A Socially Distanced Case Study: Implementing the Unified Protocol-Adolescent in the Treatment of Comorbid Depression and Anxiety via Telehealth

Abstract

Anxiety and depression are two of the most common mental health diagnoses in adolescents, with higher prevalence rates for gender-nonconforming youth relative to an age-equivalent population of cisgender youth (Veale et al., 2017). This case study examined the effectiveness of the Unified Protocol-Adolescent (UP-A) for a gender-nonconforming 13-year-old diagnosed with both generalized anxiety and mild depression. Amid the ongoing COVID-19 pandemic, this transdiagnostic implementation provided psychoeducation and targeted emotion identification, present-moment awareness, cognitive restructuring, and problem-solving over 21 sessions. Outcome data demonstrated significant reductions in anxiety and depression symptoms, with a notable qualitative change on three subjective measures of anxiety/depression symptoms, as ratings moved from clinical to nonclinical score ranges. Moreover, outcome data demonstrated the potential efficacy of the UP-A administered via telehealth for nonbinary youth with comorbid anxiety and depression. Clinical and research implications regarding the utility of implementing a flexible, transdiagnostic approach to treating diverse adolescents’ emotional disorders are discussed.