Community Study of Outcome Monitoring for Emotional Disorders in Teens (COMET)

Emotional disorders, including an array of anxiety and depressive syndromes, are the most common psychiatric disorders among adolescents, are highly comorbid, and severely impair the lives of youth and their families. Extant evidence-based therapies target only single disorders or symptom domains, are often not adopted by community mental health center (CMHC) clinicians, and have only modest effect sizes. To improve the clinical outcomes of these youth, the proposed study tests the effectiveness of two novel interventions (a transdiagnostic intervention, the Unified Protocol for the Treatment of Emotional Disorders in Adolescents, and a measurement and feedback system, the Youth Outcomes Questionnaires) relative to usual care in CMHCs.


This research study is led by Dr. Peter Thunfors.

Participation details:

January 01, 2016
Mental Health, Pediatrics
Baystate Medical Center, 759 Chestnut St, Springfield, MA

Inclusion Criteria:

  • Male or female adolescents between the ages of 12-18 years at the time of enrollment with clinically significant symptoms of anxiety or depression at baseline. Evidence of clinically significant symptoms will be defined as a Clinical Severity Rating (CSR) greater than or equal to 4 on any DSM-5 defined anxiety disorder (e.g., generalized anxiety disorder, social phobia, selective mutism, separation anxiety disorder) or depressive disorder (e.g., major depressive disorder, persistent depressive disorder), or an adjustment disorder with depressed mood, anxiety, or mixed anxiety and depressed mood.
  • The adolescent is determined by the community mental health center to be eligible for outpatient psychosocial services at the clinic and determined by the study IE to be appropriate for outpatient psychosocial intervention (e.g., no major cognitive impairment or active suicidality) based on clinical interview.
  • The adolescent lives (for at least 50% time) with legal guardian and this guardian is willing to attend treatment sessions and participate in study assessments (every effort will be made to encourage the same caregiver to participate in all assessments).
  • Adolescent and parent/guardian are able to complete all study procedures in English or Spanish.

Exclusion Criteria:

  • Adolescents will be excluded if they are receiving concurrent psychotherapy, family therapy or similar psychosocial interventions.
  • Adolescents who are currently suicidal or who have engaged in suicidal behaviors within the past 6 months will be excluded and referred for appropriate clinical intervention.
  • Adolescents with a current substance abuse disorder as determined using the ADIS-5-C/P, will be excluded.
  • Adolescents with a reported history of intellectual disability or for whom there is substantial evidence (e.g., multiple learning disorders, extensive school-based accommodations for learning) that the cognitive level of the UP-A would make it inappropriate as an individual therapy modality, as determined via Family Background Questionnaire and/or based on PI judgement, will be excluded.
  • Given additional complexities obtaining informed consent, adolescents who are currently placed in the foster care system will be excluded.
Interventional (Clinical Trial)