Blog
The Psychotherapy Practice Research Network (PPRNet) blog began in 2013 in response to psychotherapy clinicians, researchers, and educators who expressed interest in receiving regular information about current practice-oriented psychotherapy research. It offers a monthly summary of two or three published psychotherapy research articles. Each summary is authored by Dr. Tasca and highlights practice implications of selected articles. Past blogs are available in the archives. This content is only available in English.
This month...
…I blog about transtheoretical principles of change, microaggressions and outcomes, interpretations and outcomes.
Type of Research
Topics
- ALL Topics (clear)
- Adherance
- Alliance and Therapeutic Relationship
- Anxiety Disorders
- Attachment
- Attendance, Attrition, and Drop-Out
- Client Factors
- Client Preferences
- Cognitive Therapy (CT) and Cognitive-Behavioural Therapy (CBT)
- Combination Therapy
- Common Factors
- Cost-effectiveness
- Depression and Depressive Symptoms
- Efficacy of Treatments
- Empathy
- Feedback and Progress Monitoring
- Group Psychotherapy
- Illness and Medical Comorbidities
- Interpersonal Psychotherapy (IPT)
- Long-term Outcomes
- Medications/Pharmacotherapy
- Miscellaneous
- Neuroscience and Brain
- Outcomes and Deterioration
- Personality Disorders
- Placebo Effect
- Practice-Based Research and Practice Research Networks
- Psychodynamic Therapy (PDT)
- Resistance and Reactance
- Self-Reflection and Awareness
- Suicide and Crisis Intervention
- Termination
- Therapist Factors
- Training
- Transference and Countertransference
- Trauma and/or PTSD
- Treatment Length and Frequency
September 2017
Can a Unified Protocol Bring Together Diverse Evidence-Based Treatments?
Barlow, D.H., Farchione, T., Bullis, J.R., Gallagher, M.W., Murray-Latin, H.,… Cassiello-Robbins, C. (2017). The unified protocol for transdiagnostic treatment of emotional disorders compared with diagnosis-specific protocols for anxiety disorders: A randomized clinical trial. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2017.2164.
One barrier to disseminating and implementing evidence-based treatments is that therapists have to learn to competently apply many different manualized protocols – at least one for each disorder that they treat (depression, anxiety disorders, eating disorders, and others). Barlow and colleagues argue that it is possible to unify many of these protocols under one umbrella, and so they created a unified protocol for this purpose. The unified protocol is an emotion-focused, cognitive-behavioral intervention that targets temperamental characteristics, particularly neuroticism and emotion dysregulation that underly anxiety, depressive, and related disorders. The unified protocol consists of motivational enhancement followed by 5 treatment modules: (1) mindful emotion awareness, (2) cognitive flexibility, (3) identifying and preventing patterns of emotion avoidance, (4) increasing awareness and tolerance of emotion related physical sensations, and (5) emotion-focused exposure. In this trial, 223 participants with an anxiety disorder (generalized anxiety, obsessive compulsive, panic disorder, or social anxiety disorder) were randomly assigned to the unified protocol, or to the evidence-based treatment specific to the disorder, or to a no-treatment wait-list condition. The sample size was large enough to test a hypothesis of equivalent findings between the two treatment conditions. The differences in changes to symptoms between the unified protocol and the specific interventions for each disorder were small and non-significant at post-treatment and at the follow-up assessments. The treatment conditions were significantly more effective than the wait-list control condition. There were no differences between the treatments in drop-out rates or treatment adherence.
Practice Implications
It may be possible for therapists to competently learn to apply a single unified evidence-based treatment for a variety of anxiety disorders that has equivalent outcomes to currently recognized but separate treatment approaches. The unified protocol suggests that the temperamental factors underlying anxiety disorders (emotion dysregulation, emotion avoidance, cognitive inflexibility) can be targeted to treat a wide-range of emotional disorders.