(PS3-69) Community Implementation of Virtual Unified Protocol for Children Groups: Child Self-reported Improvements

Background:   

There is a high prevalence of emotional disorders in children ages 3 through 17; which has increased by more than 40% since the decade p</span>rior (National Healthcare Quality and Disparities Report, 2022), exacerbating the need for effective mental health care in community settings for this population. The Unified Protocol for Transdiagnostic Treatment of Emotion Disorders in Children (UP-C; Ehrenreich-May et al., 2018) is an evidence-based treatment program with cognitive-behavioral and third-wave behavior therapy elements for children 7 through 13 years old. It is a transdiagnostic, emotion-focused parent and child group intervention designed to address both the core underlying features of emotional disorders in youth (e.g., anxiety, depression) as well as parenting characteristics and behaviors that may exacerbate or maintain youth emotional disorders, with a focus on tolerating distressing emotions. Previous research on the UP-C has shown equivalence to an anxiety-focused group CBT protocol in a university-based RCT (Kennedy et al., 2018) and pre-to-post treatment improvement in anxiety and depressive symptom severity based on child- and parent- report in a Japanese Psychiatry clinic (Fujisato et al., 2021). However, less is known about the effectiveness of the UP-C in routine clinical practice. Therefore, the aim of this project was to evaluate the impact of the UP-C on children’s anxiety and depression symptoms when delivered in a community-based outpatient mental health setting.  

Methods:   

UP-C groups for children (grades 4-6) and their parents were conducted via a telehealth from January 2022 – June 2023 as part of routine clinical practice in a Medicaid-serving outpatient Psychiatry and Behavioral Health department clinic. Adaptations to the UP-C format and content were made to fit the delivery context.  As part of a university-approved quality improvement project, children completed questionnaires, including the Revised Children’s Anxiety and Depression Scale- Child Short form report (RCADS-C, Chorpita et al 2005) and the Distress Tolerance Scale (DTS, Simons & Gaher, 2005), prior to the first group session and immediately following group completion. Paired t-tests were used to compare baseline and post-group scores. 12 children with complete baseline and post data were included in this sample. 

Results:   

RCADS-C t-scores significantly decreased between baseline and post group participation: (Anxiety: t(10)= 2.4, p =.03; Depression: t(10)= 3.5, p < .01; Total: t(10)=3.0, p = .01). DTS-Distress Tolerance scale scores significantly increased between baseline and post group participation (t(11)=-2.4, p <.04). 

Conclusion:   

Completion of a community-based virtually implemented UP-C group was associated with improved child self-report ratings of distressed tolerance and depression and anxiety symptoms, highlighting the potential value of this program for addressing internalizing symptoms in routine clinical practice. Future research utilizing experimental and implementation science research methods are warranted.