None listed
Conditions
Brief summary
The Unified Protocol for Adolescents (UP-A) is a transdiagnostic intervention for the treatment of anxiety and/or depressive disorders. The aim is to examine possible mechanisms by which the intervention produces change in participants (12-18 year olds with a primary anxiety or depressive diagnosis). 6-8 participants will be recruited and treated using the UP-A. Hypothesised mechanisms of change (e.g., improved emotion regulation) will be measured from session to session for each adolescent. Expected outcomes include: symptom reductions in participants and information about which treatment targets are associated with symptom reduction (i.e., mechanisms by which the intervention is working).
Interventions
The Unified Protocol for the Treatment of Emotional Disorders in Adolescence (UP-A): The UP-A is an emotion-focused, transdiagnostic approach for adolescents (ages 12-18) with a primary emotional disorder. It is a developmental adaptation of the Unified Protocol, a transdiagnostic treatment for adults with emotional disorders. Clinicians present all skills in the context of the emotions most salient to presenting concerns and adolescent/caregiver conceptualizations of treatment needs, thereby personalizing treatment. The UP-A is delivered in 8-21 weekly sessions, with clinician flexibility regarding the sequencing and depth with which various sections are presented to clients and caregivers, as well as the emotions targeted during the course of the intervention. The number of sessions received by adolescents and their parents/guardians is based on the clinician's perception of the young person's treatment needs. Sessions are approximately 60 minutes in duration. Topics covered include: psychoeducation about anxiety, depression and emotions; behavioural and emotional exposure; emotion regulation; and cognitive challenging. A parent or primary guardian is asked to attend all sessions of the UP-A, although the degree of involvement varies based on clinical need. At a maximum, clinicians may elect to use optional parenting materials throughout treatment and for up to three parent-alone sessions. These sessions use the guiding acronym ICE (Independence, Consistency and Empathy) to reinforce youth session materials and problem-solve concerns common in the parenting of youth with emotional disorders (e.g., overprotection, conflict, etc.). The person running the sessions in this trial will be either a qualified Clinical Psychologist (the Chief Investigator) or postgraduate clinical psychology student interns within the University of QLD Clinical Psychology training program (under supervision from Dr. Cobham). Sessions will be video or audio recorded for treatment adherence.
Sponsors
University of Queensland
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
12 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Male or female adolescents aged 12-18 years with clinically significant symptoms of anxiety or depression (evidence of clinically significant symptom will be defined as a Clinical Severity Rating - CSR - greater than or equal to 4 on any DSM-5 defined anxiety disorder or depressive disorder). The adolescent lives with a legal guardian and this guardian is willing to attend treatment sessions and participate in study assessments. Adolescents and their parents/guardians are able to complete all study procedures in English.
Exclusion criteria
1. Adolescents who are currently receiving psychological treatment for their anxiety / depressive symptoms (Note: the use of psychopharmacologic treatments for anxiety or depression is allowable under the following conditions: the adolescent must be on a stable dosage for months for SSRI medication, or 1 month for benzodiazepine medication prior to consenting to the study). 2. Adolescents who are currently suicidal or who have engaged in suicidal behaviors within the past 6 months will be excluded and referred for appropriate clinical intervention. The short version of the Columbia-Suicide Severity Rating Scale (C-SSRS) will be used to screen for suicidality at baseline. The C-SSRS allows the Chief Investigator to gather information on suicidal behavior, suicide attempts, and presence and intensity of suicidal ideation. The information will be used to identify adolescents possessive or active suicidal ideation, intent or plan. 3. Adolescents with a substance abuse problem within the last 6 months, as assessed by the ADIS-5-C/P, will be excluded. 4. Youth with primary conditions not specified for exclusion (e.g., eating disorders, schizophrenia) will be screened. As long as an emotional disorder treatment focus is appropriate, these youth will be included. 5. Adolescents with a reported history of intellectual disability or for whom there is substantial evidence (e.g., multiple learning disorders, extensive school-based accommodations for learning) that the cognitive level of the UP-A would make it inappropriate as an individual therapy modality will be excluded. 6. Given additional complexities obtaining informed consent, adolescents who are currently placed in the foster care system will be excluded.
Outcome results
None listed