The DOI matches its Crossref record; 59 of the 59 references it cites were found in a registry or an index.
A systematic review of Unified Protocol applications with adult populations: Facilitating widespread dissemination via adaptability
Abstract
The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) was designed to be a flexible, evidence-based intervention that could treat a wide range of emotional disorders. The purpose of this systematic review is to summarize (1) the range of presenting problems to which the UP has been applied with adult patients, and (2) the settings in which the protocol has been used, as well as any modifications made to it. Using PRISMA guidelines, we conducted a literature search of PsychInfo, PubMed, Proquest Dissertations and Theses, and Web of Science. The 77 studies included in this review indicated the UP has been applied to a wide range of presenting problems including anxiety, depressive, bipolar, traumatic-stressor, substance use, eating, borderline personality, insomnia, and physical health disorders. Additionally, the UP has been applied to non-diagnosable problems such as non-suicidal self-injury, subclinical presentations, and sexual minority stress. The strongest base of evidence for the UP is among Caucasian females in the United States with anxiety-related or depressive disorders. Numerous adaptions of the UP were present in the literature. Overall, results suggest the UP can be flexibly applied to a range of diagnostic presentations. However, many studies reviewed were preliminary and further research is needed.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“the UP is a highly modifiable intervention that affords the opportunity to promote regulatory flexibility by integrating other coping skills, such as acceptance and self-compassion”
From RESILIENCE, COPING, AND THE COVID-19 PANDEMIC ACROSS THE GLOBE – AN UPDATE: WHAT HAVE WE LEARNED? (2023) · cites this paper as Cassiello-Robbins et al., 2020
In the citing paper
“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 [33]
In the citing paper
“Recent systematic reviews and meta-analysis evidence that the UP could help to manage EDs in the general population (Sakiris and Berle, 2019; Cassiello-Robbins et al., 2020; Carlucci et al., 2021; Longley and Gleiser, 2023) and also in individuals with comorbid medical conditions such as those living with Human Immunodeficiency Virus (HIV), cancer, chronic pain or multiple sclerosis, among others”
From Unified Protocol for the transdiagnostic treatment of emotional disorders in people with post COVID-19 condition: study protocol for a multiple baseline n-of-1 trial (2023) · cites this paper as Cassiello-Robbins et al., 2020
In the citing paper
“The most recent systematic review (Cassiello-Robbins et al., 2020) identified 77 studies indicating support for the UP’s suitability to a wide range of psychological conditions (i.e., 9 types of disorders), and also non-diagnosable problems.”
From Can We Boost Treatment Adherence to an Online Transdiagnostic Intervention by Adding Self-Enhancement Strategies? Results From a Randomized Controlled Non-inferiority Trial (2021) · cites this paper as Cassiello-Robbins et al., 2020
In the citing paper
“The protocol’s efficacy, effectiveness and generalizability already rely on a large and robust body of evidence (see Sakiris and Berle, 2019; Cassiello-Robbins et al., 2020 for reviews and meta-analyses).”
From Can We Boost Treatment Adherence to an Online Transdiagnostic Intervention by Adding Self-Enhancement Strategies? Results From a Randomized Controlled Non-inferiority Trial (2021) · cites this paper as Cassiello-Robbins et al., 2020
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,842
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859
Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & the PRISMA Group* (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00135 · Cited by 37,554
Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.6.617 · Cited by 12,052
The file drawer problem and tolerance for null results.
Rosenthal, R. (1979) · Psychological Bulletin · doi:10.1037/0033-2909.86.3.638 · Cited by 9,068 · cited 1×
“That is, it is not possible to know how many studies were conducted but not reported (Rosenthal, 1979).”
BackgroundSimmons, J. P., Nelson, L. D., & Simonsohn, U. (2011) · Psychological Science · doi:10.1177/0956797611417632 · Cited by 6,567
Diagnostic and Statistical Manual of Mental Disorders
Siegel, L. J., & Fletcher‐Janzen, E. (2014) · Wiley eBooks · doi:10.1002/9781118660584.ese0728 · Cited by 3,438
Etkin, A., & Wager, T. D. (2007) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2007.07030504 · Cited by 3,391
Mayberg, H. S., Liotti, M., Brannan, S. K., McGinnis, S., Mahurin, R. K., Jerabek, P. A., Silva, J. A., Tekell, J. L., Martin, C. C., Lancaster, J. L., et al. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.5.675 · Cited by 2,416
The Neurocircuitry of Fear, Stress, and Anxiety Disorders
Shin, L. M., & Liberzon, I. (2010) · Neuropsychopharmacology · doi:10.1038/npp.2009.83 · Cited by 2,083 · cited 1×
“…features including overlap in diagnostic criteria (Brown & Barlow, 2009) and common neurobiological mechanisms (e.g., hyperexcitability of limbic structures and limited inhibitory control by cortical structures; Etkin & Wager, 2007; Mayberg et al., 1999; Porto et al., 2009; Shin & Liberzon, 2010).”
