Research of Unified Protocol for the Treatment of Common Mental Disorders in Adolescents in Hong Kong
Condition: Depressive Disorder; Anxiety Disorders
MeSH terms: Depressive Disorder; Anxiety Disorders; Mental Disorders; Psychotic Disorders
Study type: Interventional
Phase: Phase 2/Phase 3

Summary: 
      The Unified Protocol (UP) is an emotion-focused, cognitive-behavioural intervention that is
      developed to target core temperamental characteristics underlying anxiety and depressive
      disorders. Ehrenreich and colleagues developed UP for adolescents (UP-A). The current study
      aims at evaluating efficacy of UP-A for the treatment of emotional disorders in Chinese
      adolescents in Hong Kong.

      The current study would recruit 27 Chinese-speaking patients, age 13 to 18, with a primary
      diagnosis of any Diagnostic and Statistical Manual (Fifth edition) anxiety disorders and/or
      depressive disorder. They would be randomized into one of the two treatment arms, namely UP-A
      treatment condition (UP-A), and treatment-as-usual (TAU) condition. Following randomization,
      participants in the UP-A condition would attend individual treatment based on UP-A, which
      last for 10 to 12 weeks. Participants in the TAU condition would be provided with usual
      clinical psychological service (i.e. treatment as usual) in the first 12 weeks before they
      start attending the same individual treatment program.

      Primary outcomes would be patient's self-rated measures on clinical symptoms, and secondary
      outcomes would be their clinical diagnoses, parent-rated and other self-rated measures. It is
      hypothesized that, comparing to those in TAU, participants in the UP-A condition would show
      improvements in depressive symptoms, anxiety symptoms and functional impairment at the end of
      treatment. When the outcomes of all participants are combined, it is hypothesized that
      participants will show demonstrate improvement in depressive symptoms, anxiety symptoms, and
      functional impairment after completing the UP-A and at the 3-month follow-up.
    

Detailed description: 
      A Chinese treatment protocol would be developed based on the UP-A. The adolescent program
      consists of 8 modules, and the parent program consists of 3 modules. Similar to the work by
      Ehrenreich and Barlow, a flexible modular approach would be adopted, when extra sessions
      would be arranged to cater for individual treatment needs and heterogeneity of symptom
      severity. The whole treatment comprised of 10 to 12 individual sessions for the adolescents,
      and 4 to 6 sessions for parents or guardian. The total duration would be around 3 months.
      Each treatment sessions would be around 1 hour.
    

Intervention name(s): Unified protocol for adolescents (UP-A); Treatment as usual (TAU)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The Unified Protocol (UP) is an emotion-focused, cognitive-behavioural intervention that is developed to target core temperamental characteristics underlying anxiety and depressive disorders. The goal of the UP is to help patients to cultivate a greater willingness to experience uncomfortable emotions and to reduce maladaptive emotion response tendencies, so as to lessen the intensity and frequency of uncomfortable emotions. Ehrenreich and colleagues modified from the original UP and developed the UP for adolescents (UP-A).
A Chinese treatment protocol would be developed based on the UP-A. Contents of the treatment includes motivational enhancement, psychoeducation of emotion, avoidance and emotion driven behaviours, interoceptive exposure, cognitive reappraisal, emotion awareness training and emotion exposure. It consists of 10 to 12 individual sessions for the adolescents, and 4 to 6 sessions for parents or guardians.; TAU participants will receive usual clinical psychological service provided in the clinic (i.e. treatment as usual) in the first 12 weeks, before they start receiving same individual treatment program based on UP-A.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This study is to examine the effect of transdiagnostic cognitive behavioural therapy (Unified Protocol for adolescents, UP-A), in comparison with treatment-as-usual, in the reduction of depressive and anxiety symptoms among adolescents with common mental disorders.
All participants would be randomized into one of the two treatment arms, namely UP-A treatment condition (UP-A) and treatment-as-usual (TAU) condition. Following randomization, participants in UP-A condition would attend individual psychological treatment based on UP-A, which last for 10 to 12 weeks. Participants in the TAU condition would be provided with usual clinical psychological service (i.e. treatment as usual) in the first 12 weeks before they start attending the same individual treatment program based on UP-A.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Unified Protocol; Cognitive Behavioural Therapy; Depression; Anxiety; Adolescents