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On the efficacy of the unified protocol for transdiagnostic treatment of emotional disorders: A systematic review and meta-analysis

Carlucci, Leonardo, Saggino, Aristide, Balsamo, Michela·2021·Clinical Psychology Review

DOI 10.1016/j.cpr.2021.101999

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Abstract

In recent years a large array of treatment protocols conceptualized as transdiagnostic have been developed with clinical and practical advantages compared to traditional single-disorder protocols. Within this panorama, the Transdiagnostic Unified Protocol (UP) of Emotional Disorders was developed aimed at treating the negative affective processes underlying several diagnostic categories, and accounting for the covariance of different emotional disorders. The UP has been found to efficiently target the roots of these disorders leading to a reduction in symptoms of co-occurring disorders. However, several questions have marginally addressed in the previous studies, and some UP features still remain unexplored. The present meta-analysis aims at evaluating whether the UP results to significant changes in anxiety and depression symptoms severity in children, adolescents, and adults. 19 RCTs and 13 uncontrolled pre-post trials comprising 2183 patients/clients met inclusion criteria for meta-analysis. Large to moderate combined overall effect size for both depression plus anxiety were detected in the uncontrolled pre-post studies (g = 0.756) and in RTCs studies (g = 0.452), respectively. Large effect size at pre-treatment to 3-6-month follow-up was observed for combined depression plus anxiety (g = 1.113). Subgroup analysis suggested that UP treatment does not differ across the anxiety and depression self-report measures. Moreover, UP intervention outperformed both passive and active control conditions to treat negative affective syndromes. Meta-regression confirmed the moderate effects of therapist level of experience, the sample characteristics, and the UP-protocol adaptations. The findings indicate that the manualized UP treatment has potential to contribute to improving mental health outcomes, particularly of anxiety and depression.

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“These reviews reveal that the UP significantly improves anxious and depressive symptoms with moderate to large effect sizes [51, 52].”
Background
Emotional Disorders, Distress Tolerance and Suicide Risk: A Mediation Model
Antuña‐Camblor, C., Esteller-Collado, G., Muñoz‐Navarro, R., Rabito-Alcón, M. F., & Rodríguez‐Díaz, F. J. (2024) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228241299287 · Cited by 4
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Authors: Carlucci, L., Saggino, A., & Balsamo, M.
Affiliations: University of Chieti-Pescara (IT)
Corresponding author: Carlucci, Leonardo
ORCID: Carlucci, Leonardo
Balsamo, Michela
Venue: Clinical Psychology Review
Publisher: Elsevier BV
Published: 2021-07
Volume: 87
Pages: 101999
ISSN: 0272-7358 (ISSN-L)
DOI: 10.1016/j.cpr.2021.101999
OpenAlex: W3134743031
Cited by: 234
References: 140
Citations by year: 2026: 45 · 2025: 50 · 2024: 43 · 2023: 61 · 2022: 31 · 2021: 3
FWCI: 5.67
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
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 › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords: transdiagnostic treatment, emotional disorders, anxiety, depression, negative affect, treatment efficacy, children and adolescents, adults, manualized psychotherapy, therapist experience
MeSH terms: Adolescent, Adult, Anxiety, Anxiety Disorders, Child, Clinical Protocols, Humans, Cognitive Behavioral Therapy, Mood Disorders

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On the efficacy of the unified protocol for transdiagnostic treatment of emotional disorders: A systematic review and meta-analysis

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