Efficacy and feasibility of an adapted version of the unified protocol on relieving depression and anxiety symptoms in adolescents

Depression and anxiety symptoms are increasingly common among adolescents, prompting a focus on effective treatments. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) has shown mixed results. Researchers suggested that the brief mindfulness component in the original UP-A might limit its effectiveness. To enhance the UP-A, this study integrated extended mindfulness practices. Additionally, based on the ecological system theory, we added social support practices, aiming to enhance the adolescents' ability of utilize resources in their environments to overcome life difficult circumstances. We recruited 53 adolescents with high depression and/or anxiety symptoms, randomly assigning them to an adapted UP-A group (n = 28) or a waitlist control group (n = 25). Participants were assessed on depression, anxiety, mindfulness, distress tolerance, and social support before, after, and one month following the intervention. The intervention group received an eight-week program (once a week), and the waitlist group received no intervention. Results showed significant time and group interaction effects on depression, mindfulness, and distress tolerance, but not on anxiety and social support. The intervention group had significantly lower depression levels post- intervention, but not at follow-up. For the waitlist control group, the differences of depression among pre-intervention, post-intervention and follow-up were not significant. Mindfulness levels increased post-intervention but did not change at follow-up. For the waitlist control group, levels of mindfulness did not change significantly at post-intervention compared with pre-intervention. It decreased from post-intervention to follow-up significantly. Compared to pre-intervention, distress tolerance did not significantly differ during post-intervention and follow-up among the intervention group. However, it decreased from pre-intervention to post-intervention in the waitlist group while increased from post-intervention to follow-up. The study concludes that the adapted UP-A effectively reduces depression symptoms among Chinese adolescents and has moderate feasibility. This research supports the efficacy of the UP-A in China and adds to intervention strategies for adolescent depression.