The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Delivered to Firefighters via Videoconferencing: Pilot Outcomes Highlighting Improvements in Alcohol Use Disorder and Posttraumatic Stress Disorder Symptoms
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Four pilot studies have examined the UP as a treatment for PTSD, with all four demonstrating that the UP was associated with reductions in PTSD and other mental health symptoms.
“To date, four pilot studies have examined the UP as a treatment for PTSD, with all four demonstrating that the UP was associated with reductions in PTSD and other mental health symptoms (26, 34, 35, 37).”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [26]
A growing evidence base supports the utility of the UP for improving emotional and emotion-adjacent symptoms, including anxiety, depression, anger, substance misuse, self-injury, somatization, obsessive-compulsive symptoms, and trauma-related symptoms.
“A growing evidence base supports the utility of the UP for improving emotional and emotion-adjacent symptoms, including anxiety, depression, anger, substance misuse, self-injury, somatization, obsessive-compulsive symptoms, and trauma-related symptoms (26, 31–37).”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [26]
Receiving the UP was associated with improvements in the types of mental health symptoms most commonly experienced by emergency responders.
“Thus, receiving the UP was associated with improvements in the types of mental health symptoms most commonly experienced by emergency responders.”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [26]
The PCL-5 has demonstrated good reliability and validity in emergency responders.
“The PCL-5 has demonstrated good reliability and validity in emergency responders (26).”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [26]
The UP's manualized, skills-based approach seemed to promote treatment acceptability and to be a strong match with emergency response culture.
“Moreover, the UP's manualized, skills-based approach seemed to promote treatment acceptability and to be a strong match with emergency response culture.”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [26]
In the prior study, medium and large effect size improvements in symptoms of PTSD, depression, anxiety, AUD, and quality of life were reported, and each was sustained at 1-month follow-up.
“We reported medium and large effect size improvements in symptoms of PTSD, depression, anxiety, AUD, and quality of life. Each of these findings was sustained at 1-month follow-up.”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [26]
In a prior study of the UP in fire fighters, a high proportion (80.3%) completed treatment, underscoring feasibility and acceptability of this highly structured, skills based intervention in this population.
“A high proportion (80.3%) of participants completed treatment, underscoring feasibility and acceptability of this highly structured, skills based intervention in this population.”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [26]
The finding of small reductions in AUD symptoms differs from the prior study in which large improvements in AUD symptoms were observed.
“This finding differs from our prior study (26) in which we observed large improvements in AUD symptoms.”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [26]
The effect sizes for PTSD symptom reductions closely mirrored-and were slightly larger than-the effects observed in the prior study of the UP in fire fighters.
“These effect sizes closely mirrored—and were slightly larger than—the effects observed in the prior study of the UP in fire fighters.”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [26]
The magnitude of improvements in depression and anxiety symptoms closely mirrored but was somewhat larger than the effects observed in the study of the UP with fire fighters.
“Again, the magnitude of these improvements closely mirrored but was somewhat larger than the effects observed in the study of the UP with fire fighters.”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [26]
Participants in this study reported that their working alliance with their clinician was quite strong, replicating prior findings regarding therapeutic alliance.
“Participants in this study reported that their working alliance with their clinician was quite strong, replicating our prior findings regarding therapeutic alliance.”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [26]
The generalizability of these findings to other emergency responder professions may be limited, though the similarity of the current findings to the prior study of fire fighters is noted.
“The generalizability of these findings to other emergency responder professions may be limited, though we again reference the similarity of the current findings to our prior study of fire fighters (26).”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [26]
Results pertaining to the subgroup of participants who screened positive for PTSD should be interpreted with particular caution, owing to the small sample size, though these results were consistent with those observed in a subsample that screened positive for PTSD in a prior study of the UP in fire fighters that had a somewhat larger sample.
“Results pertaining to the subgroup of participants who screened positive for PTSD should be interpreted with particular caution, owing to the small sample size, though these results were consistent with those observed in a subsample that screened positive for PTSD in a prior study of the UP in fire fighters that had a somewhat larger sample (26).”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [26]
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- Authors
- Meyer, E. C., Coe, E., Pennington, M. L., Cammarata, C., Kimbrel, N. A., Ostiguy, W., Leto, F., & Gulliver, S. B.
- Affiliations
- University of Pittsburgh (US)
- Baylor Scott & White Health (US)
- Government of New York City (US)
- Duke University (US)
- Corresponding author
- Gulliver, Suzy B.
- ORCID
- Venue
- Cognitive and Behavioral Practice
- Publisher
- Elsevier BV
- Published
- 2024-05
- Volume
- 31
- Issue
- 2
- Pages
- 215-229
- ISSN
- 1077-7229 (ISSN-L)
- OpenAlex
- W4304689163
- Cited by
- 15
- References
- 39
- Citations by year
- 2026: 8 · 2025: 2 · 2024: 2 · 2023: 3
- FWCI
- 1.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cognitive and Behavioral Practice (publishedVersion)
- Funders
- IAFF Charitable Foundation
- Federal Emergency Management Agency (EMW-2016-FP-00371)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- Unified Protocol, transdiagnostic treatment, firefighters, post-traumatic stress disorder, alcoholism, videoconferencing, telemedicine, neuroticism, emotion regulation, depression, anxiety, quality of life, suicide risk, occupational trauma exposure, cultural adaptation, stigma
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