Unified Protocol For Transdiagnostic Treatment Of Emotional Disorders In Children And Adolescents: Therapist Guide

The Unified Protocols For Transdiagnostic Treatment Of Emotional Disorders In Children And Adolescents - Therapist Guide provides step-by-step instructions and evidence-based strategies for treating emotional disorders in young clients. Client workbooks are available for download separately.

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Introduction

Chapter 1 – Core Module 1: Building and Keeping Motivation

Chapter 2 – Core Module 2: Getting to Know Your Emotions and Behaviors

Chapter 3 – Core Module 3: Introduction to Emotion-Focused Behavioral Experiments

Chapter 4 – Core Module 4: Awareness of Physical Sensations

Chapter 5 – Core Module 5: Being Flexible in Your Thinking

Chapter 6 – Core Module 6: Awareness of Emotional Experiences

Chapter 7 – Core Module 7: Situational Emotion Exposure

Chapter 8 – Core Module 8: Reviewing Accomplishments and Looking Ahead

Chapter 9 – Module-P: Parenting the Emotional Adolescent

Chapter 10 – Introduction to the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C)—Structural and Pragmatic Considerations

Chapter 11 – UP-C Session 1: Introduction to the Unified Protocol—C Skill: Consider How I Feel

Chapter 12 – UP-C Session 2: Getting to Know Your Emotions—C Skill: Consider How I Feel

Chapter 13 – UP-C Session 3: Using Science Experiments to Change Emotions and Behavior—C Skill: Consider How I Feel

Chapter 14 – UP-C Session 4: Our Body Clues—C Skill: Consider How I Feel

Chapter 15 – UP-C Session 5: Look at My Thoughts—L Skill: Look at My Thoughts

Chapter 16 – UP-C Session 6: Use Detective Thinking—U Skill: Use Detective Thinking and Problem Solving

Chapter 17 – UP-C Session 7: Problem Solving and Conflict Management—U Skill: Use Detective Thinking and Problem Solving

Chapter 18 – UP-C Session 8: Awareness of Emotional Experiences—E Skill: Experience My Emotions

Chapter 19 – UP-C Session 9: Introduction to Emotion Exposure—E Skill: Experience My Emotions

Chapter 20 – UP-C Session 10: Facing Our Emotions Part 1—E Skill: Experience My Emotions

Chapter 21 – UP-C Sessions 11–14: Facing Our Emotions Part 2—E Skill: Experience My Emotions

Chapter 22 – UP-C Session 15: Wrap-up and Relapse Prevention—S Skill: Stay Healthy and Happy

Chapter 23 – UP-A Group and UP-C Individual Therapy Variations, Other Adaptations—Considerations for Adapting UP-A and UP-C for Different Populations

References

Front Matter

Overview

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents: Therapist Guide provides mental health professionals with a flexible, transdiagnostic framework for treating emotional disorders in young clients. Building on the principles established in the adult unified protocol (UP), this guide addresses the wide array of emotional disorders often seen in children and adolescents, including anxiety, depression, trauma, somatic symptom disorders, and obsessive-compulsive disorders. By emphasizing common elements across these disorders—such as intense negative emotions, avoidance behaviors, and a propensity toward distress—this protocol equips therapists to treat not only individual diagnoses but also the underlying vulnerabilities that contribute to multiple or co-occurring conditions.

The unified protocol comes in three volumes: a therapist guide, a workbook for children, and a workbook for adolescents.

Why Use This Resource?

This program provides a step-by-step, structured approach for treating common mental health difficulties in children and young people (CYP). It includes:

Detailed explanations of cognitive-behavioral principles tailored to a broad range of emotional disorders.
Transdiagnostic, evidence-based interventions for overcoming emotional difficulties.
Practical guidance for structuring sessions and implementing client exercises.
Strategies for overcoming common obstacles during treatment.

Key Benefits

Comprehensive

Covers interventions for children and adolescents in one structured guide.

Educational

Helps children and young people (CYP) understand the nature of their difficulties.

Structured

Offers a clear outline for delivering effective therapy.

Flexible

Allows for modular application, tailoring treatment to individual client needs.

Trusted

Part of the Treatments That Work™ series, developed by leading experts.

Who is this for?

Anxiety Disorders

Persistent fears and worries.

Depression

Low mood, withdrawal, and loss of interest.

Trauma

Distress related to traumatic events.

Emotion Dysregulation

Difficulty managing intense emotional responses.

Mixed Anxiety And Depression

Co-occurring symptoms of anxiety and low mood.

Integrating it into your practice

Assessment

Explore how children and young people (CYP) experience their mental health difficulties.

Psychoeducation

Teach CYP about key emotional processes that maintain their symptoms.

Skills

Implement effective cognitive-behavioral interventions to address symptoms.

Monitoring

Use structured worksheets to track progress and refine interventions.

Relapse Prevention

Equip clients with long-term strategies for maintaining their progress.

Theoretical Background & Therapist Guidance

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents: Therapist Guide provides mental health professionals with a flexible, transdiagnostic framework for treating emotional disorders in young clients. Building on the principles established in the adult unified protocol, this guide addresses the wide array of emotional disorders often seen in children and adolescents, including anxiety, depression, trauma, somatic symptom disorders, and obsessive-compulsive disorders. By emphasizing common elements across these disorders - such as intense negative emotions, avoidance behaviors, and a propensity toward distress - this protocol equips therapists to treat not only individual diagnoses but also the underlying vulnerabilities that contribute to multiple or co-occurring conditions.

