Feasibility and acceptability of a brief, online transdiagnostic psychotherapy for young adults.

Background The Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders is a flexible form of cognitive behavioural therapy targeting diverse mental health disorders in children and adults. Objective The goal was to develop a brief version of UP tailored to the unique needs of young adults that could be administered in an online therapist-directed, group format. Method Nineteen young adults (age 18-23) receiving mental health services from a community agency or a specialty clinic were enrolled in a feasibility test of the novel transdiagnostic, online intervention (five sessions, 90 minutes each). Qualitative interviews were conducted with participants after each session they attended and upon study completion (n = 80 interviews with n = 17 participants). Standardized quantitative mental health measures were collected at baseline (n = 19), end of treatment (5 weeks; n = 15) and at follow-up (12 weeks; n = 14). Results Thirteen of the 18 participants (72%) who began treatment attended at least four of the five sessions. During the qualitative interviews, participants noted that core UP concepts such as understanding of emotions, mindfulness, cognitive flexibility, and behavioural activation are applicable in their day-to-day lives. Quantitative data showed a significant reduction in anxiety-related life impairment at follow-up compared to baseline, but not end of treatment compared to baseline. Reductions in global anxiety and depression symptoms were not statistically significant. Conclusions This novel, brief version of the UP may be a feasible online intervention for young adults seen at mental health clinics for diverse mental health issues and warrants further study to demonstrate effectiveness.

[1]  L. Timulak,et al.  Effectiveness of the internet-based Unified Protocol transdiagnostic intervention for the treatment of depression, anxiety and related disorders in a primary care setting: a randomized controlled trial , 2022, Trials.

[2]  C. Deckers,et al.  College students' perceptions of telemental health to address their mental health needs. , 2022, Journal of American college health : J of ACH.

[3]  Steven F. Siegel,et al.  Telemedicine and mental health care of young adults during COVID-19: A qualitative study. , 2022, Practice Innovations.

[4]  C. Suso‐Ribera,et al.  Implementation, efficacy and cost effectiveness of the unified protocol in a blended format for the transdiagnostic treatment of emotional disorders: a study protocol for a multicentre, randomised, superiority controlled trial in the Spanish National Health System , 2021, BMJ Open.

[5]  J. Yi-Frazier,et al.  Telemental Health For Youth With Chronic Illnesses: Systematic Review , 2021, JMIR mental health.

[6]  U. Volpe,et al.  A Systematic Review on TeleMental Health in Youth Mental Health: Focus on Anxiety, Depression and Obsessive-Compulsive Disorder , 2021, Medicina.

[7]  A. Saggino,et al.  On the efficacy of the unified protocol for transdiagnostic treatment of emotional disorders: A systematic review and meta-analysis. , 2021, Clinical psychology review.

[8]  Jill Ehrenreich-May,et al.  Brief Transdiagnostic Intervention for Parents With Emotional Disorder Symptoms During the COVID-19 Pandemic: A Case Example , 2021, Cognitive and Behavioral Practice.

[9]  V. Zemon,et al.  Children and Telehealth in Mental Healthcare: What We Have Learned From COVID‐19 and 40,000+ Sessions , 2021, Psychiatric research and clinical practice.

[10]  Bradley J. Wright,et al.  Exploring the Efficacy of Telehealth for Family Therapy Through Systematic, Meta-analytic, and Qualitative Evidence , 2021, Clinical Child and Family Psychology Review.

[11]  N. Hadler,et al.  College Student Perspectives of Telemental Health: a Review of the Recent Literature , 2021, Current Psychiatry Reports.

[12]  J. Boettcher,et al.  The unified protocol as an internet-based intervention for emotional disorders: Randomized controlled trial , 2020, PloS one.

[13]  R. McNally,et al.  A Single-Session Workshop to Enhance Emotional Awareness and Emotion Regulation for Graduate Students: A Pilot Study , 2020 .

