The Unified Protocol Institute leverages a global community of active practitioners to help merge the worlds of science and practice. We collaborate with researchers worldwide to ensure our trainees and clients benefit from the latest scientific advancements in treatment.
Using research to redefine treatment
Backed by research
35+
diagnoses
in DSM-5 are characterized by difficulty managing strong emotions
77+
academic studies
have used the UP to treat patients with a range of emotional disorders
11
countries
where the UP has been successfully tested in therapeutic settings
From research to real-world impact
The Unified Protocol Institute specializes in both small and large-scale implementation strategies to help bring the UP to your organization. We use research collected from private practices, community mental health clinics, university counseling centers, intensive outpatient programs, inpatient hospitals, and other settings to provide the most effective and up-to-date solutions.
Find out how we can help you access the power of the UP in your specific setting.
Featured publications
The UP is as effective as diagnosis-specific CBT for anxiety disorders, with less patient dropout.
Barlow, Farchione, Bullis, et al. (2017)
In a study of over 200 patients with anxiety and comorbid emotional disorders, the UP produced reductions in symptoms of anxiety and depression equivalent to first line, single-disorder CBT protocols. Patients treated with the UP were more likely to complete treatment than patients treated with a diagnosis-led CBT protocol. Read more here.
The UP is more effective at reducing neuroticism than first-line, symptom-focused CBT.
Sauer-Zavala, Fournier, et al. (2021)
Treatment response to the UP is enduring, with gains maintained up to three years post-treatment.
Bullis, Eustis, et al. (2023)
Treatment gains after 12-16 sessions of the UP were maintained three years post-treatment and remained comparable to first-line, symptom-focused CBT for heterogenous anxiety disorders at three-year follow-up. Read more here.
The UP outperformed treatment-as-usual and waitlist control conditions in improving symptoms of anxiety and depression and reducing levels of negative affect and neuroticism.
Longley & Glesier (2023)
A meta-analysis of randomized controlled trials (RCTs) evaluating the efficacy of the UP demonstrated that the UP has large, positive effects on anxiety and depressive symptoms, with gains maintained through a six-month follow-up. Read more here.
Over 70 studies conducted in 11 countries demonstrated that the UP is a flexible, effective treatment for a wide range of presenting problems.
Cassiello-Robbins, Southward, et al. (2020)
This systematic review of the UP in adult populations summarizes the many different presenting problems for which the UP has been used, the different treatment settings, and how it has been adapted. Read more here.
The UP reliably produces large effect sizes for the reduction of anxiety and depression and outperforms passive and active control conditions in the treatment of negative affect.
Carlucci, Saggino, & Balsamo (2021)
In a meta-analysis of over 2,100 patients, treatment with the UP resulted in large and significant reductions in anxiety and comorbid depressive symptom severity. Read more here.
Other selected publications by topic
Explore the scientific foundation and clinical applications of the UP through our list of scholarly articles.
Therapist guide and client workbook
Barlow D.H., Farchione .TJ., Sauer-Zavala S., Latin H.M., Ellard K.K., Bullis J.R,. et al. (2018). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Workbook (2nd ed.). Oxford University Press.
Barlow D.H., Sauer-Zavala S., Farchione .TJ., Latin H.M., Ellard K.K., Bullis J.R,. et al. (2018). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist guide (2nd ed.). Oxford University Press.
Barlow, D.H., Ellard, K.K., Fairholme, C.P., Farchione, T.J., Boisseau, C.L. Allen, L.B. & Ehrenreich-May, J. (2011). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Workbook (1 st ed.). Oxford University Press.
Barlow, D.H., Farchione, T.J., Fairholme, C.P., Ellard, K.K., Boisseau, C.L. Allen, L.B. & Ehrenreich-May, J. (2011). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist guide (1 st ed.). Oxford University Press.
Theory and protocol development
Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35(2), 205–230.
Ellard, K. K., Fairholme, C. P., Boisseau, C. L., Farchione, T. J., & Barlow, D. H. (2010). Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders: Protocol development and initial outcome data. Cognitive and Behavioral Practice, 17(1), 88–101.
Wilamowska, Z. A., Thompson-Hollands, J., Fairholme, C. P., Ellard, K. K., Farchione, T. J., & Barlow, D. H. (2010). Conceptual background, development, and preliminary data from the unified protocol for transdiagnostic treatment of emotional disorders. Depression and Anxiety, 27(10), 882–890.