Core features of the unified protocols for youth include:

Broad applicability. The unified protocols for children (UP-C) and adolescents (UP-A) are designed to be versatile, making them suitable for children and adolescents with various emotional disorders, such as generalized anxiety disorder, social anxiety, panic disorder, depression, and more.
Modular structure. The protocols are divided into eight core modules, allowing therapists to tailor treatment based on individual client needs and presenting issues. Modules can be applied sequentially or, after initial familiarity, adjusted as needed to target specific areas.
Focus on emotional awareness and regulation. Techniques in each module aim to increase clients’ emotional awareness, allowing young clients to face their intense emotions with less avoidance and distress over time.
Parent involvement. Recognizing that parenting styles can reinforce maladaptive coping in children, the guide includes optional modules focused on enhancing parental support and addressing unhelpful patterns, such as overprotection or criticism.

The unified protocols emphasize practical interventions that guide clients through a series of modules, each designed to target key areas:

Emotion awareness and mindfulness. Clients learn to recognize and understand their emotions without judgment.
Cognitive flexibility. This module encourages clients to explore new ways of thinking, helping to reduce cognitive biases and rigidity.
Behavioral exposure. Therapists guide clients in confronting emotions and situations they tend to avoid, reducing avoidance behaviors over time.
Parent and family interventions. Sessions may include strategies to help parents respond effectively to their child’s emotional needs, thus preventing reinforcement of avoidance or negative emotions.

For adolescents, the UP-A has proven beneficial in treating anxiety and depression. Early studies, including multiple baseline and open-trial designs, showed significant improvements in symptoms from pre- to post-treatment (Ehrenreich et al., 2009; Trosper, Buzzella, Bennett, & Ehrenreich, 2009). In an RCT with a waitlist control group, adolescents who received the UP-A experienced significant reductions in anxiety, depression, and global severity of symptoms, with further gains reported at a six-month follow-up (Ehrenreich-May et al., 2017; Queen, Barlow, & Ehrenreich-May, 2014). For children, the UP-C began as a universal prevention program for anxiety and depression in younger children before being adapted as a group treatment for children aged 7 to 12 with emotional disorders (Ehrenreich-May & Bilek, 2011). Early open-trial studies demonstrated improvements in symptoms from pre- to post-treatment (Ehrenreich-May & Bilek, 2012). A randomized controlled trial comparing the UP-C to an established group anxiety-focused CBT program found both treatments equally effective for anxiety, while the UP-C showed additional benefits in reducing depressive symptoms and emotional dysregulation (Kennedy, Bilek, & Ehrenreich-May, under review).

Authored by leading psychologists including David Barlow, Michelle Craske and Edna Foa, Treatments That Work™ is a series of manuals and workbooks based on the principles of cognitive behavioral therapy (CBT). Each pair of books (Therapist/Clinician Guide and Workbook) - contains step-by-step procedures for delivering evidence-based psychological interventions and will help you to provide the best possible care for your clients.

At Psychology Tools, we are proud to make many of the Treatments That Work™ titles available to our members. Each book is available to download chapter-by-chapter, and Psychology Tools members with a currently active subscription to the appropriate plan are licensed to share copies with their clients.

What's inside

Step-by-step guidance for implementing the UP-C (children) and UP-A (adolescents) protocols.
Therapist checklists and progress monitoring tools.
Tools for engaging caregivers in the treatment process.
Case examples and troubleshooting tips for common challenges.

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FAQs

No, this resource is designed for therapists. Clients may benefit from the companion Client Workbooks, which provides exercises for independent practice.

The full program is designed to be completed over multiple sessions, but can be tailored to individual client needs.

The guide includes structured assessments and self-monitoring tools to evaluate symptom changes over time.

Encourage gradual implementation and support clients in identifying and addressing the barriers they encounter.

How This Resource Improves Clinical Outcomes

By integrating this resource into therapy, therapists are able to:

Deliver a structured, comprehensive treatment specifically developed for children and young people (CYP).
Implement effective, evidence-based interventions.
Help CYP maintain long-term gains through relapse prevention strategies.
Tailor treatment to meet diverse client needs.

Clinicians Who Use This Resource Also Use

Unified Protocol For Transdiagnostic Treatment Of Emotional Disorders In Adolescents: Workbook

References And Further Reading

Barlow, D. H. (2010). Negative effects from psychological treatments: A perspective. American Psychologist, 65(2), 13-20.

Ehrenreich-May, J., & Bilek, E. L. (2012). Development of the UP-C for the treatment of emotional disorders in youth. Clinical Child and Family Psychology Review, 15(3), 213-235.

McHugh, R. K., & Barlow, D. H. (2012). Dissemination and implementation of evidence-based psychological interventions. Oxford: Oxford University Press.

Weisz, J. R., & Kazdin, A. E. (2017). Evidence-based psychotherapies for children and adolescents (3rd ed.). New York: Guilford.

A Guide To Emotions