Efficacy of the Unified Protocol for transdiagnostic treatment of comorbid psychopathology accompanying emotional disorders compared to treatments targeting single disorders

OBJECTIVE: This study aimed to examine whether the Unified Protocol (UP), a transdiagnostic cognitive-behavioral therapy for emotional disorders (i.e., anxiety, mood, and related disorders), is efficacious in the treatment of co-occurring emotional disorders compared to established single disorder protocols (SDPs) that target specific disorders (e.g., panic disorder). METHOD: Participants included 179 adults seeking outpatient psychotherapy. Participant age ranged from 18 to 66 years, with an average of 30.66 years (SD = 10.77). The sample was 55% female and mostly Caucasian (83%). Diagnostic assessments were completed with the Anxiety Disorder Interview Schedule (ADIS), and disorder-specific, clinician-rated measures for the comorbid diagnoses of interest. RESULTS: In both treatment conditions, participants' mean number of diagnoses dropped significantly from baseline to posttreatment, and baseline to 12-month follow-up. Additionally, large effects were observed for changes in comorbid generalized anxiety (ESɢ: UP = −1.72; SDP = −1.98), social anxiety (ESɢ: UP = −1.33, −0.86; SDP = −1.60, −1.54), and depression (ESɢ: UP = −0.83; SDP = −0.84). Significant differences were not observed in between-group comparisons. CONCLUSIONS: Results suggest that both the UP and SDPs are efficacious in reducing symptoms of comorbid emotional disorders. The clinical, practical, and cost-effective advantages of transdiagnostic CBT are discussed.Please note the following financial disclosures/conflicts of interest: Dr. Barlow reported receiving royalties from Oxford University Press, United Kingdom (which includes royalties for the treatment manuals included in this study); Guilford Publications Inc., United States; Cengage Learning, United States; Pearson Publishing, United Kingdom. He reported receiving grants from the National Institute of Mental Health, United States (R01 MH090053) and the National Institute of Alcohol and Alcohol Abuse, United States (R01 AA023676). He reported serving as a consultant for and receiving honoraria from the Agency for Healthcare Research and Quality, United States; the Foundation for Informed Medical Decision Making, United States; the Department of Defense, United States; the Renfrew Center, United States; the Chinese University of Hong Kong, Hong Kong;Universidad Catolica de Santa Maria, Peru); New Zealand Psychological Association, New Zealand; Hebrew University of Jerusalem, Israel; Mayo Clinic, United States; and various American universities. (R01 MH090053 - National Institute of Mental Health, United States; R01 AA023676 - National Institute of Alcohol and Alcohol Abuse, United States)Accepted manuscrip