2 - (3 Min 4) Does Parent-only Intervention Work? A Real-world Study of the Unified Protocol for Adolescents with Emotional Disorders in China

Background
Adolescent emotional disorders represent a significant global public health concern due to high prevalence, frequent comorbidity, and limited pharmacotherapy response. The Unified Protocol for Adolescents (UP-A), targeting shared transdiagnostic mechanisms, has demonstrated robust efficacy internationally. Our team adapted the UP-A for Chinese youth and incorporated a parent intervention group, with prior studies confirming its effectiveness at both individual and family levels. Moreover, clinical observations suggested that improvements in parenting practices contributed to the alleviation of adolescent emotional symptoms. This study examined whether parent-only participation could yield significant improvements in adolescent outcomes within real-world clinical settings.
Methods
This real-world study compared three conditions: the parent-only (P) group, the parent-adolescent (P-A) group, and the treatment-as-usual (TAU) group. In addition to major depressive disorder and anxiety disorders, patients with bipolar disorder were also included. Both intervention groups received 12 weekly group-based sessions with 3-month follow-up. In the P group, only parents attended; in the P-A group, parents and adolescents participated in separate concurrent groups. The TAU group received routine outpatient care. Linear mixed-effects models with multiple imputation were used to examine changes across baseline, 4 weeks (T2), 8 weeks (T3), and post-treatment (T4).
Results
Ninety-nine adolescents (33 per group) and their parents (n=129) were enrolled. To date, 63 adolescents (21 per group) have completed intervention, with 5 dropouts (P: 2; P-A: 2; TAU: 1). Significant group × time interactions were found for CGI-S (F=3.32, p=0.01) and CGAS (F=3.52, p=0.005). Both intervention groups showed significant improvements over TAU. The P-A group demonstrated earlier CGI-S reductions from T3 (p′ < 0.001, d=1.16) with further gains at T4 (d=1.39), and significant CGAS increases at T4 (p′ < 0.001, d=1.10). The P group showed comparable CGI-S improvement from T3 (p′ < 0.001, d=0.96), with robust enhancement at T4 (CGI-S: d=1.85; CGAS: d=1.08). The TAU group showed only moderate effects at T4 (CGI-S: d=0.90; CGAS: d=0.51).
For RCADS scores, group × time interactions were non-significant (F=1.63–1.84, p>0.10), but the P group demonstrated significant within-group reductions at T3–T4 (anxiety: p′≤0.007, d=0.63–0.66; depression: p′ < 0.001, d=0.71–0.88).
Conclusion
Both parent-only and parent-adolescent UP-A interventions produced clinically meaningful improvements in adolescent symptoms and functioning, each with distinct advantages. The P-A approach may facilitate direct skill acquisition, while the P approach offers a viable alternative for families where adolescents are reluctant to engage but parents remain motivated. These findings support flexible intervention delivery models within routine clinical practice.