Clinical Utility of an Internet-Delivered Version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (iUP-A): A Pilot Open Trial
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The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) has been shown to be effective for reducing symptoms of anxiety and depression in adolescents with emotional disorders. Internet-delivered psychological treatments have great potential to improve access to evidence-based psychological therapy since they are associated with reduced human and economic costs and less social stigma. Recently, our group developed an online version of the UP-A (the iUP-A) for the treatment of emotional disorders in adolescents. The aim of this pilot trial was to test the clinical utility of the iUP-A in a small sample (n = 12) of adolescents with elevated anxiety and/or depressive symptoms. Intention-to-treat and completer analyses revealed pre- to post-intervention self-reported decreases of anxiety and depressive symptoms, anxiety sensitivity, emotional avoidance, panic disorder symptoms, panic disorder severity, generalized anxiety disorder symptoms, pathological worry, and major depressive disorder symptoms. We found high feasibility and acceptability of the program with all participants and responsible parents reporting an improvement in the adolescents’ ability to cope with emotions. Results suggest that the iUP-A may provide a new approach to improve access to treatment for anxious and depressive adolescents in Spain; however, further research must be conducted before firm conclusions can be drawn.
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Indicated prevention programs in adolescents focusing on transdiagnostic mechanisms have found significant positive effects on subclinical depressive and/or anxiety symptoms compared to no and to active wait-list control groups when delivered via the Internet.
“Indicated prevention programs in adolescents focusing on these mechanisms have found significant positive effects on subclinical depressive and/or anxiety symptoms in adolescents compared to no and to (active) wait-list control groups when delivered via the Internet [78, 94–98].”
From Efficacy of a transdiagnostic Internet prevention approach in adolescents (EMPATIA study): study protocol of a randomized controlled trial (2024) · cites this paper as [95]
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Experimental — accuracy not yet measuredAn internet-based version of UP-A with high feasibility and acceptability was recently developed by Sandín et al.
“An internet-based version of UP-A with high feasibility and acceptability was recently developed by Sandín et al. [33] that provides a new approach to improved access to treatment for anxious and depressive adolescents.”
The pilot trial of the internet-delivered UP-A showed preliminary evidence of the program's efficacy in improving outcomes (anxiety and depression) and vulnerability of transdiagnostic mechanisms.
“showing preliminary evidence of the program’s efficacy in improving outcomes (anxiety and depression) and vulnerability of transdiagnostic mechanisms.”
From Using Information and Communication Technologies (ICT) for Mental Health Prevention and Treatment (2021) · cites this paper as [5]
The internet-delivered version of the UP-A showed high feasibility and acceptability, with all participants and responsible parents reporting an improvement in the adolescents' ability to cope with emotions.
“The internet-delivered version of the UP-A showed high feasibility and acceptability, with all participants and responsible parents reporting an improvement in the adolescents’ ability to cope with emotions.”
From Using Information and Communication Technologies (ICT) for Mental Health Prevention and Treatment (2021) · cites this paper as [5]
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Sandín, B., Valiente, R. M., Arnáez, S., García-Escalera, J., Schmitt, J. C., Díaz-Mandado, O., & Chorot, P. (2026) · Internet Interventions · doi:10.1016/j.invent.2026.100948
Self-citationJuszczyk-Kalina, A., Farchione, T. J., Williams, A. L., & Holas, P. (2026) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2026.2720139
Cortés, L., García-Escalera, J., Casanova, I., Segura, A., Valiente, R. M., & Chorot, P. (2026) · BMC Psychology · doi:10.1186/s40359-026-05472-8
Self-citationBigler, M. E., Milgram, L., Grassie, H. L., Halliday, E. R., & Ehrenreich, J. T. (2026) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2026.103241
- Authors
- Sandín, B., García-Escalera, J., Valiente, R. M., Espinosa, V., & Chorot, P.
- Affiliations
- Universidad Nacional de Educación a Distancia (ES)
- Corresponding author
- Valiente, Rosa M.
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2020-11-10
- Volume
- 17
- Issue
- 22
- Pages
- 8306
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC7697415
- OpenAlex
- W3104705490
- Cited by
- 43
- References
- 53
- Citations by year
- 2026: 9 · 2025: 6 · 2024: 8 · 2023: 7 · 2022: 7 · 2021: 6
- FWCI
- 4.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UNED repository (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- European Social Fund (PEJD-2019-POST/SOC-16746)
- Ministerio de Economía, Industria y Competitividad, Gobierno de España (PSI2013-4480-P)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- adolescents, anxiety disorders, depression, transdiagnostic treatment, feasibility and acceptability, anxiety sensitivity, emotional avoidance, panic disorder, generalized anxiety disorder, pathological worry, emotion regulation
- MeSH terms
- Adolescent, Mental Disorders, Humans, Pilot Projects, Psychotherapy, Spain, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Treatment Outcome, Internet
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