Effectiveness of the Unified Protocol for transdiagnostic treatment of emotional disorders in group format in Spain: Results from a randomized controlled trial with 6-months follow-up

Abstract

Background

The present study aims to investigate the effectiveness of the Unified Protocol (UP), a transdiagnostic treatment of emotional disorders (EDs), when applied in a group format in the public mental health system in Spain.

Methods

488 participants with a primary diagnosis of ED were randomized to the UP group or to the treatment as usual (TAU; individual, disorder-specific cognitive behavioral therapy). Personality, depression and anxiety symptoms, affect, and quality of life were assessed at pre-treatment, 3 months after treatment onset (coinciding with the end of the UP treatment), and 6 and 9 months after treatment onset (follow-ups). The moderating effect of the treatment condition and the number of sessions received in the evolution of study outcomes was investigated with a linear mixed model analysis.

Results

A significant improvement in outcomes occurred in both conditions, except for extraversion in the TAU. Improvements in depression, anxiety and quality of life were larger in the UP condition. After the treatment, improvements were maintained at follow-ups in all study outcomes. An interaction between Time*Condition*Sessions was found for depression.

Conclusion

The results add to the existing evidence on the effectiveness of the UP and may be important for implementation purposes in the Spanish or other similar public mental health systems. Trial registration number NCT03064477 (March 10, 2017).

Keywords:

• emotional disorders
• Unified Protocol
• transdiagnostic
• group format
• public mental health

Data Availability Statement

The data that support the findings of this study are available from the corresponding author, [Jorge Osma], upon reasonable request.

Acknowledgements

We would like to thank all collaborating centers, all healthcare professionals, and all volunteers and participants that made this study possible.

Supplemental data

Supplemental data for this article can be accessed here https://doi.org/10.1080/10503307.2021.1939190.

Additional information

Funding

This work was supported by Gobierno de Aragon and FEDER 2014–2020 “Construyendo Europa desde Aragon” [Grant Number Research team S31_20D]; Plan Estatal de I+D+I 2013–2016 and co-funded by the “ISCIII-Subdireccion General de Evaluacion y Fomento de la investigacion del Fondo Europeo de Desarrollo Regional (FEDER). Otra manera de hacer Europa” [Grant Number PI17/00320].