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Builders of Emotional Regulation: Acceptability, Feasibility, and Effectiveness of the Group Unified Protocol for Treating Emotional Disorders in Online and In-Person Modalities

15 lipca 2026 zaktualizowane przez: Liliana Pedro, University of Coimbra

The Unified Protocol (UP) is a transdiagnostic, emotion-focused, cognitive-behavioral intervention developed to treat emotional disorders. The UP intervenes in the transdiagnostic mechanisms linked to the etiology and maintenance of emotional disorders, promoting adaptive emotional regulation strategies (e.g. conscious awareness of emotions; cognitive flexibility). Originally developed for the in-person and individual format, the UP can be adapted and implemented in the online group format. It offers other advantages, namely reduced waiting lists and treatment costs, an easier implementation and increased access to psychological treatment for the most isolated populations.

This clinical trial aims to implement and evaluate the acceptability, feasibility and effectiveness of UP in an online group format in a clinical population with a primary diagnosis of anxiety disorder and/or mood disorder, compared with UP in an in-person group format. It also aims to explore the psychological processes of therapeutic change (e.g., cognitive flexibility) and their potential mediating role in the response to treatment. Additionally, the study seeks to examine group relationship processes (e.g., group cohesion and therapeutic alliance) and participants' attitudes toward different therapy delivery modalities (online versus in-person), as potential factors influencing treatment engagement and outcomes.

Participants will be recruited through online advertisements, including social media platforms (e.g., Facebook and Instagram), the UpC3 website (https://upc3.pt), referrals from other mental health services, and flyers and posters displayed at the University of Coimbra.

A total of 54 participants with a primary diagnosis of an anxiety disorder and/or mood disorder were randomized (1:1 allocation ratio) to one of two conditions: (1) UP delivered in an online synchronous group format (n = 28) or (2) UP delivered in an in-person group format (n = 26).

In both conditions, participants received 12 weekly 2-hour sessions of the UP in group. Outcomes were assessed at baseline (T0), mid-treatment (T1), post-treatment (T2), and at 3-month (T3) and 6-month (T4) follow-up assessments.

Przegląd badań

Status

Zakończony

Warunki

Interwencja / Leczenie

Typ studiów

Interwencyjne

Zapisy (Rzeczywisty)

54

Faza

  • Nie dotyczy

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Lokalizacje studiów

  • Portugalia
    • Coimbra District
      • Coimbra, Coimbra District, Portugalia, 3000-115
        • Faculty of Psychology and Education Sciences

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

  • Dorosły
  • Starszy dorosły

Akceptuje zdrowych ochotników

Nie

Opis

Inclusion Criteria:

  • age ≥ 18;
  • be Fluent in Portuguese;
  • a score greater than 9 on the Patient Health Questionnaire-9 (PHQ-9; Ferreira et al., 2019) and/or a score of 8 or higher on the Generalized Anxiety Disorder-7 (GAD-7; Sousa et al., 2015);
  • principal diagnosis (most interfering and severe) of an emotional disorder (i.e. anxiety, depression and other related disorder) according to DSM-5 criteria
  • be able to attend treatment sessions and assessments, regardless of the therapeutic format (online and in-person);
  • participants taking pharmacological treatment will be asked to maintain the same dosages and medications for at least 1 month prior to the start of treatment and during treatment;
  • to have access to a computer or mobile phone with Internet and Webcam;

Exclusion Criteria:

  • current diagnosis of severe mental disorder (e.g., bipolar disorder, schizophrenia, eating disorders), moderate to severe substance use disorder or there is suicide risk at the time of assessment
  • not being able to participate in more than half of the intervention program sessions
  • to have previously received at least 8 sessions of psychological treatment consisting of cognitive-behavioral principles
  • currently receiving other psychological treatment.

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Brak (otwarta etykieta)