Barlow, D. H., Ellard, K. K., Sauer-Zavala, S., Bullis, J. R., & Carl, J. R. (2014). The Origins of Neuroticism. Perspectives on Psychological Science: A Journal of the Association for Psychological Science, 9(5), 481–496.
Barlow, D. H., Sauer-Zavala, S., Carl, J. R., Bullis, J. R., & Ellard, K. K. (2014). The nature, diagnosis, and treatment of neuroticism: Back to the future. Clinical Psychological Science, 2(3), 344–365.
Sauer-Zavala, S., Gutner, C. A., Farchione, T. J., Boettcher, H. T., Bullis, J. R., & Barlow, D. H. (2017). Current definitions of “transdiagnostic” in treatment development: A search for consensus. Behavior Therapy, 48(1), 128–138.
Sauer-Zavala, S., Wilner, J. G., & Barlow, D. H. (2017). Addressing neuroticism in psychological treatment. Personality Disorders, 8(3), 191–198.
Bullis, J. R., Boettcher, H., Sauer-Zavala, S., Farchione, T. J., & Barlow, D. H. (2019). What is an emotional disorder? A transdiagnostic mechanistic definition with implications for assessment, treatment, and prevention. Clinical Psychology: Science and Practice, 26(2), e12278.
Systematic reviews and meta-analyses
Sakiris, N., & Berle, D. (2019). A systematic review and meta-analysis of the Unified Protocol as a transdiagnostic emotion regulation based intervention. Clinical Psychology Review, 72, 101751.
Cassiello-Robbins, C., Southward, M. W., Tirpak, J. W., & Sauer-Zavala, S. (2020). A systematic review of Unified Protocol applications with adult populations: Facilitating widespread dissemination via adaptability. Clinical Psychology Review, 78, 101852.
Carlucci, L., Saggino, A., & Balsamo, M. (2021). On the efficacy of the unified protocol for transdiagnostic treatment of emotional disorders: A systematic review and meta-analysis. Clinical Psychology Review, 87, 101999.
Longley, S. L., & Gleiser, T. S. (2023). Efficacy of the Unified Protocol: A systematic review and meta-analysis of randomized controlled trials. Clinical Psychology: Science and Practice, 30(2), 208–221.
Benuto, L. T., Reyes, S. R., Ramirez, V., Falcon-Ruiz, N., Villar, G., & Rojas Perez, O. F. (2025). Inclusion of People of Color in Randomized Controlled Trials for the Unified Protocol: A Systematic Review. Journal of racial and ethnic health disparities, 10.1007/s40615-025-02509-3. Advance online publication. https://doi.org/10.1007/s40615-025-02509-3
Clinical outcomes and transdiagnostic applications
Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Thompson-Hollands, J., Carl, J. R., Gallagher, M. W., & Barlow, D. H. (2012). Unified protocol for transdiagnostic treatment of emotional disorders: A randomized controlled trial. Behavior Therapy, 43(3), 666–678.
Ciraulo, D. A., Barlow, D. H., Gulliver, S. B., Farchione, T., Morissette, S. B., Kamholz, B. W., Eisenmenger, K., Brown, B., Devine, E., Brown, T. A., & Knapp, C. M. (2013). The effects of venlafaxine and cognitive behavioral therapy alone and combined in the treatment of co-morbid alcohol use-anxiety disorders. Behaviour Research and Therapy, 51(11), 729–735.
Gallagher, M. W., Sauer-Zavala, S. E., Boswell, J. F., Carl, J. R., Bullis, J., Farchione, T. J., & Barlow, D. H. (2013). The impact of the Unified Protocol for Emotional disorders on quality of life. International Journal of Cognitive Therapy, 6(1), 10.1521/ijct.2013.6.1.57.
Conklin, L. R., Cassiello-Robbins, C., Brake, C. A., Sauer-Zavala, S., Farchione, T. J., Ciraulo, D. A., & Barlow, D. H. (2015). Relationships among adaptive and maladaptive emotion regulation strategies and psychopathology during the treatment of comorbid anxiety and alcohol use disorders. Behaviour Research and Therapy, 73, 124–130.
