Assessment & Research

Transdiagnostic treatment of bipolar disorder and comorbid anxiety with the unified protocol: a clinical replication series.

Ellard et al. (2012) · Behavior modification 2012
★ The Verdict

One CBT protocol eased both mood and anxiety for adults living with bipolar plus an anxiety disorder.

✓ Read this if BCBAs working with adults who carry dual mood and anxiety diagnoses
✗ Skip if Clinicians looking only for child or single-diagnosis protocols

01Research in Context

01

What this study did

Syriopoulou-Delli et al. (2012) tested the Unified Protocol (UP) on three adults who had both bipolar disorder and an anxiety disorder.

UP is one CBT package that works for many emotional disorders. Each adult got weekly one-on-one UP sessions.

02

What they found

All three people had fewer mood swings and less anxiety after treatment.

The gains were still there three months later.

03

How this fits with other research

Cox et al. (2015) ran UP in groups of mixed-diagnosis adults and saw the same good results. This backs up UP’s core skills.

González-Robles et al. (2019) added a short positive-psychology module to transdiagnostic CBT. They got bigger jumps in happy mood while still cutting anxiety and depression. This shows UP can be boosted even more.

Older studies like Moxley (1989) and Frame et al. (1984) used breathing or self-exposure for agoraphobia and also saw lasting gains. UP gives a broader CBT frame that may help clients who have more than one diagnosis.

04

Why it matters

If you serve adults with both bipolar and anxiety, UP offers one clear manual you can start tomorrow. You do not need separate plans for each label. Track mood and anxiety each session; you should see both drop within a few weeks.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Open the UP module on emotion awareness and run the 10-minute ‘name it and rate it’ exercise at the start of your next session.

02At a glance

Intervention
other
Design
case series
Sample size
3
Population
anxiety disorder, other
Finding
positive

03Original abstract

Bipolar disorder (BD) is a chronic, debilitating disorder with recurrent manic and depressive episodes. More than 75% of bipolar patients have a current or lifetime diagnosis of a comorbid anxiety disorder. Comorbid anxiety in BD is associated with greater illness severity, greater functional impairment, and poorer illness-related outcomes. Effectively treating comorbid anxiety in individuals with BD has been recognized as one of the biggest unmet needs in the field of BD. Recently, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) was developed to be applicable to the full range of anxiety and mood disorders, based on converging evidence from genetics, cognitive and affective neuroscience, and behavioral research suggesting common, core emotion-related pathology. Here, the authors present a preliminary evaluation of the efficacy of the UP for the treatment of BD with comorbid anxiety, in a clinical replication series consisting of three cases.

Behavior modification, 2012 · doi:10.1177/0145445512451272