ClinicalTrials.gg
RecruitingNCT07682064PSIGTEUpdated Jul 2, 2026

Effectiveness of the Group Unified Protocol for Emotional Disorders in Adults in a Public Mental Health Setting

An interventional study of UP and TAU in Emotional Disorders, ANXIETY DISORDERS (or Anxiety and Phobic Neuroses) and Depressive Disorder, sponsored by Patricia Fernández Couto. Recruiting at 1 site in Spain. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-07-02.

Primary conditionPhobic DisordersRegistry: Anxiety DisordersReclassifiedWhy we changed it
Registry
Anxiety Disorders — the first condition term the registry derived for this study.
ClinicalTrials.gg
Phobic Disorders
Why
  1. The registry often attaches Anxiety Disorders to studies about something else, and this study's title and listed conditions do not name it.
  2. The study's listed conditions name Phobic Disorders, a narrower term within Anxiety Disorders.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by Patricia Fernández Couto · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Jun 2026, 4 months ago, but the record still lists the study as recruiting.
  • Registered 2 years 1 month after the study started (first participant enrolled Apr 2024, registered Jun 2026).
  • Started Apr 2024; still recruiting 2 years 6 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
106
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

This study has three primary objectives:

  1. To adapt the Spanish version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP; Barlow et al., 2011, 2019a, 2019b) for delivery in a group format within the Spanish Public Mental Health System for adults diagnosed with emotional disorders.
  2. To evaluate the effectiveness of the intervention.
  3. To assess its clinical feasibility and acceptability in routine clinical practice.

Outcomes will include anxiety, depression, somatic symptoms, transdiagnostic variables, functional impairment, quality of life, and participant satisfaction. These outcomes will be assessed at baseline, post-treatment, and 3-month follow-up.

The intervention is expected to improve emotional symptoms, functional impairment, and quality of life. In addition, the study will explore whether this group-based transdiagnostic approach may help lower demand on public mental health services.

Read the detailed description

Anxiety and depressive disorders are among the leading causes of disability and contributors to the global burden of disease worldwide. To address this public health challenge, stepped-care models have been developed to organize treatment according to patients' clinical needs and progression. Within this framework, the transdiagnostic approach proposes that emotional disorders share common underlying transdiagnostic mechanisms, including elevated negative affect and maladaptive emotion regulation strategies such as emotional avoidance.

Accordingly, the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP) has emerged as an evidence-based intervention for anxiety, depressive, and related emotional disorders. The UP aims to enhance adaptive emotion regulation and lower maladaptive behavioral avoidance, thereby promoting improvements across a broad range of emotional symptoms.

This study aims to adapt and implement the Spanish version of the UP in a group format for adults diagnosed with an emotional disorder receiving treatment within the Spanish Public Mental Health System. In addition, the study will evaluate the intervention's effectiveness, feasibility, acceptability, and cost-effectiveness. The intervention will be delivered in Public Mental Health Units of the La Rioja Health Service.

Adults aged 18 to 65 years diagnosed with an emotional disorder will be recruited. The study will employ a randomized controlled trial design with two parallel groups: a Treatment as Usual (TAU) group and an experimental group (UP + TAU). Assessments will be conducted at pre-treatment, post-treatment, and 3-month follow-up. Outcome measures will assess anxiety, depression, somatic symptoms, transdiagnostic processes, functional impairment, quality of life, participant satisfaction, and intervention cost-effectiveness.

02

Conditions studied

  • Emotional Disorders
  • ANXIETY DISORDERS (or Anxiety and Phobic Neuroses)
  • Depressive Disorder
  • Somatic Disorders

Browse trials for

Keywords

  • Unified Protocol
  • emotional disorder
  • UP
  • treatment
03

In context

Phobic Disorders Reclassified

84 studies on the registry are indexed under Phobic Disorders; 15 are open to participants now.

This study's planned enrollment of 106 is above the median of 66 across 69 interventional studies indexed under Phobic Disorders.

Browse Phobic Disorders studies →

Lead sponsor

This is the only study on the registry with Patricia Fernández Couto as lead sponsor.

Compared within Phobic Disorders, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Anxiety Disorders. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Aged 18 to 65 years.
  • Ability and willingness to provide written .
  • Sufficient proficiency in Spanish to participate in the intervention and complete study assessments.
  • Sufficient cognitive capacity to understand the intervention content.
  • A primary diagnosis of an emotional disorder with mild, moderate, or severe symptom severity, including Depressive Disorders, Anxiety Disorders, Obsessive-Compulsive and Related Disorders, Trauma and Stressor-Related Disorders, Dissociative Disorders and Somatic Symptom and Related Disorders.
  • Presence of emotional symptoms (e.g., anxiety, depressive, or phobic symptoms), somatic symptoms, obsessive symptoms, and/or avoidance behaviors associated with impairment, as indicated by moderate or higher scores on the GAD-7, PHQ-9, and/or PHQ-15.