[14]  S. Madigan,et al.  COVID-19 and telemental health: Benefits, challenges, and future directions. , 2020 .

[15]  Alessandro Rossi,et al.  Mental Health Through the COVID-19 Quarantine: A Growth Curve Analysis on Italian Young Adults , 2020, Frontiers in Psychology.

[16]  K. McBrien,et al.  Perspectives from primary health care providers on their roles for supporting adolescents and young adults transitioning from pediatric services , 2020, BMC Family Practice.

[17]  Ananda Sen,et al.  Telemedicine Versus Face-to-Face Delivery of Cognitive Behavioral Therapy for Insomnia: A Randomized Controlled Non-Inferiority Trial. , 2020, Sleep.

[18]  M. Hotopf,et al.  Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population , 2020, The Lancet Psychiatry.

[19]  I. Hickie,et al.  Transdiagnostic clinical staging in youth mental health: a first international consensus statement , 2020, World psychiatry : official journal of the World Psychiatric Association.

[20]  S. Kertz,et al.  Therapist and Treatment-Seeking Students’ Perceptions of Telemental Health , 2020 .

[21]  Jill Ehrenreich-May,et al.  The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) Adapted as a School-Based Anxiety and Depression Prevention Program: An Initial Cluster Randomized Wait-List-Controlled Trial. , 2020, Behavior therapy.

[22]  S. Sauer‐Zavala,et al.  Unified Protocol for the Transdiagnostic Prevention of Emotional Disorders: Evaluation of a Brief, Online Course for College Freshmen. , 2020, Behavior therapy.

[23]  S. Kellett,et al.  The dose-response effect in routinely delivered psychological therapies: A systematic review , 2020, Psychotherapy research : journal of the Society for Psychotherapy Research.

[24]  Chiaying Wei,et al.  Transition Cliffs for Young Adults with Anxiety and Depression: Is Integrated Mental Health Care a Solution? , 2019, The Journal of Behavioral Health Services & Research.

[25]  D. Berle,et al.  A systematic review and meta-analysis of the Unified Protocol as a transdiagnostic emotion regulation based intervention. , 2019, Clinical psychology review.

[26]  Jill Ehrenreich-May,et al.  A Randomized Controlled Pilot Trial of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children , 2019, Behavior modification.

[27]  P. McGorry,et al.  Early intervention in youth mental health: progress and future directions , 2018, Evidence-Based Mental Health.

[28]  Jill Ehrenreich-May,et al.  An Open Trial Applying the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) Adapted as a School-Based Prevention Program , 2018, Child & Youth Care Forum.

[29]  Hannah T. Boettcher,et al.  Development of a Single-Session, Transdiagnostic Preventive Intervention for Young Adults at Risk for Emotional Disorders , 2018, Behavior modification.

[30]  M. Ruggeri,et al.  Comparison of Early Intervention Services vs Treatment as Usual for Early-Phase Psychosis: A Systematic Review, Meta-analysis, and Meta-regression , 2018, JAMA psychiatry.

[31]  G. Andrews,et al.  Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: An updated meta-analysis. , 2018, Journal of anxiety disorders.

[32]  Stephen Kinsella,et al.  Clinical efficacy and economic evaluation of online cognitive behavioral therapy for major depressive disorder: a systematic review and meta-analysis , 2018, Expert review of pharmacoeconomics & outcomes research.

[33]  T. Farchione,et al.  The unified protocol for transdiagnostic treatment of emotional disorders , 2017, World psychiatry : official journal of the World Psychiatric Association.

[34]  Hannah T. Boettcher,et al.  The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Compared With Diagnosis-Specific Protocols for Anxiety Disorders: A Randomized Clinical Trial , 2017, JAMA psychiatry.

[35]  D. Barlow,et al.  An initial waitlist-controlled trial of the unified protocol for the treatment of emotional disorders in adolescents. , 2017, Journal of anxiety disorders.