BackgroundBrown, T. A., Campbell, L. A., Lehman, C. L., Grisham, J. R., & Mancill, R. B. (2001) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.110.4.585 · Cited by 1,562
Toward a unified treatment for emotional disorders
Barlow, D. H., Allen, L. B., & Choate, M. L. (2004) · Behavior Therapy · doi:10.1016/s0005-7894(04)80036-4 · Cited by 1,430
(2008) · Cited by 1,397
Joosten, E. A. G., DeFuentes-Merillas, L., de Weert, G. H., Sensky, T., van der Staak, C. P. F., & de Jong, C. A. J. (2008) · Psychotherapy and Psychosomatics · doi:10.1159/000126073 · Cited by 1,135
The Future of Intervention Science: Process-Based Therapy
Hofmann, S. G., & Hayes, S. C. (2019) · Clinical Psychological Science · doi:10.1177/2167702618772296 · Cited by 888
(2010) · Cited by 874
Barlow, D. H., Farchione, T. J., Bullis, J. R., Gallagher, M. W., Murray-Latin, H., Sauer-Zavala, S., Bentley, K. H., Thompson-Hollands, J., Conklin, L. R., Boswell, J. F., et al. (2017) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2017.2164 · Cited by 853
Self-citationMöller-Leimkühler, A. M. (2002) · Journal of Affective Disorders · doi:10.1016/s0165-0327(01)00379-2 · Cited by 851 · cited 2×
“, depression, anxiety-related, borderline personality, eating disorders) are more common in female populations (Kessler, Chiu, Demler, & Walters, 2005), and data suggest women seek treatment at higher rates than men (Möller-Leimkühler, 2002).”
BackgroundThe Nature, Diagnosis, and Treatment of Neuroticism: Back to the Future
Barlow, D. H., Sauer-Zavala, S., Carl, J. R., Bullis, J. R., & Ellard, K. K. (2014) · Clinical Psychological Science · doi:10.1177/2167702613505532 · Cited by 850
Self-citationCognitive Behavior Therapy and Eating Disorders
Weiss, F. (2008) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.2008.62.4.422 · Cited by 838
Weisz, J. R. (2012) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.147 · Cited by 827 · cited 1×
“Modular treatments have demonstrated steeper trajectories of improvement compared to traditional manualized treatment suggesting this approach improves treatment efficiency (Weisz et al., 2012).”
BackgroundClinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual
Barnaby, B. (2015) · Occupational Medicine · doi:10.1093/occmed/kqv128 · Cited by 813
The psychotherapy dose-response effect and its implications for treatment delivery services.
Hansen, N. B., Lambert, M. J., & Forman, E. M. (2002) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.9.3.329 · Cited by 783
Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: A Randomized Controlled Trial
Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Thompson-Hollands, J., Carl, J. R., Gallagher, M. W., & Barlow, D. H. (2012) · Behavior Therapy · doi:10.1016/j.beth.2012.01.001 · Cited by 746
Brown, T. A., & Barlow, D. H. (2009) · Psychological Assessment · doi:10.1037/a0016608 · Cited by 639
Acceptability and suppression of negative emotion in anxiety and mood disorders.
Campbell-Sills, L., Barlow, D. H., Brown, T. A., & Hofmann, S. G. (2006) · Emotion · doi:10.1037/1528-3542.6.4.587 · Cited by 579
Ellard, K. K., Fairholme, C. P., Boisseau, C. L., Farchione, T. J., & Barlow, D. H. (2010) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2009.06.002 · Cited by 523
A national survey of practicing psychologists' attitudes toward psychotherapy treatment manuals
Addis, M. E., & Krasnow, A. D. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.2.331 · Cited by 509
A national survey of practicing psychologists' attitudes toward psychotherapy treatment manuals.