Exclusion criteria

Exclusion Criteria:

  • Refusal to provide or withdrawal of consent during the study.
  • Current severe substance use disorder or behavioral addiction.
  • Current high suicide risk.
  • Current psychotic symptoms or psychotic disorder.
  • Neurological disorders or severe medical conditions that could interfere with participation in or adherence to the intervention.
  • Intellectual disability, significant language difficulties, or any other condition that may impair the participant's ability to understand the intervention content.
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
106 participants (estimated)

Study arms

  • Experimental
    3-month Unified Protocol + Treatment as Usual

    The UP (Barlow et al., 2011, 2019a, 2019b) is an emotion-focused, transdiagnostic cognitive-behavioral therapy for adults. Participants will receive a 9-session group-based adaptation of the UP, delivered in addition to treatment as usual (TAU). The program is designed for adults with emotional disorders receiving care within the Spanish Public Mental Health System.

    Behavioral: UP

  • Active comparator
    3-month Treatment as Usual

    Participants assigned to the control group will receive treatment as usual (TAU) provided by the collaborating Public Mental Health Units. TAU will be delivered individually by the participant's assigned mental health professional and may include psychological and/or pharmacological treatment according to routine clinical practice.

    Behavioral: TAU

Interventions

  • BehavioralUP

    The UP includes eight modules designed to enhance emotion regulation skills: (1) Motivation Enhancement and Goal Setting; (2) Psychoeducation and Tracking Emotional Experiences; (3) Training in Present-Focused Emotional Awareness; (4) Cognitive Flexibility; (5) Countering Emotional Behaviors; (6) Understanding and Tolerating Physical Sensations; (7) Emotional Exposure; and (8) Recognizing Achievements and Maintaining Progress.

  • BehavioralTAU

    TAU in the Public Mental Health Units of the La Rioja Health Service consists of care provided by specialists in Clinical Psychology and/or Psychiatry in accordance with routine clinical practice.

06

What researchers measure

Primary outcomes

  1. Anxiety Symptoms

    Change in total score on the Generalized Anxiety Disorder-7 (GAD-7; Spitzer et al., 2006). The GAD-7 consists of seven items with total scores ranging from 0 to 21, where higher scores indicate greater anxiety symptom severity.

    Time frame: Baseline, at the end of the 3-month intervention, and 3 months after the end of the intervention.

  2. Depressive Symptoms

    Change in total score on the Patient Health Questionnaire-9 (PHQ-9; Kroenke et al., 2001). The PHQ-9 includes nine items with total scores ranging from 0 to 27, where higher scores indicate greater depressive symptom severity.

    Time frame: Baseline, at the end of the 3-month intervention, and 3 months after the end of the intervention.

  3. Somatic Symptoms

    Change in total score on the Patient Health Questionnaire-15 (PHQ-15; Kroenke et al., 2010). The PHQ-15 consists of fifteen items with total scores ranging from 0 to 30, where higher scores indicate greater somatic symptom severity.

    Time frame: Baseline, at the end of the 3-month intervention, and 3 months after the end of the intervention.

Secondary outcomes

  1. Experiential avoidance

    Change in total score on the Acceptance and Action Questionnaire-II (AAQ-II; Ruiz et al., 2013). The AAQ-II includes seven items with total scores ranging from 7 to 42, where higher scores reflect greater experiential avoidance.

    Time frame: Baseline, at the end of the 3-month intervention, and 3 months after the end of the intervention.

  2. Functional impairment

    Change in total score on the Inadaptation Scale (EI; Echeburúa et al., 2000). The EI consists of six items with total scores ranging from 0 to 30, where higher scores indicate greater functional impairment.

    Time frame: Baseline, at the end of the 3-month intervention, and 3 months after the end of the intervention.

  3. Perceived quality of life

    Change in total and domain scores on the WHO Quality of Life-BREF (WHOQOL-BREF; Lucas-Carrasco, 2012). The WHOQOL-BREF includes 26 items across multiple domains, with item scores ranging from 1 to 5. Higher scores indicate better perceived quality of life.

    Time frame: Baseline, at the end of the 3-month intervention, and 3 months after the end of the intervention.

  4. Transdiagnostic dimensions

    Change in scores across domains on the Multidimensional Emotional Disorder Inventory (MEDI; Rosellini \& Brown, 2019). The MEDI includes 49 items rated from 0 to 8, grouped into nine domains. Higher scores indicate greater severity of transdiagnostic emotional disorder dimensions.

    Time frame: Baseline, at the end of the 3-month intervention, and 3 months after the end of the intervention.

  5. Satisfaction with the program

    Participant satisfaction will be assessed post-intervention using a 10-item questionnaire adapted from García-Escalera et al. (2020). Each item is rated on a 5-point Likert scale ranging from 0 to 4. Total scores range from 0 to 40, with higher scores indicating greater satisfaction. Some items are reverse coded prior to score calculation.