[36]  M. Olfson,et al.  National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults , 2016, Pediatrics.

[37]  G. Andersson Internet-Delivered Psychological Treatments. , 2016, Annual review of clinical psychology.

[38]  Tram Nguyen,et al.  Effectiveness of Health System Services and Programs for Youth to Adult Transitions in Mental Health Care: A Systematic Review of Academic Literature , 2016, Administration and Policy in Mental Health and Mental Health Services Research.

[39]  Peter B. Jones,et al.  From early intervention in psychosis to youth mental health reform: a review of the evolution and transformation of mental health services for young people , 2016, Social Psychiatry and Psychiatric Epidemiology.

[40]  J. Hayden,et al.  Therapist-supported internet cognitive—behavioural therapy for anxiety disorders in adults , 2015, BJPsych Advances.

[41]  Clare Stroud,et al.  Investing in the health and well-being of young adults. , 2015, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[42]  E J Costello,et al.  A heavy burden on young minds: the global burden of mental and substance use disorders in children and youth , 2014, Psychological Medicine.

[43]  Jay N. Giedd,et al.  Adolescent mental health—Opportunity and obligation , 2014, Science.

[44]  R. Rapee,et al.  Psychometric properties of the Child Anxiety Life Interference Scale (CALIS). , 2013, Journal of anxiety disorders.

[45]  A. Guastella,et al.  Applying clinical staging to young people who present for mental health care , 2013, Early intervention in psychiatry.

[46]  W. Hiller,et al.  Effectiveness of and dropout from outpatient cognitive behavioral therapy for adult unipolar depression: a meta-analysis of nonrandomized effectiveness studies. , 2013, Journal of consulting and clinical psychology.

[47]  J. Swift,et al.  Premature discontinuation in adult psychotherapy: a meta-analysis. , 2012, Journal of consulting and clinical psychology.

[48]  S. Reise,et al.  The Revised Child Anxiety and Depression Scale-Short Version: scale reduction via exploratory bifactor modeling of the broad anxiety factor. , 2012, Psychological assessment.

[49]  Jill Ehrenreich-May,et al.  The Development of a Transdiagnostic, Cognitive Behavioral Group Intervention for Childhood Anxiety Disorders and Co-Occurring Depression Symptoms , 2012 .

[50]  H. Christensen,et al.  Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review , 2010, BMC psychiatry.

[51]  David H. Barlow,et al.  Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide , 2010 .

[52]  D. Barlow,et al.  Conceptual background, development, and preliminary data from the unified protocol for transdiagnostic treatment of emotional disorders , 2010, Depression and anxiety.

[53]  Craig Whittington,et al.  Meta‐Analysis of Homework Effects in Cognitive and Behavioral Therapy: A Replication and Extension , 2010 .

[54]  Christina L. Boisseau,et al.  Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders: Protocol Development and Initial Outcome Data. , 2010, Cognitive and behavioral practice.

[55]  Eric Stice,et al.  A meta-analytic review of depression prevention programs for children and adolescents: factors that predict magnitude of intervention effects. , 2009, Journal of consulting and clinical psychology.

[56]  Maria E Fernandez,et al.  How we design feasibility studies. , 2009, American journal of preventive medicine.

[57]  Hsiu-Fang Hsieh,et al.  Three Approaches to Qualitative Content Analysis , 2005, Qualitative health research.

[58]  Don C Des Jarlais,et al.  Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: the TREND statement. , 2004, American journal of public health.

[59]  B. Chorpita,et al.  Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale. , 2000, Behaviour research and therapy.

[60]  R. Brookman The age of "adolescence". , 1995, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[61]  K J Rothman,et al.  No Adjustments Are Needed for Multiple Comparisons , 1990, Epidemiology.

[62]  E. Costello,et al.  Longitudinal patterns of anxiety from childhood to adulthood: the Great Smoky Mountains Study. , 2014, Journal of the American Academy of Child and Adolescent Psychiatry.