Addis, M. E., & Krasnow, A. D. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.68.2.331 · Cited by 508
Barlow, D. H., Ellard, K. K., Sauer-Zavala, S., Bullis, J. R., & Carl, J. R. (2014) · Perspectives on Psychological Science · doi:10.1177/1745691614544528 · Cited by 491
Self-citationMurray, L. K., Dorsey, S., Haroz, E. E., Lee, C., Alsiary, M. M., Haydary, A., Weiss, W. M., & Bolton, P. A. (2013) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2013.06.005 · Cited by 404
Sakiris, N., & Berle, D. (2019) · Clinical Psychology Review · doi:10.1016/j.cpr.2019.101751 · Cited by 369
McHugh, R. K., Murray, H. W., & Barlow, D. H. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.07.005 · Cited by 320
Wilamowska, Z. A., Thompson-Hollands, J., Fairholme, C. P., Ellard, K. K., Farchione, T. J., & Barlow, D. H. (2010) · Depression and Anxiety · doi:10.1002/da.20735 · Cited by 314
Modularity in the design and application of therapeutic interventions
Chorpita, B. F., Daleiden, E. L., & Weisz, J. R. (2005) · Applied and Preventive Psychology · doi:10.1016/j.appsy.2005.05.002 · Cited by 295
The Four-Function Model of Nonsuicidal Self-Injury
Bentley, K. H., Nock, M. K., & Barlow, D. H. (2014) · Clinical Psychological Science · doi:10.1177/2167702613514563 · Cited by 259
Chorpita, B. F., & Weisz, J. R. (2009) · Cited by 242
Bullis, J. R., Boettcher, H., Sauer‐Zavala, S., Farchione, T. J., & Barlow, D. H. (2019) · Clinical Psychology: Science and Practice · doi:10.1111/cpsp.12278 · Cited by 216
Self-citationPorto, P. R., Oliveira, L., Mari, J. D. J., Volchan, E., Figueira, I. L. D. V., & Ventura, P. R. (2009) · Journal of Neuropsychiatry · doi:10.1176/jnp.2009.21.2.114 · Cited by 203
Effectiveness of cognitive-behavioral therapy with adult ethnic minority clients: A review.
Horrell, S. C. V. (2008) · Professional Psychology Research and Practice · doi:10.1037/0735-7028.39.2.160 · Cited by 114
Bullis, J. R., Boettcher, H. T., Sauer-Zavala, S. E., Farchione, T. J., & Barlow, D. H. (2019) · Clinical Psychology Science and Practice · doi:10.1037/h0101755 · Cited by 113
Self-citationUnified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents
Ehrenreich, J. T., Kennedy, S. M., Sherman, J. A., Bilek, E. L., Buzzella, B. A., Bennett, S. M., & Barlow, D. H. (2017) · Oxford University Press eBooks · doi:10.1093/med-psych/9780199340989.001.0001 · Cited by 112
Empirical investigations of thought suppression in OCD
Purdon, C. L. (2004) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2004.04.004 · Cited by 107
Anger: The unrecognized emotion in emotional disorders.
Cassiello-Robbins, C. F., & Barlow, D. H. (2016) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12139 · Cited by 107
Self-citationWolitzky-Taylor, K., Zimmermann, M., Arch, J. J., De Guzman, E., & Lagomasino, I. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.06.010 · Cited by 104
(2011) · Cited by 104
Ciraulo, D. A., Barlow, D. H., Gulliver, S. B., Farchione, T. J., Morissette, S. B., Kamholz, B. W., Eisenmenger, K., Brown, B., Devine, E. G., Brown, T. A., et al. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.08.003 · Cited by 92
Racial and Ethnic Disparity in Major Depressive Disorder
Shao, Z., Richie, W. D., & Bailey, R. K. (2015) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-015-0188-6 · Cited by 90
Case formulation-driven psychotherapy.
Persons, J. B. (2006) · Clinical Psychology Science and Practice · doi:10.1111/j.1468-2850.2006.00019.x · Cited by 71
Treating ethnic minority adults with anxiety disorders: Current status and future recommendations
Carter, M. M., Mitchell, F. E., & Sbrocco, T. (2012) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2012.02.002 · Cited by 67
Sauer-Zavala, S., Cassiello-Robbins, C., Ametaj, A. A., Wilner, J. G., & Pagan, D. (2019) · Behavior Modification · doi:10.1177/0145445518774914 · Cited by 67 · cited 6×
“Some amount of flexibility has been incorporated as a noted strength in the UP from the start (e.g., tailoring the length of a given module to the needs of the patient; Sauer-Zavala et al., 2019).”
BackgroundInfluentialSelf-citationThe case for borderline personality disorder as an emotional disorder: Implications for treatment.
