3 - (SYM 79) UP for ICP: Initial Outcomes of an 8 Session Adaptation of the UP for Massed Delivery in an Intensive Outpatient Setting for Veterans and Active-duty Service Members

Background: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP; Barlow et al., 2011) has been shown to be effective in the treatment of over 35 mental health diagnoses (Cassiello-Robbins et al., 2020). Most clinical trials utilizing UP have implemented a traditional course of 12 to 18 weekly outpatient sessions. Few studies have looked at the effectiveness of the UP in a massed intensive outpatient treatment setting. This study looked at initial outcomes of an 8-session adaptation of the UP (UP-ICP; Bullis & Robbins, 2023) created specifically for a two-week intensive outpatient program for Veterans and active-duty service members.

Methods: Participants were treatment seeking Veterans and active-duty service members who completed the 2-week Intensive Clinical Program at Massachusetts General Hospital’s Home Base program. 50 participants with primary diagnoses of trauma and stressor-related, depressive, and anxiety disorders completed UP-ICP after completing an initial intake session and engaging in collaborative treatment planning with their individual therapists. They completed an average of 8 individual UP-ICP therapy sessions over the course of 12 days and completed self-report measures of PTSD (PCL-5) and depressive symptoms (PHQ-9) on the first and last days of the program.

Results: Pre-post changes were analyzed using paired-samples t tests (N=50). There was a significant reduction in pre (M=39.42, SD=19.52) and post (M=31.34, SD=20.18) PCL-5 scores; t(49)=4.23, p< .001. Pre (M=12.60, SD=6.57) and post (M=10.80, SD=7.22) PHQ-9 scores were also significantly different t(49)=2.39, p=.02. Treatment effect sizes for trauma-related symptom severity were moderate (Cohen’s d=.59), and effect sizes for depressive symptom severity were smaller (Cohen’s d=.34).

Discussion: These preliminary data provide support for the effectiveness of UP-ICP in treating trauma-related and depressive symptomatology in a real-world, massed treatment setting. This is promising, given that patients present to IOPs with a variety of clinical needs and comorbid diagnoses. There is a need for effective treatments of a range of emotional disorders in these settings. Of note, effect sizes for other treatments (e.g. PE and CPT) completed in the ICP were moderate for both the PCL-5 and PHQ-9. Future research may compare treatment approaches in this setting. Our outcome measures were also limited, and inclusion of anxiety and substance use measures would be helpful in assessing treatment impact in other symptom domains.