Sauer-Zavala, S., Bentley, K. H., & Wilner, J. G. (2016). Transdiagnostic treatment of borderline personality disorder and comorbid disorders: a clinical replication series. Journal of Personality Disorders, 30(1), 35–51.
Barlow, D. H., Farchione, T. J., Bullis, J. R., Gallagher, M. W., Murray-Latin, H., Sauer-Zavala, S., Bentley, K. H., Thompson-Hollands, J., Conklin, L. R., Boswell, J. F., Ametaj, A., Carl, J. R., Boettcher, H. T., & Cassiello-Robbins, C. (2017). The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders compared with diagnosis-specific protocols for anxiety disorders: A randomized clinical trial. JAMA Psychiatry, 74(9), 875–884.
Bentley, K. H., Nock, M. K., Sauer-Zavala, S., Gorman, B. S., & Barlow, D. H. (2017). A functional analysis of two transdiagnostic, emotion-focused interventions on nonsuicidal self- injury. Journal of Consulting and Clinical Psychology, 85(6), 632–646.
Bentley, K. H., Sauer-Zavala, S., Cassiello-Robbins, C. F., Conklin, L. R., Vento, S., & Homer, D. (2017). Treating suicidal thoughts and behaviors within an emotional disorders framework: Acceptability and feasibility of the Unified Protocol in an inpatient setting. Behavior Modification, 41(4), 529–557.
Ellard, K. K., Bernstein, E. E., Hearing, C., Baek, J. H., Sylvia, L. G., Nierenberg, A. A., Barlow, D. H., & Deckersbach, T. (2017). Transdiagnostic treatment of bipolar disorder and comorbid anxiety using the Unified Protocol for Emotional Disorders: A pilot feasibility and acceptability trial. Journal of Affective Disorders, 219, 209–221.
Steele, S. J., Farchione, T. J., Cassiello-Robbins, C., Ametaj, A., Sbi, S., Sauer-Zavala, S., & Barlow, D. H. (2018). Efficacy of the Unified Protocol for transdiagnostic treatment of comorbid psychopathology accompanying emotional disorders compared to treatments targeting single disorders. Journal of Psychiatric Research, 104, 211–216.
Varkovitzky, R. L., Sherrill, A. M., & Reger, G. M. (2018). Effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders among veterans with posttraumatic stress disorder: A pilot study. Behavior Modification, 42(2), 210–230.
Sauer-Zavala, S., Ametaj, A. A., Wilner, J. G., Bentley, K. H., Marquez, S., Patrick, K. A., Starks, B., Shtasel, D., & Marques, L. (2019). Evaluating transdiagnostic, evidence-based mental health care in a safety-net setting serving homeless individuals. Psychotherapy (Chicago, Ill.), 56(1), 100–114.
Wilner Tirpak, J., Cassiello-Robbins, C., Ametaj, A., Olesnycky, O. S., Sauer-Zavala, S., Farchione, T. J., & Barlow, D. H. (2019). Changes in positive affect in cognitive-behavioral treatment of anxiety disorders. General Hospital Psychiatry, 61, 111–115.
Bentley, K. H., Sauer-Zavala, S., Stevens, K. T., & Washburn, J. J. (2020). Implementing an evidence-based psychological intervention for suicidal thoughts and behaviors on an inpatient unit: Process, challenges, and initial findings. General Hospital Psychiatry, 63, 76–82.
Cassiello-Robbins, C., Sauer-Zavala, S., Brody, L. R., & Barlow, D. H. (2020). Exploring the effects of the mindfulness and countering emotional behaviors modules from the Unified Protocol on dysregulated anger in the context of emotional disorders. Behavior Therapy, 51(6), 933–945.
Gallagher, M. W., Phillips, C. A., D’Souza, J., Richardson, A., Long, L. J., Boswell, J. F., Farchione, T. J., & Barlow, D. H. (2020). Trajectories of change in well-being during cognitive behavioral therapies for anxiety disorders: Quantifying the impact and covariation with improvements in anxiety. Psychotherapy (Chicago, Ill.), 57(3), 379–390.
Nazari, N., Sadeghi, M., Ghadampour, E., & Mirzaeefar, D. (2020). Transdiagnostic treatment of emotional disorders in people with multiple sclerosis: Randomized controlled trial. BMC Psychology, 8(1), 114.