Sauer-Zavala, S. E., & Barlow, D. H. (2014) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12063 · Cited by 66
Self-citationSauer-Zavala, S. E., Cassiello-Robbins, C. F., Conklin, L. R., Bullis, J. R., Thompson‐Hollands, J., & Kennedy, K. (2016) · Behavior Modification · doi:10.1177/0145445516673827 · Cited by 54
Self-citationParsons, J. T., Rendina, H. J., Moody, R. L., Gurung, S., Starks, T. J., & Pachankis, J. E. (2017) · AIDS and Behavior · doi:10.1007/s10461-016-1533-4 · Cited by 51
Mohajerin, B., Bakhtiyar, M., Olesnycky, O. S., Dolatshahi, B., & Motabi, F. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.11.058 · Cited by 45
Bentley, K. H., Sauer-Zavala, S. E., Cassiello-Robbins, C. F., Conklin, L. R., Vento, S. A., & Homer, D. (2017) · Behavior Modification · doi:10.1177/0145445516689661 · Cited by 44
Self-citationUnified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents
Halliday, E. R., & Ehrenreich, J. T. (2020) · Neuromethods · doi:10.1007/978-1-0716-0700-8_13 · Cited by 41
Bentley, K. H., Sauer-Zavala, S., Stevens, K. T., & Washburn, J. J. (2020) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2018.09.012 · Cited by 28 · cited 2×
“In a pre-post implementation study in the United States, the UP was adapted for an inpatient setting to be delivered over 7 days and to incorporate explicit emotion-induction exercises (Bentley et al., 2018).”
BackgroundMethodSelf-citationAre substance use disorders emotional disorders? Why heterogeneity matters for treatment.
McHugh, R. K., & Goodman, F. R. (2019) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12286 · Cited by 8
Research works printed but not linked: 1
- Cassiello-Robbins, 2015, Disseminating transdiagnostic evidence-based treatments to community clinicians: The efficacy of training workshops
Cited by
Sorted by citations
Management of Anxiety and Depression in Adult Survivors of Cancer: ASCO Guideline Update
Andersen, B. L., Lacchetti, C., Ashing, K., Berek, J. S., Berman, B. S., Bolte, S., Dizon, D. S., Given, B., Nekhlyudov, L., Pirl, W., et al. (2023) · Journal of Clinical Oncology · doi:10.1200/jco.23.00293 · Cited by 318
The role of emotion regulation in the characterization, development and treatment of psychopathology
Lincoln, T. M., Schulze, L., & Renneberg, B. (2022) · Nature Reviews Psychology · doi:10.1038/s44159-022-00040-4 · Cited by 234
CBT at the crossroads: the rise of transdiagnostic treatments.
Schaeuffele, C., Schulz, A., Knaevelsrud, C., Renneberg, B., & Boettcher, J. (2021) · International Journal of Cognitive Therapy · doi:10.1007/s41811-020-00095-2 · Cited by 150
Neuroticism and disorders of emotion: a new synthesis
Barlow, D. H., Curreri, A. J., & Woodard, L. S. (2021) · Current Directions in Psychological Science · doi:10.1177/09637214211030253 · Cited by 117
Phenotyping misophonia: Psychiatric disorders and medical health correlates
Rosenthal, M. Z., McMahon, K., Greenleaf, A. S., Cassiello-Robbins, C. F., Guetta, R. E., Trumbull, J., Anand, D., Frazer-Abel, E., & Kelley, L. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.941898 · Cited by 83
Self-citation
Metadata
- Authors
- Cassiello-Robbins, C., Southward, M. W., Tirpak, J. W., & Sauer-Zavala, S.
- Affiliations
- Duke Medical Center (US)
- University of Kentucky (US)
- Corresponding author
- Cassiello-Robbins, Clair
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2020-06
- Volume
- 78
- Pages
- 101852
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W3018886528
- Cited by
- 179
- References
- 59
- Citations by year
- 2026: 21 · 2025: 26 · 2024: 30 · 2023: 40 · 2022: 32 · 2021: 24 · 2020: 5
- FWCI
- 3.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- Unified Protocol, transdiagnostic treatment, emotional disorders, adults, dissemination, intervention adaptability, anxiety disorders, depression, bipolar disorder, trauma, substance use disorders, eating disorders, borderline personality disorder, insomnia, non-suicidal self-injury, sexual minority stress, treatment setting
- MeSH terms
- Affective Symptoms, Mental Disorders, Clinical Protocols, Humans, Outcome and Process Assessment, Health Care, Psychotherapy, Evidence-Based Practice
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
