Child & Youth Care Forum

, Volume 48, Issue 1, pp 29–53 | Cite as

An Open Trial Applying the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) Adapted as a School-Based Prevention Program

  • Julia García-Escalera
  • Paloma ChorotEmail author
  • Bonifacio Sandín
  • Jill Ehrenreich-May
  • Antonio Prieto
  • Rosa M. Valiente
Original Paper



Anxiety and depressive disorders in adolescents have an enormous burden worldwide due to their high prevalence and disability. Despite the high comorbidity between these disorders, preventive interventions have often been developed separately for anxiety and depression.


The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A; Ehrenreich-May et al. in Unified protocols for transdiagnostic treatment of emotional disorders in children and adolescents, Oxford University Press, New York, 2018), a transdiagnostic treatment that targets core dysfunctions associated with anxiety and depression within a single protocol, was adapted as a universal preventive anxiety and depression program for the purposes of this investigation. The subsequent study of this adapted protocol evaluated pre- to post-intervention changes across a range of primary and secondary outcome measures. The secondary aims of this study were to assess the acceptability and feasibility of the adapted UP-A.


Twenty-eight students (mean age = 14.67; SD = 0.87) participated in this uncontrolled trial conducted in Madrid, Spain. The program included nine weekly 55-min sessions administered in a school setting by an advanced doctoral student in clinical psychology to two groups of 15 and 13 students, respectively.


Intent-to-treat analyses revealed significant declines in self-reported anxiety symptoms, interference of anxiety and depression, and top problems’ mean severity. Moderate to high participant satisfaction was indicated.


The initial promising findings suggest that future trials of the UP-A adapted as a school-based universal anxiety and depression prevention program using a larger sample size are warranted. However, the results of this study should be interpreted cautiously due to limitations regarding the small sample size as well as the lack of a control group and a follow-up period. Suggestions are provided as to how the intervention might be refined in content and delivery.


Universal prevention Unified Protocol Transdiagnostic Adolescents Anxiety Depression 



The authors would like to thank the Secondary School that participated in the study (IES Jaime Vera, Madrid, Spain), it’s teachers, students, the school principal (Dimás Rodríguez Perdomo) and the school counselor (María Teresa Andreu Escaño).


This work is supported by: (1) The Spanish Ministry of Economy, Industry and Competitiveness [Ministerio de Economía, Industria y Competitividad], Grant #PSI2013-4480-P to authors BS, PC, and RMV; (2) the Spanish Ministry of Education, Culture and Sport [Ministerio de Educación, Cultura y Deporte], Grant #FPU13/03315 to author JGE and Grant #FPU13/05914 to author AP. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research Involving Human Participants

All procedures performed in the study were in accordance with national and institutional ethical standards for research with human subjects and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was granted ethical approval from the Research Ethics Committee of Universidad Nacional de Educación a Distancia, Madrid, Spain. The study is registered at (NCT03123991).

Informed Consent

All parents or guardians as well as adolescent participants provided written informed consent.


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Authors and Affiliations

  1. 1.Facultad de PsicologíaUniversidad Nacional de Educación a DistanciaMadridSpain
  2. 2.Department of PsychologyUniversity of MiamiCoral GablesUSA

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