Effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Among Veterans With Posttraumatic Stress Disorder: A Pilot Study.
A 16-week UP group delivered inside the VA cut PTSD, depression, and emotion-regulation problems for veterans.
01Research in Context
What this study did
Stephens et al. (2018) ran a 16-week group program inside a VA PTSD clinic. Fifty-two veterans met each week and worked through the Unified Protocol, a set of skills that targets all emotional disorders at once.
The team checked PTSD, depression, and emotion-control scores before and after the group. No control group was used.
What they found
Every measure moved in the right direction. Veterans left the group with lower PTSD, lower depression, and better control of strong feelings.
The gains were large enough to be clinically visible, not just numbers on a page.
How this fits with other research
Laposa et al. (2017) tested the same UP group format one year earlier, but with civilians who had mixed anxiety disorders. Both studies saw the same pattern: symptoms dropped and emotion skills rose. The 2018 paper shows the results hold when you swap civilians for trauma-exposed veterans.
Dudley et al. (2019) moved the UP downward in age, running a controlled trial with anxious 7- to 13-year-olds. Kids who got UP-C ended up with lower depression and better emotion regulation than kids who got standard anxiety CBT. Together the three studies trace a line: UP works across ages, diagnoses, and service settings.
Koegel et al. (2014) and Amore et al. (2011) also ran 16-week outpatient pilots for mood disorders, but they used acceptance-based and behavioral-activation packages instead of UP. All five papers show positive pre-post change, suggesting the 16-week open-trial format itself is a reliable way to test new transdiagnostic protocols.
Why it matters
If you work with veterans or any multiply-diagnosed adults, you now have a ready-made group curriculum that tackles PTSD, depression, and emotion dysregulation in one shot. You can lift the 16-week UP manual, run it in your clinic, and expect measurable drops in core symptoms. Start by screening your caseload for veterans who carry both PTSD and mood scores—you can funnel them into the next UP cohort instead of running separate anxiety and depression groups.
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02At a glance
03Original abstract
Effective treatment options are needed for veterans who do not participate in trauma-focused psychotherapy. Research has yet to examine the effectiveness of transdiagnostic psychotherapy in veterans with posttraumatic stress disorder (PTSD) and co-occurring psychological disorders. This pilot study examined the effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) delivered in a 16-week group format. We examined treatment outcomes in male and female veterans ( n = 52) in an outpatient specialty PTSD clinic at a large Veterans Affairs (VA) medical center. We hypothesized significant decreases in emotion regulation difficulty (Difficulties in Emotion Regulation Scale), PTSD symptom severity (PTSD Checklist for DSM-5), and depressive symptom severity (Patient Health Questionnaire-9). In addition, we hypothesized that reductions in emotion regulation difficulty across treatment would negatively predict PTSD and depressive symptoms at posttreatment. PTSD symptoms, depressive symptoms, and emotion regulation difficulty all evidenced significant improvements at the end of treatment relative to baseline ( ps < .001). In addition, reductions in emotion regulation across treatment were associated with lower PTSD and depressive symptoms at posttreatment ( ps < .001). This pilot study provides preliminary evidence supporting use of UP among veterans with PTSD and co-occurring disorders. Well-designed clinical trials evaluating efficacy of UP among veterans are needed.
Behavior modification, 2018 · doi:10.1177/0145445517724539