Sauer-Zavala, S., Bentley, K. H., Steele, S. J., Tirpak, J. W., Ametaj, A. A., Nauphal, M., Cardona, N., Wang, M., Farchione, T. J., & Barlow, D. H. (2020). Treating depressive disorders with the Unified Protocol: A preliminary randomized evaluation. Journal of Affective Disorders, 264, 438–445.
Wilner, J. G., Dufour, S., Kennedy, K., Sauer-Zavala, S., Boettcher, H., Farchione, T. J., & Barlow, D. H. (2020). Quality of life in heterogeneous anxiety disorders: Changes across cognitive-behavioral treatments. Behavior Modification, 44(3), 343–364.
Hood, C. O., Southward, M. W., Bugher, C., & Sauer-Zavala, S. (2021). A preliminary evaluation of the Unified Protocol among trauma-exposed adults with and without PTSD. International Journal of Environmental Research and Public Health, 18(21), 11729.
O’Donnell, M. L., Lau, W., Chisholm, K., Agathos, J., Little, J., Terhaag, S., Brand, R., Putica, A., Holmes, A. C. N., Katona, L., Felmingham, K. L., Murray, K., Hosseiny, F., & Gallagher, M. W. (2021). A pilot study of the efficacy of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in treating posttraumatic psychopathology: A randomized controlled trial. Journal of Traumatic Stress, 34(3), 563–574.
Gutner, C. A., Song, J., Canale, C. A., Suvak, M. K., Litwack, S. D., Niles, B. L., & Stirman, S. W. (2022). A pilot randomized effectiveness trial of the Unified Protocol in trauma-exposed veterans. Depression and Anxiety, 39(12), 813–823.
Peláez, T., López-Carrillero, R., Ferrer-Quintero, M., Ochoa, S., & Osma, J. (2022). Application of the unified protocol for the transdiagnostic treatment of comorbid emotional disorders in patients with ultra-high risk of developing psychosis: A randomized trial study protocol. Frontiers in Psychology, 13, 976661.
Southward, M. W., Terrill, D. R., & Sauer-Zavala, S. (2022). The effects of the Unified Protocol and Unified Protocol skills on loneliness in the COVID-19 pandemic. Depression and Anxiety, 39(12), 913–921.
Tully, P. J., Turnbull, D. A., Horowitz, J. D., Beltrame, J. F., Baune, B. T., Sauer-Zavala, S., Baumeister, H., Bean, C. G., Pinto, R. B., Cosh, S., & Wittert, G. A. (2022). Transdiagnostic cognitive-behavioral therapy for depression and anxiety disorders in cardiovascular disease patients: Results from the CHAMPS pilot-feasibility trial. Frontiers in Psychiatry, 13, 741039.
Castro-Camacho, L., Barlow, D. H., García, N., Farchione, T. J., Idrobo, F., Rattner, M., Quant, D. M., González, L., & Moreno, J. D. (2023). Effects of a contextual adaptation of the Unified Protocol in multiple emotional disorders in individuals exposed to armed conflict in colombia: A randomized clinical trial. JAMA Psychiatry, 80(10), 991–999.
Lau, W., Chisholm, K., Gallagher, M. W., Felmingham, K., Murray, K., Pearce, A., Doyle, N., Alexander, S., O’Brien, H., Putica, A., Khatri, J., Bockelmann, P., Hosseiny, F., Librado, A., Notarianni, M., & O’Donnell, M. L. (2023). Comparing the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders to prolonged exposure for the treatment of PTSD: Design of a non-inferiority randomized controlled trial. Contemporary Clinical Trials Communications, 33, 101134.
Sherrill, A. M., Mehta, M., Patton, S. C., Sprang Jones, K., Hellman, N., Chrysosferidis, J., Yasinski, C. W., Rothbaum, B. O., & Rauch, S. A. M. (2024). Effectiveness of the massed delivery of unified protocol for emotional disorders within an intensive outpatient program for military service members and veterans. Psychological Services, No Pagination Specified-No Pagination Specified.
Rosenthal, M. Z. (2024). The unified protocol for transdiagnostic treatment of emotional disorders for misophonia: A pilot trial exploring acceptability and efficacy. Frontiers in Psychology, 14.
