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Youth Top Problems and Early Treatment Response to the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents

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Abstract

The Top Problems assessment is an idiographic measure of client concerns that may allow clinicians to identify early treatment response. Few studies have examined early response to evidence-based therapies using Top Problems. We collected weekly Top Problems ratings from 95 youth with emotional disorders who received treatment using the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/UP-A). We assessed Top Problems rating change from session 1 to session 4, the role of pre-treatment variables in early Top Problems rating change, and the role of early Top Problems rating change in post-treatment symptom outcomes. Top Problems ratings decreased significantly from session 1 to session 4. Younger child age and higher parent cognitive flexibility were associated with early Top Problems improvement. Controlling for pre-treatment, early Top Problems rating change did not explain the variance in post-treatment outcomes. Future research should examine Top Problems trajectories over treatment course.

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  1. Department of Psychology, University of Miami, Coral Gables, FL, USA

    Lauren Milgram, Niza A. Tonarely & Jill Ehrenreich-May

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  1. Lauren Milgram
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Correspondence to Lauren Milgram.

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Dr. Ehrenreich-May is the first author of the therapist guide and workbooks for the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C and UP-A) and receives royalties from these publications. She also receives payments for UP-C and UP-A clinical trainings, consultation and implementation support services. All other authors report no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Milgram, L., Tonarely, N.A. & Ehrenreich-May, J. Youth Top Problems and Early Treatment Response to the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents. Child Psychiatry Hum Dev 53, 582–598 (2022). https://doi.org/10.1007/s10578-021-01151-4

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