A Waitlist-Controlled Trial of the Unified Protocol for the Treatment of Emotional Disorders in Adolescents
Condition: Anxiety Disorders; Depression
MeSH terms: Depression; Anxiety Disorders
Study type: Interventional

Summary: 
      This study will evaluate the effectiveness of an emotion-focused cognitive behavioral
      treatment program for adolescents with anxiety or unipolar depressive disorders.
    

Detailed description: 
      Anxiety and depression are among the most prevalent psychiatric disorders in youth.
      Adolescents with anxiety or depression experience persistent emotional distress that can
      cause problems with school, family, and friends. In addition, anxiety and depressive
      disorders commonly co-exist, causing further distress for those affected. If left untreated,
      the difficulties associated with these disorders can persist into adulthood. Fortunately,
      anxiety and depression are highly treatable using a combination of medications and forms of
      psychotherapy, but many youth in community settings are unlikely to receive these treatments.
      An emotion-focused, cognitive behavioral treatment, specifically designed to meet a broad
      range of treatment needs of adolescents, may provide one way of translating effective
      treatment components to community settings. This study will evaluate the effectiveness of a
      transdiagnostic, emotion-focused, cognitive behavioral treatment program, called the Unified
      Protocol for the Treatment of Emotional Disorders in Adolescents (UP-A), for youth with
      anxiety or unipolar depressive disorders.

      Participants in this study will be assigned to receive either immediate or delayed UP-A
      program sessions. Study participation will last up to 12 months after beginning treatment.
      Upon initiation of treatment, parent and child participants will undergo initial assessments
      that will include questionnaires about anxiety, worry, depression and emotion regulation; and
      an interview pertaining to the adolescent's anxiety and depression. Both parent and
      adolescent participants will then attend up to 21 weekly treatment sessions, lasting 60
      minutes each. During sessions, participants will learn skills regarding acceptance of intense
      emotional states, how to actively cope with emotions, and act in healthy ways during anxiety-
      and depression-provoking situations. Throughout the course of treatment, parent and
      adolescent participants will be asked to keep records about the adolescent's emotions and
      functioning. Participants will also be given at-home assignments to practice skills learned
      in treatment sessions. During and after treatment, participants will complete questionnaires
      about their thoughts on the treatment sessions. Participants will repeat the initial
      assessment either following the waitlist delayed treatment condition or 8 weeks into
      treatment, immediately after the last treatment session as well as at months 3 and 6 of
      follow-up.
    

Intervention name(s): Unified Protocol for Adolescents (UP-A)
Intervention type(s): Behavioral
Intervention description(s): All participants will be offered the UP-A intervention, inclusive of 8 and 21 weekly sessions of an emotion-focused treatment with cognitive-behavioral elements, either immediately following randomization or after an 8-week delayed treatment waitlist. The UP-A sessions are delivered in a flexible manner. Several of the UP-A's treatment elements are fixed and received by all participants (psychoeducation about emotions and emotional behavior, awareness and mindfulness skills, antecedent cognitive reappraisal/problem-solving skills, emotion exposure strategies, and relapse prevention skills), although applied for varying numbers of sessions depending on clinical need. Other strategies (motivational enhancement, parenting strategies and crisis management strategies) are applied on an as-needed basis based on client needs.
Other intervention name(s): Emotion Regulation; Evidence Based Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Unipolar Depression; Anxiety; Adolescent; Emotion; Cognitive Behavioral