Peláez T, López-Carrilero R, Espinosa V, Balsells S, Ochoa S, Osma J. Efficacy of the unified protocol for transdiagnostic treatment of comorbid emotional disorders in patients with ultra high risk for psychosis: Results of a randomized controlled trial. J Affect Disord. 2024 Dec 15;367:934-943
Meyer, E. C., Roth, S. G., Coe, E., Taylor, D. J., & Gulliver, S. B. (2025). Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders. Frontiers in health services, 5, 1452976. https://doi.org/10.3389/frhs.2025.1452976
Engen, M. J., Lyngstad, S. H., Eikenæs, E., Vøllestad, J., Høegh, M. C., Lagerberg, T. V., & Aminoff, S. R. (2025). A mixed methods pilot feasibility study of the unified protocol group psychotherapy for early bipolar disorder. Frontiers in psychiatry, 16, 1524243. https://doi.org/10.3389/fpsyt.2025.1524243
Peláez T, López-Carrilero R, Espinosa V, Balsells S, Fusar-Poli P, Ochoa S, Osma J. Impact of the Unified Protocol on Attenuated Psychotic Symptoms, Cognitive Biases and Cognitive Insight in Patients at Ultra High Risk (UHR) for Psychosis: Secondary Results of a Pilot Randomized Controlled Trial. J Clin Psychol. 2026 Jun;82(6):915-926. doi: 10.1002/jclp.70117. Epub 2026 Feb 24. PMID: 41734262; PMCID: PMC13127844.
Neuroticism and aversive reactions to emotions
Sauer-Zavala, S., Boswell, J. F., Gallagher, M. W., Bentley, K. H., Ametaj, A., & Barlow, D. H. (2012). The role of negative affectivity and negative reactivity to emotions in predicting outcomes in the unified protocol for the transdiagnostic treatment of emotional disorders. Behaviour Research and Therapy, 50(9), 551–557.
Sauer-Zavala, S., Fournier, J. C., Steele, S. J., Woods, B. K., Wang, M., Farchione, T. J., & Barlow, D. H. (2021). Does the unified protocol really change neuroticism? Results from a randomized trial. Psychological Medicine, 51(14), 2378–2387.
Elhusseini, S. A., Cravens, L. E., Southward, M. W., & Sauer-Zavala, S. (2022). Associations between improvements in aversive reactions to negative emotions and increased quality of life in the unified protocol. Journal of Behavioral and Cognitive Therapy, 32(1), 25–32.
Zemestani, M., Ommati, P., Rezaei, F., & Gallagher, M. W. (2022). Changes in neuroticism- related constructs over the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in patients on an optimal dose of SSRI. Personality Disorders, 13(2), 171–181.
Semcho, S. A., Southward, M. W., Stumpp, N. E., Smith, M. M., Fruhbauerova, M., & Sauer- Zavala, S. (2023). Within-person changes in aversive reactivity predict session-to-session reductions in anxiety and depression in the unified protocol. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 1–14.
Internet-delivered UP
Tulbure, B. T., Rusu, A., Sava, F. A., Sălăgean, N., & Farchione, T. J. (2018). A web-based transdiagnostic intervention for affective and mood disorders: Randomized controlled trial. JMIR Mental Health, 5(2), e36.
González-Robles, A., Díaz-García, A., García-Palacios, A., Roca, P., Ramos-Quiroga, J. A., & Botella, C. (2020). Effectiveness of a transdiagnostic guided internet-delivered protocol for emotional disorders versus treatment as usual in specialized care: Randomized controlled trial. Journal of Medical Internet Research, 22(7), e18220.
Schaeuffele, C., Bär, J., Buengener, I., Grafiadeli, R., Heuthaler, E., Strieder, J., Ziehn, P., Knaevelsrud, C., Renneberg, B., & Boettcher, J. (2022). Transdiagnostic processes as mediators of change in an internet-delivered intervention based on the Unified Protocol. Cognitive Therapy and Research, 46(2), 273–286.
Schaeuffele, C., Homeyer, S., Perea, L., Scharf, L., Schulz, A., Knaevelsrud, C., Renneberg, B., & Boettcher, J. (2022). The unified protocol as an internet-based intervention for emotional disorders: Randomized controlled trial. PLOS ONE, 17(7), e0270178.
