A systematic review of Unified Protocol applications with adult populations: Facilitating widespread dissemination via adaptability

Abstract The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) was designed to be a flexible, evidence-based intervention that could treat a wide range of emotional disorders. The purpose of this systematic review is to summarize (1) the range of presenting problems to which the UP has been applied with adult patients, and (2) the settings in which the protocol has been used, as well as any modifications made to it. Using PRISMA guidelines, we conducted a literature search of PsychInfo, PubMed, Proquest Dissertations and Theses, and Web of Science. The 77 studies included in this review indicated the UP has been applied to a wide range of presenting problems including anxiety, depressive, bipolar, traumatic-stressor, substance use, eating, borderline personality, insomnia, and physical health disorders. Additionally, the UP has been applied to non-diagnosable problems such as non-suicidal self-injury, subclinical presentations, and sexual minority stress. The strongest base of evidence for the UP is among Caucasian females in the United States with anxiety-related or depressive disorders. Numerous adaptions of the UP were present in the literature. Overall, results suggest the UP can be flexibly applied to a range of diagnostic presentations. However, many studies reviewed were preliminary and further research is needed.