Unified Protocol

Domain II · Behavioural & cognitive · Barlow, Sauer-Zavala, Farchione · 2011

What it is

Sequence (2nd ed.)

Format

• Session count and format
• Typical length: 12 to 16 weekly individual sessions. In the large equivalence trial this meant 16 sessions within 21 weeks for GAD, social anxiety and OCD, and 12 sessions within 16 weeks for panic disorder. All eight modules were delivered whatever the session count.

Who practises it, and how they are trained or regulated

• Core modules. Modules 3 to 7 are the five "core" skill modules. The 2015 Pittsburgh training slides note that the physical-sensations module is completed even when bodily sensations are not the client's main focus.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• members comparing diagnoses. Steer back to the shared processes.
• the client attributing gains only to the therapist. Highlight what they did.
• strong affect as the core belief surfaces. Slow down and use the mindful stance.
• using the anchor as a distraction. It should bring the client into the present, not out of it.
• goals framed as removing emotions, such as "never feel nervous". Reframe them as doing things while feeling.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.