Timulak, L., Richards, D., Bhandal-Griffin, L., Healy, P., Azevedo, J., Connon, G., Martin, E., Kearney, A., O’Kelly, C., Enrique, A., Eilert, N., O’Brien, S., Harty, S., González-Robles, A., Eustis, E. H., Barlow, D. H., & Farchione, T. J. (2022). Effectiveness of the internet-based Unified Protocol transdiagnostic intervention for the treatment of depression, anxiety and related disorders in a primary care setting: A randomized controlled trial. Trials, 23(1), 721.
Martínez-García L, Fadrique-Jiménez A, -Galán VF, Flors CR, Osma J. RegulEm, an unified protocol based-app for the treatment of emotional disorders: a parallel mixed methods usability and quality study. BMC Med Inform Decis Mak. 2024 Sep 27;24(1):267
Elizabeth H. Eustis, Maya Nauphal, Brittany Jaso, Daniella Spencer-Laitt, Lauren Woodard, Todd J. Farchione, David H. Barlow, Development and Pilot Testing of an Internet-Based Version of the Unified Protocol That Targets Positive Affect Regulation: A Treatment Development Report, Cognitive and Behavioral Practice, 2024, , ISSN 1077-7229
Schaeuffele C, Knaevelsrud C, Renneberg B, Boettcher J. Understanding change from the patient perspective in a transdiagnostic Internet-based intervention for emotional disorders: a qualitative content analysis. Cogn Behav Ther. 2024 Sep 10:1-18. doi: 10.1080/16506073.2024.2399173. Epub ahead of print. PMID: 39255048.
Martínez-García, L., Belaunzaran Mendizabal, J., Santos Goñi, M., Miralles, I., & Osma, J. (2025). RegulEm, a smartphone app based on the unified protocol for the transdiagnostic treatment of emotional disorders: Description of its application in blended format in a clinical case. Digital Health, 11, 20552076241292418.
Teplow, D., Spencer-Laitt, D., Long, L. J., Hey, A. J., Moreno, J. D., & Farchione, T. J. (2025). Strengths use and emotional disorder symptom reduction during a transdiagnostic cognitive behavioral therapy: A random-intercept cross-lagged panel model study. Psychotherapy, 62(2), 220–234. https://doi.org/10.1037/pst0000553
Socias-Soler, J., Francisco, C., Martínez-García, L., Peris-Baquero, O., & Osma, J. (2025). Unified Protocol for Emotional Disorders in University Students: Protocol for a Randomized Trial of Online and Blended Formats. International journal of methods in psychiatric research, 34(2), e70025. https://doi.org/10.1002/mpr.70025
Long-term outcomes
Bullis, J. R., Fortune, M. R., Farchione, T. J., & Barlow, D. H. (2014). A preliminary investigation of the long-term outcome of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Comprehensive Psychiatry, 55(8), 1920–1927.
Eustis, E. H., Gallagher, M. W., Tirpak, J. W., Nauphal, M., Farchione, T. J., & Barlow, D. H. (2020). The Unified Protocol compared with diagnosis-specific protocols for anxiety disorders: 12-month follow-up from a randomized clinical trial. General Hospital Psychiatry, 67, 58–61.
Bullis, J. R., Eustis, E. H., Curreri, A. J., Cardona, N. D., Woods, B. K., Rosellini, A. J., Barlow, D. H., & Farchione, T. J. (2023). The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders compared with diagnosis-specific protocols for anxiety disorders: A three- year follow-up. Journal of Mood & Anxiety Disorders, 3.
Group delivery
Bullis, J. R., Sauer-Zavala, S., Bentley, K. H., Thompson-Hollands, J., Carl, J. R., & Barlow, D. H. (2015). The unified protocol for transdiagnostic treatment of emotional disorders: Preliminary exploration of effectiveness for group delivery. Behavior Modification, 39(2), 295–321.
Laposa, J. M., Mancuso, E., Abraham, G., & Loli-Dano, L. (2017). Unified Protocol Transdiagnostic Treatment in group format. Behavior Modification, 41(2), 253–268.
Reinholt, N., Aharoni, R., Winding, C., Rosenberg, N., Rosenbaum, B., & Arnfred, S. (2017). Transdiagnostic group CBT for anxiety disorders: The unified protocol in mental health services. Cognitive Behaviour Therapy, 46(1), 29–43.
