Acceptability and preliminary effectiveness of the Unified Protocol in blended format in the Spanish public mental...

This study evaluated the acceptability and preliminary effectiveness of the UP in blended format, combining face-to-face UP sessions with the use of the UP-App, versus Treatment as Usual (TAU) for treating Emotional disorders (ED) in Spanish specialized mental health units.

A total of 76 adults presenting a diagnosis of ED were randomly assigned to UP + APP (n = 40) or TAU (n = 36) and completed self-report questionnaires at baseline, 3 and 6 months after treatment onset.

Improvements in both conditions for ODSIS (b = -2.84; T = -2.36), depressed mood (b = -6.85; T = 0.01), and the describing facet of mindfulness were found (b = 4.01; T = 2.31). No significant differences were found between both conditions in terms of treatment outcomes or in the Time∗Condition interaction. However, engagement with the UP-App understood as number of completed UP-App modules was related to improvements in emotion regulation and the acting with awareness facet of mindfulness, especially at 6 months, suggesting a possible time-dependent effect and UP-App modules completed. The UP-App showed good usability at 3 months (76.47) and excellent at 6 months (83.96), but low adherence (7.5% completers). Satisfaction with the treatment was similar in both conditions.

This study suggests that the UP + APP may be as effective as TAU for ED in the SNHS. However, high dropout rates and low adherence to the UP-App constrain these results. Future research should explore a modified implementation format of the UP + APP ensuring a greater presence of the therapist, as well as an updated version of the UP-App incorporating feedback from the current study and new functionalities, in an RCT with a larger sample, as well as comparing standard UP vs UP + APP to determine the unique contribution of the UP-App on effectiveness, adherence, and user experience with UP.Trial registration:ClinicalTrials.gov identifier: NCT04304911.