises a Therapist Guide, as well as two Workbooks, one for children, and one for adolescents.--

Recent conceptualization of anxiety, depressive, and related emotional disorders emphasize their similarities rather than their differences. In response, there has been a movement in recent years away from traditional disorder-specific manuals for the treatment of these disorders and toward treatment approaches that focus on addressing psychological processes that appear to cut across disorders. These transdiagnostic evidence-based treatments may prove to be more cost efficient and have the potential to increase availability of evidence-based treatments to meet a significant public health need. Among clinicians, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP), developed by Dr. David Barlow and colleagues, is the most recognizable and widely used transdiagnostic treatment protocol with empirical support for its use. Applications of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders provides clinicians with a how to guide for using the UP to treat a broad range of commonly encountered psychological disorders in adults. Each chapter covers a specific anxiety, depressive, or related emotional disorder, and important transdiagnostic processes are highlighted and discussed in relation to treatment. Case studies are employed throughout to illustrate the real-world application of this unique cognitive behavioral protocol and to instruct clinicians in the nuts and bolts of assessment, case formulation, and treatment in accordance with a transdiagnostic perspective.

The Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents, based in groundbreaking research from Jill Ehrenreich-May, David H. Barlow, and colleagues, suggest that there may be a simpler and more efficient method of utilizing effective strategies, such as those commonly included in CBT and third-wave behavior therapies, in a manner that addresses the broad array of emotional disorder symptoms in children and adolescents. The Unified Protocols for children and adolescents include a Therapist Guide with two full courses of therapy described (a modular, individual therapy for adolescents; and, a more structured, group therapy for children, complete with a full parent-directed component), as well as two Workbooks, one for children along with their parents or caregivers, and one for adolescents. The child and adolescent Unified Protocols frame effective strategies in the general language of strong or intense emotions and promote change through a common lens that applies across emotional disorders, including anxiety, depression, obsessive compulsive disorders and others. Specifically, the child and adolescent Unified Protocols help youth by allowing them to focus on a straightforward goal across emotional disorders: reducing intense negative emotion states by extinguishing the distress and anxiety these emotions produce 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.

Introductory information for therapists -- The nature of emotional disorders -- Basic principles underlying treatment and outline of the treatment procedures -- Overview of general treatment format and procedures -- Module 1 : motivation enhancement for treatment engagement -- Module 2 : understanding emotions -- Module 2 : recognizing and tracking your emotional responses -- Module 3 : emotional awareness training: learning to observe experiences -- Module 4 : cognitive appraisal and reappraisal -- Module 5 : emotion avoidance -- Module 5 : emotion-driven behaviors -- Module 6 : awareness and tolerance of physical sensations -- Module 7 : interoceptive and situational emotion exposures -- Medications for anxiety, depression, and related emotional disorders -- Module 8 : accomplishments, maintenance, and relapse prevention.

This work suggests that there may be a simple and efficient method of utilizing effective treatment strategies, such as those commonly included in CBT, in a manner that addresses the broad array of emotional disorder symptoms in children and adolescents.