Osma, J., Navarro Haro, M. V., Peris Baquero, Ó., & Suso Ribera, C. (2022). Unified Protocol in a group format for improving specific symptoms of emotional disorders in the spanish public health system. Psicothema, 34(1), 25–34.
Reinholt, N., Hvenegaard, M., Christensen, A. B., Eskildsen, A., Hjorthøj, C., Poulsen, S., Arendt, M. B., Rosenberg, N. K., Gryesten, J. R., Aharoni, R. N., Alrø, A. J., Christensen, C. W., & Arnfred, S. M. (2022). Transdiagnostic versus diagnosis-specific group cognitive behavioral therapy for anxiety disorders and depression: A randomized controlled trial. Psychotherapy and Psychosomatics, 91(1), 36–49.
Ayuso-Bartol, A., Gómez-Martínez, M.Á., Riesco-Matías, P. et al. Systematic Review and Meta-analysis of the Efficacy and Effectiveness of the Unified Protocol for Emotional Disorders in Group Format for Adults. Int J Ment Health Addiction (2024)
Socias-Soler J, Peris-Baquero O, Martínez-García L, Prieto-Rollán I, Osma J. Unified protocol in online group versus blended format for treating emotional disorders in university students: Preliminary results on feasibility at 6-month follow-up. Psychol Psychother. 2026 Jun;99(2):645-668. doi: 10.1111/papt.70047. Epub 2026 Feb 23. PMID: 41731322; PMCID: PMC13162187.
Prevention
Bentley, K. H., Boettcher, H., Bullis, J. R., Carl, J. R., Conklin, L. R., Sauer-Zavala, S., Pierre- Louis, C., Farchione, T. J., & Barlow, D. H. (2018). Development of a single-session, transdiagnostic preventive intervention for young adults at risk for emotional disorders. Behavior Modification, 42(5), 781–805.
Sauer-Zavala, S., Tirpak, J. W., Eustis, E. H., Woods, B. K., & Russell, K. (2021). Unified Protocol for the Transdiagnostic Prevention of Emotional Disorders: Evaluation of a brief, online course for college freshmen. Behavior Therapy, 52(1), 64–76.
Castro-Camacho, L., Díaz, M. M., & Barbosa, S. (2022). Effect of a group prevention program based on the unified protocol for college students in Colombia: A quasi-experimental study. Journal of Behavioral and Cognitive Therapy, 32(2), 111–123.
Bernstein, E. E., Bentley, K. H., Nock, M. K., Stein, M. B., Beck, S., & Kleiman, E. M. (2022). An Ecological momentary intervention study of emotional responses to smartphone-prompted CBT skills practice and the relationship to clinical outcomes. Behavior Therapy, 53(2), 267–280.
Hermoso, J., & Osma, J. (2022). Assessment of acceptability and initial effectiveness of a unified protocol prevention program to train emotional regulation skills in female nursing professionals during the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 19(9), 5715.
Kleiman, E. M., Bentley, K. H., Wacha-Montes, A., Taylor, M. E., Lozy, O., Conti, K., & Reese Mayer, W. (2022). A pilot implementation-effectiveness trial of a single-session telehealth workshop and smartphone-based cognitive behavioral intervention for managing emotions among college students. Behavior Therapy, 53(5), 1024–1036.
Bernstein, E. E., Shingleton, R. M., Finch, E. F., LeBlanc, N. J., Bentley, K. H., Barreira, P., & McNally, R. J. (2024). A roadmap to address stress in graduate students: How to develop and disseminate a student-led single-session evidence based intervention. Journal of American College Health: J of ACH, 1–8.
Toyomoto R, Furukawa TA, Noma H, Tajika A, Watanabe M, Honda Y, Banno C, Ogasawara S, Kitaori T, Sugiura-Ogasawara M, Goto S. Optimising internet-based cognitive-behavioural therapy programme to prevent perinatal depression: a unified protocol for two harmonised randomised controlled trials. BMJ Open. 2026 Feb 18;16(2):e099326. doi: 10.1136/bmjopen-2025-099326. PMID: 41708168; PMCID: PMC12918657.