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: Unified Protocol in synchronous online group
Participants received 12 weekly 90-minute sessions of the Unified Protocol (UP) delivered in a synchronous online group format via Zoom.
Behawioralne: Unified Protocol
The Unified Protocol (UP) is a transdiagnostic cognitive-behavioral intervention developed to target the core mechanisms underlying emotional disorders. The intervention consists of eight treatment modules focused on enhancing emotional awareness, cognitive flexibility, reducing emotional avoidance and maladaptive emotion-driven behaviors, increasing tolerance of physical sensations, and promoting emotion-focused exposure.
Aktywny komparator: Unified Protocol in in-person group
Participants received 12 weekly 90-minute sessions of the Unified Protocol (UP) delivered in in-person group format.
Behawioralne: Unified Protocol
The Unified Protocol (UP) is a transdiagnostic cognitive-behavioral intervention developed to target the core mechanisms underlying emotional disorders. The intervention consists of eight treatment modules focused on enhancing emotional awareness, cognitive flexibility, reducing emotional avoidance and maladaptive emotion-driven behaviors, increasing tolerance of physical sensations, and promoting emotion-focused exposure.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Changes from baseline in depressive symptoms
Ramy czasowe: Baseline, week 12 (end of treatment), and 3- and 6-month follow-up
Measured with the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 is a 9-item self-report scale used to measure the severity of depressive symptoms, answered on a 4-point Likert scale, ranging from 0 (Not at all) to 3 (Almost every day). Total scores range from 0 to 27, with higher scores indicating greater depressive severity, and scores above 9 suggest clinically significant depressive symptoms.
Baseline, week 12 (end of treatment), and 3- and 6-month follow-up
Changes from baseline in anxiety symptoms
Ramy czasowe: Baseline, week 12 (end of treatment), and 3- and 6-month follow-up
Measured with the Generalized Anxiety Disorder-7 (GAD-7). The GAD-7 (Sousa et al., 2015) is a 7-item self-report scale used to measure the severity of anxiety symptoms, answered on a 4-point Likert scale, ranging from 0 (Not at all) to 3 (Almost every day). Total scores range from 0 to 21, with higher scores indicating greater anxiety severity, and scores equal to or greater than 8 suggesting clinically significant anxiety symptoms.
Baseline, week 12 (end of treatment), and 3- and 6-month follow-up

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Changes from baseline in severity and degree of impairment of depressive symptoms
Ramy czasowe: Baseline, week 12 (end of treatment), and 3- and 6-month follow-up
Measured with the Overall Depression Severity and Impairment Scale (ODSIS). It comprises five items answered on a 5-Likert scale ranging from 0 (e.g., I didn't feel depressed) to 4 (e.g., Constant depression). The total score is the sum of all the items and ranges from 0 to 20.
Baseline, week 12 (end of treatment), and 3- and 6-month follow-up
Changes from baseline in severity and degree of impairment of anxiety symptoms
Ramy czasowe: Baseline, week 12 (end of treatment), and 3- and 6-month follow-up
Measured with the Overall Anxiety Severity and Impairment Scale. The five items are rated on a 5-Likert scale ranging from 0 (e.g., I didn't feel anxious) to 4 (e.g., Constant anxiety). The total score ranges from 0 to 20.
Baseline, week 12 (end of treatment), and 3- and 6-month follow-up
Changes from baseline in transdiagnostic mechanisms
Ramy czasowe: Baseline, week 6, week 12 (end of treatment), and 3- and 6-month follow-up
Measured with the The Multidimensional Emotional Disorder Inventory (MEDI). MEDI is a 49-item self-reported questionnaire used to assess nine transdiagnostic dimensions: Neurotic temperament, Positive temperament, Depressed mood, Autonomic arousal, Somatic anxiety, Social concerns, Intrusive cognitions, Traumatic reexperiencing, and Avoidance. All items are rated on a 9-point Likert scale ranging from 0 (not characteristic of me) to 8 (extremely characteristic of me).
Baseline, week 6, week 12 (end of treatment), and 3- and 6-month follow-up
Changes from baseline in emotional regulation
Ramy czasowe: Baseline, week 6, week 12 (end of treatment), and 3- and 6-month follow-up
Measured with the Difficulties in Emotion Regulation Scale-Short Form (DERS-SF). It comprises 18 items, rated on a 5-point Likert scale ranging from 1 (almost never) to 5 (almost always). The total score was calculated as the mean of all items excluding the Awareness items, with higher scores indicating a greater level of emotional dysregulation.
Baseline, week 6, week 12 (end of treatment), and 3- and 6-month follow-up
Changes from baseline in mindfulness
Ramy czasowe: Baseline, week 6, week 12 (end of treatment), and 3- and 6-month follow-up
Measured with the Mindful Attention Awareness Scale (MAAS). MAAS is a 15-item self-report questionnaire. Items are rated on a 6-point Likert scale ranging from 1 (almost always) to 6 (almost never). Total scores range from 15 to 90, with higher scores indicating greater mindfulness.
Baseline, week 6, week 12 (end of treatment), and 3- and 6-month follow-up
Changes from baseline in behavioral ativation
Ramy czasowe: Baseline, week 6, week 12 (end of treatment), and 3- and 6-month follow-up
Measured with The Behavioral Activation for Depression Scale-Short Form (BADS-SF). It comprises 9 items, rated on a 7-point scale ranging from 0 to 6, with higher total scores indicating greater levels of activation.
Baseline, week 6, week 12 (end of treatment), and 3- and 6-month follow-up
Changes from baseline in quality of life
Ramy czasowe: Baseline, week 12 (end of treatment), and 3- and 6-month follow-up
Measured with the EUROHIS-QOL-8. This self-report scale comprises 8 items, answered on a 5-point Likert scale (from 1- not at all/very dissatisfied to 5 - completely/very satisfied). Higher values represent better-perceived quality of life.
Baseline, week 12 (end of treatment), and 3- and 6-month follow-up

