Effectiveness of a transdiagnostic indicated preventive intervention for adolescents at high risk for anxiety and depressive disorders

Abstract

Despite ample evidence for transdiagnostic interventions in clinical populations and in universal prevention approaches, there are only a few controlled trials examining their role for indicated prevention. This study is the first randomized controlled trial to assess the effectiveness of a brief, 8-session group version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A), called PROCARE-I (Preventive Transdiagnostic Intervention for Adolescents at Risk for Emotional Disorders-Indicated), delivered online, and including a booster session, in reducing symptoms of anxiety and depression in adolescents compared to an active control condition. Sixty-four adolescents (53% identifying as female) with elevated levels of anxiety and/or depression were randomly assigned to either the 8-week PROCARE-I or the active control condition. Self-report, parent, and clinician measures were collected before and after the interventions, at the 6-month follow-up, and 1 month after the booster session. After the intervention, participants in the PROCARE-I group showed improved scores on 9 of the 13 primary and secondary outcome measures, including reduction of anxiety and mood symptomatology, level of risk of developing emotional disorders, resilience, as well as increase of psychological flexibility, and emotional regulation. In contrast, those in the control group showed improvements in only 2 of the 13 outcome measures. After the booster session, significant differences were found between the PROCARE-I and control condition on measures of overall anxiety and depression symptoms, emotional risk, resilience, and quality of life. Low dropout rates and limited incidence of emotional disorders were observed at follow-ups. The interventions were well-accepted, with high satisfaction rates.