(PS10-C68) Comparison of Group and Individual Treatment Delivery of the Unified Protocol for Children

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C; Ehrenreich-May et al., 2017) is an evidence-based psychotherapy designed to target core difficulties associated with a range of internalizing disorders in youth (Kennedy et al., 2019). The UP-C was originally designed for delivery in a group format (Bilek & Ehrenreich-May, 2012); however, the treatment is often delivered individually to clients in one-on-one treatment with minor adaptations (Ehrenreich-May et al., 2017). For example, UP-C groups are 90-minute sessions with concurrent child-directed and parent-directed groups. By contrast, individual UP-C is 50 minutes, during which time is split at the therapists’ discretion between child-directed and parent-directed content. Prior randomized control trials comparing group versus individual deliveries of anxiety-focused cognitive behavioral therapies for children have indicated similar outcomes between treatment formats (e.g., Flannery-Schroeder et al., 2000; Liber et al., 2008), but this question has not been explicitly examined for the UP-C. We hypothesized that there would not be differences in child symptom outcomes between group and individual delivery of the UP-C as measured by the child- and parent-reported Revised Children's Anxiety and Depression Scale (RCADS; Chorpita et al., 2000). However, given the more consistent and extensive parent-directed content delivered in UP-C group compared with individual UP-C, we anticipated better parent mental health outcomes on the Depression Anxiety Stress Scales (DASS; Lovibond & Lovibond, 1995) and greater decreases in family accommodation (measured on the Family Accommodation Scale—Anxiety [FASA; Lebowitz et al., 2013]) for families receiving UP-C group. Using a paired samples t-test, we compared mean total scores on the RCADS, DASS, and FASA at baseline and post-treatment and found significant improvements on all measures. Across both delivery formats of the UP-C, improvements were observed in mean child-reported RCADS total scores at baseline (M = 41.59, SD = 26.58) and post-treatment (M = 30.22, SD = 24.82; t(100) = 5.25, p < .001) and in parent-reported RCADS total scores at baseline (M = 36.84; SD = 16.70) and post-treatment (M = 24.73, SD = 14.73; t(130) = 8.57, p < .001). Improvements in mean scores on the DASS from baseline (M = 13.84, SD = 12.97) to post-treatment (M = 8.87, SD = 10.26; t(118) = 5.55, p < .001) and on the FASA from baseline (M = 12.27, SD = 6.48) to post-treatment (M = 9.27, SD = 4.94; t(44) = 3.42, p = .001) were also noted. Using independent samples t-tests, there were no significant differences between delivery modalities in terms of changes on the child- and parent-reported RCADS total, anxiety index, and depression index scores (all p’s > .05). Contrary to predictions, there also were no differences in mean change on parent self-reported DASS total, anxiety index, and depression index scores and no significant mean changes in FASA scores between group and individual treatment modalities (all p’s > .05). Findings indicate that the UP-C is effective in improving children’s and parents’ symptoms, and that families benefit similarly when material is delivered in both individual and group formats.