Other papers of interest
Sauer-Zavala, S., Cassiello-Robbins, C., Ametaj, A. A., Wilner, J. G., & Pagan, D. (2019). Transdiagnostic treatment personalization: the feasibility of ordering Unified Protocol modules according to patient strengths and weaknesses. Behavior Modification, 43(4), 518–543.
Ametaj, A. A., Wilner Tirpak, J., Cassiello-Robbins, C., Snow, R., Rassaby, M. M., Beer, K., & Sauer-Zavala, S. (2021). A preliminary investigation of provider attitudes toward a transdiagnostic treatment: Outcomes from training workshops with the Unified Protocol. Administration and Policy in Mental Health, 48(4), 668–682.
Bentley, K. H., Cohen, Z. D., Kim, T., Bullis, J. R., Nauphal, M., Cassiello-Robbins, C., Sauer- Zavala, S., Sbi, S., Gallagher, M. W., Farchione, T. J., & Barlow, D. H. (2021). The nature, timing, and symptom trajectories of dropout from transdiagnostic and single-diagnosis cognitive- behavioral therapy for anxiety disorders. Behavior Therapy, 52(6), 1364–1376.
Farchione, T. J., Long, L. J., Spencer-Laitt, S., Moreno, J., & Barlow, D. H. (in press). State of the science: the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Behavior Therapy.
Sauer-Zavala, S., Rosellini, A. J., Bentley, K. H., Ametaj, A. A., Boswell, J. F., Cassiello- Robbins, C., Wilner Tirpak, J., Farchione, T. J., & Barlow, D. H. (2021). Skill acquisition during transdiagnostic treatment with the Unified Protocol. Behavior Therapy, 52(6), 1325–1338.
Southward, M. W., & Sauer-Zavala, S. (2022). Dimensions of skill use in the unified protocol: Exploring unique effects on anxiety and depression. Journal of Consulting and Clinical Psychology, 90(3), 246–257.
Cassiello-Robbins C, Ritschel LA, Mochrie KD, Edwards-Powell B, Byars K. The Unified Protocol or Dialectical Behaviour Therapy? Considerations for Choosing Between Two Evidence-Based Transdiagnostic Psychotherapies for Complex Patients. Clin Psychol Psychother. 2024 Sep-Oct;31(5):e3051. doi: 10.1002/cpp.3051. PMID: 39233457.
Farchione, T. J., Long, L. J., Spencer-Laitt, D., Moreno, J., Barlow, D. H., State of the Science: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders, Behavior Therapy, Volume 55, Issue 6, 2024, Pages 1189-1204, ISSN 0005-7894, https://doi.org/10.1016/j.beth.2024.04.007.
Croom, H., Southward, M., Sauer-Zavala, S., Testing Reciprocal Within-Person Changes in Aversive Reactions to Emotions and Skill Use in the Unified Protocol, Behavior Therapy, 2025, , ISSN 0005-7894, https://doi.org/10.1016/j.beth.2025.04.002
Wyatt, J., Walker, E., Erlich, A., Murphy, J. W., A case report on the massed delivery of the Unified Protocol with Veterans in an intensive treatment program with in-person and virtual formats, 2025, , ISSN 1077-7229,
https://doi.org/10.1016/j.cbpra.2026.02.001
https://doi.org/10.1016/j.cbpra.2026.02.001
Martínez-Borba V, Rodríguez-Márquez AE, Garcés-Arilla S, Peris-Baquero Ó, Navarro-Haro MV, Del Corral-Beamonte E, Osma J. Effectiveness and acceptability of the unified protocol for the transdiagnostic treatment of emotional disorders in people with long COVID-19: Study protocol for a randomized controlled trial. PLoS One. 2026 Feb 17;21(2):e0342908. doi: 10.1371/journal.pone.0342908. PMID: 41701690; PMCID: PMC12912558.
Burton C, Crowe L, Allan E, Singh M, Eckhardt S, Le Grange D, Ehrenreich-May J, Finchett C, Sawyer S, Dimitropoulos G. Family-Based Treatment + Unified Protocol for Avoidant/Restrictive Food Intake Disorder: An Exploratory Feasibility and Treatment Response Study in a Case Series of Adolescents. Int J Eat Disord. 2026 Feb 17. doi: 10.1002/eat.70061. Epub ahead of print. PMID: 41700505.