Inne miary wyników

Miara wyniku
Opis środka
Ramy czasowe
Group processes
Ramy czasowe: Week 6 (mid-intervention) and week 12 (end of treatment)
Measured with the Group Questionnaire (GQ). CG comprises 30 items, rated on a 7-point Likert scale ranging from 0 (totally disagree) to 7 (totally agree). Items are organized into three subscales: Positive bonding (higher scores indicating a stronger sense of belonging, cohesion, and empathy within the group); Positive Working (higher scores reflecting greater collaboration and agreement regarding therapeutic goals and tasks); and Negative Relationship (higher scores indicating greater trust and empathy and lower levels of distance among group members).
Week 6 (mid-intervention) and week 12 (end of treatment)
Changes in Therapeutic Alliance in group therapy
Ramy czasowe: Week 6 (mid-treatment) and week 12 (end of treatment)
Measured with Working Alliance Inventory - Short Revised - Group Version (WAI-SR-GV). WAI-SR-GV comprises 12 items rated on a 5-point Likert scale ranging from 1 (seldom) to 5 (always), with higher scores indicating stronger therapeutic alliance.
Week 6 (mid-treatment) and week 12 (end of treatment)
Treatment acceptability and satisfaction
Ramy czasowe: Week 12 (end of treatment), 3- and 6-months follow-up
Measured with an adaptation of the Satisfaction with Treatment Questionnaire (STQ; Larsen et al., 1979). The questionnaire comprises 13 items and was used to assess participants' satisfaction with the intervention, including perceived quality, usefulness of the techniques learned, discomfort experienced during the program, satisfaction with the program duration, and satisfaction with the group delivery format.
Week 12 (end of treatment), 3- and 6-months follow-up
Treatment adherence
Ramy czasowe: Week 12 (end of treatment), 3- and 6- months follow-up
Adherence indicators included the number of sessions attended, attendance rate across the intervention, and completion of homework assignments.
Week 12 (end of treatment), 3- and 6- months follow-up
Treatment usefulness
Ramy czasowe: Week 12 (end of treatment), 3- and 6- months follow-up
Measured with the Questionnaire for the Evaluation of the UP Components. The questionnaire consists of nine items rated on a 10-point Likert scale ranging from 0 (Not at all) to 10 (Very much), with higher scores indicating greater perceived usefulness.
Week 12 (end of treatment), 3- and 6- months follow-up
Beliefs about group therapy
Ramy czasowe: Baseline and week 12 (end of treatment)
Measured with the Group Therapy Survey-Revised (GTS-R). 17-item Portuguese version validated by the research team (Pedro et al., 2026) was used. Items are rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree) and assess beliefs about group therapy efficacy, non-endorsement of myths about group therapy, and comfort with group therapy.
Baseline and week 12 (end of treatment)
Attitudes toward online therapy
Ramy czasowe: Baseline and week 12 (end of treatment)
Measured with the Online Counseling Attitudes Scale (OCAS); it comprises 10-item, rated on a 6-point Likert scale (1 = strongly disagree to 6 = strongly agree) and assess the perceived value of and discomfort with online counseling.
Baseline and week 12 (end of treatment)
Attitudes toward in-person therapy
Ramy czasowe: Baseline and week 12 (end of treatment)
Measured with the Face-to-face Counseling Attitudes Scale (FCAS). This self-report measure comprises 10 items, rated on a 6-point Likert scale (1 = strongly disagree to 6 = strongly agree) and assess the perceived value of and discomfort with face-to-face counseling.
Baseline and week 12 (end of treatment)

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Sponsor

University of Coimbra

Współpracownicy

Fundação para a Ciência e a Tecnologia

Publikacje i pomocne linki

Osoba odpowiedzialna za wprowadzenie informacji o badaniu dobrowolnie udostępnia te publikacje. Mogą one dotyczyć wszystkiego, co jest związane z badaniem.

Przydatne linki

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Rzeczywisty)

4 maja 2023

Zakończenie podstawowe (Rzeczywisty)

8 sierpnia 2025

Ukończenie studiów (Rzeczywisty)

8 sierpnia 2025

Daty rejestracji na studia

Pierwszy przesłany

15 lipca 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

15 lipca 2026

Pierwszy wysłany (Rzeczywisty)

20 lipca 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

20 lipca 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

15 lipca 2026

Ostatnia weryfikacja

1 lipca 2026

Więcej informacji

Terminy związane z tym badaniem

Słowa kluczowe

Dodatkowe istotne warunki MeSH

Inne numery identyfikacyjne badania

  • 2021.04854.BD (Inny numer grantu/finansowania: Fundação para a Ciência e a Tecnologia (FCT))

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

NIE

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .

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