Unified Protocol for Treatment of Emotional Disorders in Brief Groups in Primary Care Services in Spain

In both conditions, the contents of the UP manual were worked following the 2nd edition of the UP manual (Barlow et al., 2018). In the 5-session version, Module 1 (Motivation for Change and Commitment to Treatment) was removed, and Modules 6 and 7 (Interoceptive and Emotional Exposure) were combined. The content of Module 8 (Achievement, Maintenance, and Relapse Prevention) was addressed during the follow-up session. The sessions were conducted in groups, lasted 2 hours each, and were held weekly.

Unified Protocol (UP) for transdiagnostic treatment of EDs in 5-session

In both conditions, the contents of the UP manual were worked following the 2nd edition of the UP manual (Barlow et al., 2018). In the 8-session UP condition, each of the original 8 treatment modules was covered weekly. Module 7 (Emotional Exposure) was delivered across two sessions. The content of Module 8 (Achievement, Maintenance, and Relapse Prevention) was addressed during the follow-up session. The sessions were conducted in groups, lasted 2 hours each, and were held weekly.

Unified Protocol (UP) for transdiagnostic treatment of EDs in 8-session

Diagnostic interview

Diagnostic interview

The PHQ-9 (Patient Health Questionnaire-9) assesses depressive symptoms over the past two weeks using a 9-item scale. Each item is scored from 0 to 3, where 0 = "Not at all" and 3 = "Nearly every day". The total score range is 0-27, and is obtained by summing all item scores. Higher scores indicate more severe depressive symptoms.

Consist of five items that evaluate the frequency and the intensity of depressive symptoms and their interference with the person's work or school life and social life. The total score range from 0 to 20 and responses use a 5-point Likert scale ranging from 0 to 4.

The GAD-7 questionnaire assesses the presence of Generalized Anxiety Disorder (GAD), as listed in the DSM-V. The scale is composed by 7 items. Scores for all 7 items range from 0 (Not at all) and 3 (Nearly every day). Therefore, the total score ranges from 0 and 21. The total score may be categorized into four severity groups: minimal (0-4), mild (5-9), moderate (10-14) and serious (14-20)

The scale presents five items. These items are related with the frequency and intensity of anxiety symptoms and their interference with the person's work or school life and with social life. All items are rated on a 5-point Likert scale ranging from 0 (I didn't feel anxious) to 4 (Constant anxiety).

Is a self-report instrument measuring mental well-being. It consists of five statements relating to the past two weeks. Each statement is rated on a 6-point scale, with higher scores indicating better mental well-being.

Consists of 36-item of six facets of emotion regulation. Items are rated on a scale of 1 ("almost never [0-10%]") to 5 ("almost always [91-100%]"). Higher scores indicate more difficulty in emotion regulation

A self-report measure that includes only 49 items and enables to quickly assess the main transdiagnostic dimensions of Emotional disorders: neurotic temperament (MEDI_NT), positive temperament (MEDI_PT), depressed mood (MEDI_DM), autonomic arousal (MEDI_AA), somatic anxiety (MEDI_SOM), intrusive cognitions (MEDI_IC), social concerns (MEDI_SOC), traumatic re-experiencing (MEDI_TRM), and avoidance (MEDI_AVD). It uses a 9-point Likert-type response scale (0 = Does not characterize me; 8 = Totally characterizes me).

Evaluate the therapeutic or working alliance through 12 items grouped in three dimensions, called task (1, 2, 10 and 12), links (3, 5, 7 and 9) and objectives (4, 6, 8 and 11) measured through a Likert-type scale with scores ranging from 1 = Never to 7 = Always.

Evaluates interference in different vital areas through six items with a 6-point Likert-type response scale (0 = Not at all; 5 = Extremely).

An adaptation of 13 items that measures quality of the intervention and its components, discomfort experienced during treatment through the following 7 questions with a 4-point Likert-type response scale (0 = nothing; 3 =very much): 1) How would you rate the quality of the treatment program you received?; 2) Did you find the kind of psychological intervention you were looking for?; 3) If a friend or family member needed similar help, would you recommend our treatment program?; 4) Has the content you have learned helped you cope more effectively with your problems?; 5) Overall, how satisfied are you with the treatment program you received?; 6) To what extent has this treatment program caused you discomfort?; 7) If you had to seek help again, would you choose a group treatment program?

The GCQ-S (Group Climate Questionnaire - Short) is a 12-item self-report measuring perceptions of the group's therapeutic environment, with each item rated 0-6 (total score 72). It has three subscales: Engagement (positive group atmosphere; higher scores = greater involvement), Conflict (tension and anger; higher scores = more interpersonal conflict), and Avoidance (withdrawal or evasion of responsibility; higher scores = more disengagement).

Measure of disease burden, including both the quality and the quantity of life lived. It is used in economic evaluation to assess the value of medical interventions.

The Work and Social Adjustment Scale (WSAS) identifies problems that affect an individual's ability to carry out everyday tasks. It consists of 5 items, each rated on a scale from 0 (Not at all) to 8 (Very severely). The total score is obtained by summing the ratings for all items, with a maximum possible score of 40. A WSAS score above 20 typically indicates moderately severe or worse psychopathology, while scores between 10 and 20 are associated with significant functional impairment but less severe clinical symptoms.

The Client Service Receipt Inventory (CSRI) is a self-report questionnaire that collects information on service use, including health and social care, medication, and other support services. The number of items varies depending on the version and study context, but it typically includes around 50-60 items. It is designed to evaluate the type, frequency, and duration of services used by clients, which can be used to estimate the associated costs and resource utilization.