    Time frame: Immediately after completion of the 3-month intervention.

  6. Use of healthcare resources

    Composite measure of healthcare utilization, including number of visits to healthcare services, missed treatment sessions, and number of medical tests performed.

    Time frame: Baseline, at the end of the 3-month intervention, and 3 months after the end of the intervention.

07

Study locations

1 of 1 sites recruiting
  • Centro de Salud Espartero
    Logroño, La Rioja 26007, Spain
    Recruiting
08

References and documents

Publications

  • Barlow, D. H., Farchione, T. J., Sauer-Zavala, S., Murray, H., Ellard, K., Bullis, J., & Bentley, K. H. (2019). Protocolo Unificado para el Tratamiento Transdiagnóstico de los Trastornos Emocionales (2nd ed.): Manual del terapeuta. Alianza Editorial. https://doi.org/10.1093/med:psych/9780199772667.001.0001
  • Barlow, D. H., Sauer-Zavala, S., Farchione, T. J., Murray, H., Ellard, K., Bullis, J., & Cassiello-Robbins, C. (2019). Protocolo Unificado para el Tratamiento Transdiagnóstico de los Trastornos Emocionales (2nd ed.): Manual del paciente. Alianza Editorial. https://doi.org/10.1093/med:psych/9780199772667.001.0001
  • Osma, J., Castellano, C., Crespo, E., & García-Palacios, A. (2015). The unified protocol for transdiagnostic treatment of emotional disorders in group format in a Spanish public mental health setting. Behavioral Psychology, 23(3), 447-466.
  • Sakiris N, Berle D. A systematic review and meta-analysis of the Unified Protocol as a transdiagnostic emotion regulation based intervention. Clin Psychol Rev. 2019 Aug;72:101751. doi: 10.1016/j.cpr.2019.101751. Epub 2019 Jun 25. PubMed 31271848 ↗
  • Garcia-Escalera J, Valiente RM, Sandin B, Ehrenreich-May J, Prieto A, Chorot P. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) Adapted as a School-Based Anxiety and Depression Prevention Program: An Initial Cluster Randomized Wait-List-Controlled Trial. Behav Ther. 2020 May;51(3):461-473. doi: 10.1016/j.beth.2019.08.003. Epub 2019 Aug 14. PubMed 32402261 ↗
  • Cassiello-Robbins C, Southward MW, Tirpak JW, Sauer-Zavala S. A systematic review of Unified Protocol applications with adult populations: Facilitating widespread dissemination via adaptability. Clin Psychol Rev. 2020 Jun;78:101852. doi: 10.1016/j.cpr.2020.101852. Epub 2020 Apr 20. PubMed 32360953 ↗
  • Carlucci L, Saggino A, Balsamo M. On the efficacy of the unified protocol for transdiagnostic treatment of emotional disorders: A systematic review and meta-analysis. Clin Psychol Rev. 2021 Jul;87:101999. doi: 10.1016/j.cpr.2021.101999. Epub 2021 Mar 9. PubMed 34098412 ↗
  • Farchione TJ, Fairholme CP, Ellard KK, Boisseau CL, Thompson-Hollands J, Carl JR, Gallagher MW, Barlow DH. Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behav Ther. 2012 Sep;43(3):666-78. doi: 10.1016/j.beth.2012.01.001. Epub 2012 Jan 18. PubMed 22697453 ↗
  • Osma J, Peris-Baquero O, Suso-Ribera C, Farchione TJ, Barlow DH. Effectiveness of the Unified Protocol for transdiagnostic treatment of emotional disorders in group format in Spain: Results from a randomized controlled trial with 6-months follow-up. Psychother Res. 2022 Mar;32(3):329-342. doi: 10.1080/10503307.2021.1939190. Epub 2021 Jun 16. PubMed 34132170 ↗
  • Barlow, D. H., Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Allen, L. B., & Ehrenreich-May, J. (2011). The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide. Oxford University Press. https://doi.org/10.1093/med:psych/9780199772667.001.0001

Individual participant data

Plan to share: No — The study team does not plan to share de-identified individual participant data. Only aggregated data will be made available through scientific publications and conference presentations.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 2, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07682064
Lead sponsor
Patricia Fernández Couto
Collaborators
University of La Rioja
Responsible party
Patricia Fernández Couto (Clinical Psychology Specialist, University of La Rioja) — Sponsor-investigator
First posted
Jul 2, 2026
Start date
Apr 27, 2024
Primary completion
Jun 30, 2026 (estimated)
Completion
Dec 2026 (estimated)
Last update
Jul 2, 2026

Study contacts

Patricia Fernández-Couto, Clinical Psychologist
Contact
pafernco@unirioja.es
(+34)941296251 ext. 80324
Patricia Fernández Couto, Clinical Psychologist
principal investigator · Servicio Riojano de Salud

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

Contact study team

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion