{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T12:53:40Z","timestamp":1781873620921,"version":"3.54.5"},"reference-count":69,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:00:00Z","timestamp":1777680000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":48,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Prim. Care"],"DOI":"10.1186\/s12875-026-03347-w","type":"journal-article","created":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:24:39Z","timestamp":1777681479000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-effectiveness and acceptability study of the Unified Protocol for the treatment of emotional disorders in brief groups in primary care services of the Spanish National Health System: a study protocol"],"prefix":"10.1186","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7293-318X","authenticated-orcid":false,"given":"Jorge","family":"Osma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5748-8832","authenticated-orcid":false,"given":"Miranda","family":"S\u00e1nchez-Albentosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6883-9165","authenticated-orcid":false,"given":"Iv\u00e1n","family":"Prieto-Roll\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7715-0925","authenticated-orcid":false,"given":"Alba","family":"Fadrique-Jim\u00e9nez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9726-3250","authenticated-orcid":false,"given":"Mar\u00eda Vicenta","family":"Navarro-Haro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2437-1207","authenticated-orcid":false,"given":"\u00d3scar","family":"Peris-Baquero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,2]]},"reference":[{"key":"3347_CR1","unstructured":"Institute for Health Metrics and Evaluation. Global Health Data Exchange (GHDx). 2023. Seattle (WA): IHME. Available from: https:\/\/www.healthdata.org\/spain?language=149."},{"issue":"2","key":"3347_CR2","doi-asserted-by":"publisher","first-page":"e12278","DOI":"10.1111\/cpsp.12278","volume":"26","author":"JR Bullis","year":"2019","unstructured":"Bullis JR, Boettcher H, Sauer-Zavala S, Farchione TJ, Barlow DH. What is an emotional disorder? A transdiagnostic mechanistic definition with implications for assessment, treatment, and prevention. Clin Psychol Sci Pract. 2019;26(2):e12278. https:\/\/doi.org\/10.1111\/cpsp.12278.","journal-title":"Clin Psychol Sci Pract"},{"key":"3347_CR3","volume-title":"World mental health today: latest data","author":"World Health Organization","year":"2025","unstructured":"World Health Organization. World mental health today: latest data. Geneva: World Health Organization; 2025."},{"issue":"10312","key":"3347_CR4","doi-asserted-by":"publisher","first-page":"1700","DOI":"10.1016\/s0140-6736(21)02143-7","volume":"398","author":"DF Santomauro","year":"2021","unstructured":"Santomauro DF, Herrera AMM, Shadid J, Zheng P, Ashbaugh C, Pigott DM, Abbafati C, Adolph C, Amlag JO, Aravkin AY, et al. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet. 2021;398(10312):1700\u201312. https:\/\/doi.org\/10.1016\/s0140-6736(21)02143-7.","journal-title":"Lancet"},{"key":"3347_CR5","unstructured":"Ministerio de Sanidad [Ministry of Health]. Informe Anual del Sistema Nacional de Salud 2023 [Annual Report of the National Health System 2023] [Report in Spanish]. 2024. Madrid: Ministry of Health. Available from: https:\/\/www.sanidad.gob.es\/estadEstudios\/estadisticas\/sisInfSanSNS\/tablasEstadisticas\/InfAnualSNS2023\/INFORME_ANUAL_2023.pdf."},{"key":"3347_CR6","unstructured":"Ministry of health. Annual Report of the National Health System. 2022. 2023. Madrid: Ministerio de Sanidad. Available from: https:\/\/www.sanidad.gob.es\/estadEstudios\/estadisticas\/sisInfSanSNS\/tablasEstadisticas\/InfAnualSNS2022\/Inf_anual_2022_Res_Ejecutivo.pdf."},{"key":"3347_CR7","doi-asserted-by":"publisher","DOI":"10.1787\/7a7afb35-en","volume-title":"Health at a Glance 2023: OECD Indicators","author":"Organisation for Economic Co-operation and Development (OECD)","year":"2023","unstructured":"Organisation for Economic Co-operation and Development (OECD). Health at a Glance 2023: OECD Indicators. Paris: OECD Publishing; 2023. https:\/\/doi.org\/10.1787\/7a7afb35-en."},{"key":"3347_CR8","unstructured":"World Health Organization. Scaling up mental health services within the PHC approach: Lessons from the WHO European Region. 2025. Copenhagen: World Health Organization, Regional Office for Europe Available from: https:\/\/iris.who.int\/bitstream\/handle\/10665\/381029\/WHO-EURO-2025-11303-51075-77740-eng.pdf?sequence=2&isAllowed=y."},{"issue":"1","key":"3347_CR9","doi-asserted-by":"publisher","first-page":"31","DOI":"10.5093\/anyes2021a5","volume":"27","author":"X Fern\u00e1ndez-Garc\u00eda","year":"2021","unstructured":"Fern\u00e1ndez-Garc\u00eda X. Status of Clinical Psychology in the National Health System (NHS) and growth perspectives. Ansiedad Estr\u00e9s. 2021;27(1):31\u201340. https:\/\/doi.org\/10.5093\/anyes2021a5.","journal-title":"Ansiedad Estr\u00e9s"},{"issue":"2","key":"3347_CR10","doi-asserted-by":"publisher","first-page":"71","DOI":"10.55414\/ap.v40i2.1414","volume":"40","author":"I Cu\u00e9llar Flores","year":"2022","unstructured":"Cu\u00e9llar Flores I, Fern\u00e1ndez Garz\u00f3n L, F\u00e9lix-Alc\u00e1ntara MP, Manzano Olivares B, De La Vega Rodr\u00edguez I, Gonz\u00e1lez MF, Albarsanz MLP, Rivera SV, Belmonte MJM. Indicadores asistenciales y est\u00e1ndares de calidad asistencial para la psicolog\u00eda cl\u00ednica en los centros de salud mental del Sistema Madrile\u00f1o de Salud evaluados por sus profesionales [Article in Spanish]. Apunt Psicol. 2022;40(2):71\u201386. https:\/\/doi.org\/10.55414\/ap.v40i2.1414.","journal-title":"Apunt Psicol"},{"issue":"2\u20133","key":"3347_CR11","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1016\/j.anyes.2017.10.003","volume":"23","author":"P Ruiz-Rodr\u00edguez","year":"2017","unstructured":"Ruiz-Rodr\u00edguez P, Cano-Vindel A, Navarro RM, Medrano L, Moriana JA, Aguado CB, Cabr\u00e9 GJ, Gonz\u00e1lez-Blanch C. Economic impact and burden of common mental disorders in Spain: A systematic and critical review. Ansiedad Estr\u00e9s. 2017;23(2\u20133):118\u201323. https:\/\/doi.org\/10.1016\/j.anyes.2017.10.003.","journal-title":"Ansiedad Estr\u00e9s"},{"key":"3347_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2023\/1981377","volume":"2023","author":"\u00d3 Peris-Baquero","year":"2023","unstructured":"Peris-Baquero \u00d3, Osma J. Unified Protocol for the transdiagnostic treatment of emotional disorders in group format in Spain: Results of a noninferiority randomized controlled trial at 15 months after treatment onset. Depress Anxiety. 2023;2023:1\u201316. https:\/\/doi.org\/10.1155\/2023\/1981377.","journal-title":"Depress Anxiety"},{"key":"3347_CR13","unstructured":"Ministry of Health. Mental Health Strategy of the National Health System 2025\u20132027. 2025. Madrid: Ministry of Health. Available from: https:\/\/www.sanidad.gob.es\/areas\/calidadAsistencial\/estrategias\/saludMental\/docs\/Plan_de_accion_para_la_salud_mental_v2.6.pdf."},{"key":"3347_CR14","volume-title":"Common mental health problems: Identification and pathways to care. Clinical guideline No. CG123","author":"National Institute for Health and Care Excellence (NICE)","year":"2011","unstructured":"National Institute for Health and Care Excellence (NICE). Common mental health problems: Identification and pathways to care. Clinical guideline No. CG123. London: NICE; 2011."},{"key":"3347_CR15","unstructured":"Consejo General de la Psicolog\u00eda de Espa\u00f1a [General Council of Psychology of Spain]. Evoluci\u00f3n de la asistencia psicol\u00f3gica en la AP espa\u00f1ola [Evolution of psychological care in Spanish primary care] [Report in Spanish]. 2023. Available from: https:\/\/www.infocop.es\/evolucion-de-la-asistencia-psicologica-en-la-ap-espanola\/?cn-reloaded=1."},{"issue":"2","key":"3347_CR16","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1176\/ps.62.2.pss6202_0152","volume":"62","author":"A Gabilondo","year":"2011","unstructured":"Gabilondo A, Rojas-Farreras S, Rodr\u00edguez A, Fern\u00e1ndez A, Pinto-Meza A, Vilagut G, Haro JM, Alonso J. Use of primary and specialized mental health care for a major depressive episode in Spain by ESEMeD respondents. Psychiatr Serv. 2011;62(2):152\u201361. https:\/\/doi.org\/10.1176\/ps.62.2.pss6202_0152.","journal-title":"Psychiatr Serv"},{"issue":"4","key":"3347_CR17","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1037\/cps0000009","volume":"28","author":"J Corpas","year":"2021","unstructured":"Corpas J, Moriana JA, Vencesl\u00e1 JF, G\u00e1lvez-Lara M. Brief psychological therapies for emotional disorders in primary care: A systematic review and meta-analysis. Clin Psychol Sci Pract. 2021;28(4):363\u201376. https:\/\/doi.org\/10.1037\/cps0000009.","journal-title":"Clin Psychol Sci Pract"},{"key":"3347_CR18","volume-title":"Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide","author":"DH Barlow","year":"2018","unstructured":"Barlow DH, Sauer-Zavala S, Farchione TJ, Latin HM, Ellard KK, Bullis JR, Bentley K, Boettcher H, Cassiello-Robbins C. Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide. 2nd ed. New York: Oxford University Press; 2018.","edition":"2"},{"key":"3347_CR19","doi-asserted-by":"publisher","first-page":"101852","DOI":"10.1016\/j.cpr.2020.101852","volume":"78","author":"C Cassiello-Robbins","year":"2020","unstructured":"Cassiello-Robbins C, Southward MW, Tirpak JW, Sauer-Zavala S. A systematic review of Unified Protocol applications with adult populations: Facilitating widespread dissemination via adaptability. Clin Psychol Rev. 2020;78:101852. https:\/\/doi.org\/10.1016\/j.cpr.2020.101852.","journal-title":"Clin Psychol Rev"},{"key":"3347_CR20","doi-asserted-by":"publisher","first-page":"101999","DOI":"10.1016\/j.cpr.2021.101999","volume":"87","author":"L Carlucci","year":"2021","unstructured":"Carlucci L, Saggino A, Balsamo M. On the efficacy of the unified protocol for transdiagnostic treatment of emotional disorders: A systematic review and meta-analysis. Clin Psychol Rev. 2021;87:101999. https:\/\/doi.org\/10.1016\/j.cpr.2021.101999.","journal-title":"Clin Psychol Rev"},{"issue":"2","key":"3347_CR21","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1037\/cps0000141","volume":"30","author":"SL Longley","year":"2023","unstructured":"Longley SL, Gleiser TS. Efficacy of the Unified Protocol: A systematic review and meta-analysis of randomized controlled trials. Clin Psychol Sci Pract. 2023;30(2):208\u201321. https:\/\/doi.org\/10.1037\/cps0000141.","journal-title":"Clin Psychol Sci Pract"},{"key":"3347_CR22","doi-asserted-by":"publisher","first-page":"101751","DOI":"10.1016\/j.cpr.2019.101751","volume":"72","author":"N Sakiris","year":"2019","unstructured":"Sakiris N, Berle D. A systematic review and meta-analysis of the Unified Protocol as a transdiagnostic emotion regulation-based intervention. Clin Psychol Rev. 2019;72:101751. https:\/\/doi.org\/10.1016\/j.cpr.2019.101751.","journal-title":"Clin Psychol Rev"},{"issue":"4","key":"3347_CR23","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1037\/0022-006X.68.4.580","volume":"68","author":"GC Davison","year":"2000","unstructured":"Davison GC. Stepped care: Doing more with less? J Consult Clin Psychol. 2000;68(4):580\u20135.","journal-title":"J Consult Clin Psychol"},{"issue":"1\u20133","key":"3347_CR24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jad.2013.02.030","volume":"149","author":"P Cuijpers","year":"2013","unstructured":"Cuijpers P, Huibers M, Ebert DD, Koole SL, Andersson G. How much psychotherapy is needed to treat depression? A meta-regression analysis. J Affect Disord. 2013;149(1\u20133):1\u201313. https:\/\/doi.org\/10.1016\/j.jad.2013.02.030.","journal-title":"J Affect Disord"},{"key":"3347_CR25","doi-asserted-by":"publisher","unstructured":"Juul S, Jakobsen JC, J\u00f8rgensen CK, Poulsen S, S\u00f8rensen P, Simonsen S. The difference between shorter- versus longer-term psychotherapy for adult mental health disorders: A systematic review with meta-analysis. BMC Psychiatry. 2023;23(1). https:\/\/doi.org\/10.1186\/s12888-023-04895-6.","DOI":"10.1186\/s12888-023-04895-6"},{"issue":"4","key":"3347_CR26","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1080\/10503307.2021.1952331","volume":"32","author":"J Corpas","year":"2022","unstructured":"Corpas J, Moriana JA, Vencesl\u00e1 JF, G\u00e1lvez-Lara M. Effectiveness of brief group transdiagnostic therapy for emotional disorders in primary care: A randomized controlled trial identifying predictors of outcome. Psychother Res. 2022;32(4):456\u201369. https:\/\/doi.org\/10.1080\/10503307.2021.1952331.","journal-title":"Psychother Res"},{"key":"3347_CR27","doi-asserted-by":"crossref","unstructured":"Peris\u2010Baquero \u00d3, Fadrique\u2010Jim\u00e9nez A, Prieto\u2010Rollan I, Camacho\u2010Guerrero L, Mart\u00ednez\u2010Lluesma S, Osma J. Brief versions of the unified protocol for transdiagnostic treatment of emotional disorders in Spanish primary care service: results of a feasibility pilot study.\u00a0J Clin Psychol. 2025;81(11):1103\u201317.","DOI":"10.1002\/jclp.70016"},{"key":"3347_CR28","volume-title":"Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5)","author":"TA Brown","year":"2014","unstructured":"Brown TA, Barlow DH. Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5). Oxford: Oxford University Press; 2014."},{"issue":"3","key":"3347_CR29","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1037\/a0036216","volume":"26","author":"KH Bentley","year":"2014","unstructured":"Bentley KH, Gallagher MW, Carl JR, Barlow DH. Development and validation of the Overall Depression Severity and Impairment Scale. Psychol Assess. 2014;26(3):815\u201330. https:\/\/doi.org\/10.1037\/a0036216.","journal-title":"Psychol Assess"},{"key":"3347_CR30","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.jad.2019.03.063","volume":"252","author":"J Osma","year":"2019","unstructured":"Osma J, Qu\u00edlez-Orden A, Suso-Ribera C, Peris-Baquero O, Norman SB, Bentley K, Sauer-Zavala S. Psychometric properties and validation of the Spanish versions of the Overall Anxiety and Depression Severity and Impairment Scales. J Affect Disord. 2019;252:9\u201318. https:\/\/doi.org\/10.1016\/j.jad.2019.03.063.","journal-title":"J Affect Disord"},{"issue":"4","key":"3347_CR31","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1002\/da.20182","volume":"23","author":"SB Norman","year":"2006","unstructured":"Norman SB, Cissell SH, Means-Christensen AJ, Stein MB. Development and validation of an Overall Anxiety Severity and Impairment Scale (OASIS). Depress Anxiety. 2006;23(4):245\u20139. https:\/\/doi.org\/10.1002\/da.20182.","journal-title":"Depress Anxiety"},{"issue":"2","key":"3347_CR32","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/s0005-7916(00)00012-4","volume":"31","author":"GJ Devilly","year":"2000","unstructured":"Devilly GJ, Borkovec TD. Psychometric properties of the credibility\/expectancy questionnaire. J Behav Ther Exp Psychiatry. 2000;31(2):73\u201386. https:\/\/doi.org\/10.1016\/s0005-7916(00)00012-4.","journal-title":"J Behav Ther Exp Psychiatry"},{"key":"3347_CR33","first-page":"159","volume-title":"Advances in group psychotherapy: Integrating research and practice","author":"KR MacKenzie","year":"1983","unstructured":"MacKenzie KR. The clinical application of a group climate measure. In: Dies RR, MacKenzie KR, editors. Advances in group psychotherapy: Integrating research and practice. New York: International Universities Press, Inc.; 1983. pp. 159\u201370."},{"issue":"142","key":"3347_CR34","doi-asserted-by":"publisher","first-page":"217","DOI":"10.4321\/s0211-57352022000200012","volume":"42","author":"VDF Garc\u00eda-Bard\u00f3n","year":"2022","unstructured":"Garc\u00eda-Bard\u00f3n VDF, V\u00e1zquez-Ramo E. El encuadre corredor terap\u00e9utico en psicoterapia grupal operativa: revisi\u00f3n del concepto y hallazgos. Rev Asoc Esp Neuropsiquiatr. 2022;42(142):217\u201334. https:\/\/doi.org\/10.4321\/s0211-57352022000200012.","journal-title":"Rev Asoc Esp Neuropsiquiatr"},{"issue":"1","key":"3347_CR35","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1080\/10503300500352500","volume":"16","author":"RL Hatcher","year":"2006","unstructured":"Hatcher RL, Gillaspy JA. Development and validation of a revised short version of the Working Alliance Inventory. Psychother Res. 2006;16(1):12\u201325. https:\/\/doi.org\/10.1080\/10503300500352500.","journal-title":"Psychother Res"},{"issue":"2","key":"3347_CR36","first-page":"298","volume":"27","author":"S Corbella","year":"2011","unstructured":"Corbella S, Botella L, G\u00f3mez AM, Herrero O, Pacheco M. Psychometric properties of Spanish version of Working Alliance Inventory-Short (WAI-S). Psicol. 2011;27(2):298\u2013301.","journal-title":"Psicol"},{"key":"3347_CR37","unstructured":"Chugani CD. Dialectical behavior therapy in college counseling centers: practical applications and theoretical considerations. University of South Florida. 2016."},{"issue":"4","key":"3347_CR38","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1007\/s13142-017-0465-5","volume":"7","author":"SJ Landes","year":"2017","unstructured":"Landes SJ, Rodriguez AL, Smith BN, Matthieu MM, Trent LR, Kemp J, Thompson C. Barriers, facilitators, and benefits of implementation of dialectical behavior therapy in routine care: Results from a national program evaluation survey in the Veterans Health Administration. Transl Behav Med. 2017;7(4):832\u201344. https:\/\/doi.org\/10.1007\/s13142-017-0465-5.","journal-title":"Transl Behav Med"},{"issue":"4","key":"3347_CR39","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1097\/00006842-200107000-00021","volume":"63","author":"C D\u00edez-Quevedo","year":"2001","unstructured":"D\u00edez-Quevedo C, Rangil T, Sanchez-Planell L, Kroenke K, Spitzer RL. Validation and utility of the patient health questionnaire in diagnosing mental disorders in 1003 general hospital Spanish inpatients. Psychosom Med. 2001;63(4):679\u201386. https:\/\/doi.org\/10.1097\/00006842-200107000-00021.","journal-title":"Psychosom Med"},{"issue":"9","key":"3347_CR40","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","volume":"16","author":"K Kroenke","year":"2001","unstructured":"Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606\u201313. https:\/\/doi.org\/10.1046\/j.1525-1497.2001.016009606.x.","journal-title":"J Gen Intern Med"},{"issue":"1","key":"3347_CR41","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/1477-7525-8-8","volume":"8","author":"J Garc\u00eda-Campayo","year":"2010","unstructured":"Garc\u00eda-Campayo J, Zamorano E, Ruiz MA, Pardo A, P\u00e9rez-P\u00e1ramo M, L\u00f3pez-G\u00f3mez V, Freire O, Rejas J. Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool. Health Qual Life Outcomes. 2010;8(1):8. https:\/\/doi.org\/10.1186\/1477-7525-8-8.","journal-title":"Health Qual Life Outcomes"},{"issue":"10","key":"3347_CR42","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","volume":"166","author":"RL Spitzer","year":"2006","unstructured":"Spitzer RL, Kroenke K, Williams JBW, L\u00f6we B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch Intern Med. 2006;166(10):1092\u20137. https:\/\/doi.org\/10.1001\/archinte.166.10.1092.","journal-title":"Arch Intern Med"},{"key":"3347_CR43","volume-title":"Wellbeing measures in primary health care: the DepCare Project [report on a WHO meeting]","author":"World Health Organization","year":"1998","unstructured":"World Health Organization. Wellbeing measures in primary health care: the DepCare Project [report on a WHO meeting]. Geneva: World Health Organization; 1998."},{"issue":"1","key":"3347_CR44","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1023\/b:joba.0000007455.08539.94","volume":"26","author":"KL Gratz","year":"2003","unstructured":"Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. J Psychopathol Behav Assess. 2003;26(1):41\u201354. https:\/\/doi.org\/10.1023\/b:joba.0000007455.08539.94.","journal-title":"J Psychopathol Behav Assess"},{"issue":"2","key":"3347_CR45","first-page":"139","volume":"19","author":"G Herv\u00e1s","year":"2008","unstructured":"Herv\u00e1s G, J\u00f3dar R. Spanish adaptation of the Difficulties in Emotion Regulation Scale. Cl\u00edn Salud. 2008;19(2):139\u201356.","journal-title":"Cl\u00edn Salud"},{"issue":"5","key":"3347_CR46","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1192\/bjp.180.5.461","volume":"180","author":"JC Mundt","year":"2002","unstructured":"Mundt JC, Marks IM, Shear MK, Greist JM. The Work and Social Adjustment Scale: A simple measure of impairment in functioning. Br J Psychiatry. 2002;180(5):461\u20134. https:\/\/doi.org\/10.1192\/bjp.180.5.461.","journal-title":"Br J Psychiatry"},{"issue":"6","key":"3347_CR47","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1017\/s1352465821000308","volume":"49","author":"AJ V\u00e1zquez","year":"2021","unstructured":"V\u00e1zquez AJ, V\u00e1zquez-Morej\u00f3n R, \u00c1lvarez PC. Work and Social Adjustment Scale (WSAS): psychometric characteristics of a Spanish adaptation in a clinical population. Behav Cogn Psychother. 2021;49(6):764\u20138. https:\/\/doi.org\/10.1017\/s1352465821000308.","journal-title":"Behav Cogn Psychother"},{"key":"3347_CR48","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.jad.2022.09.140","volume":"320","author":"J Osma","year":"2023","unstructured":"Osma J, Mart\u00ednez-Loredo V, Qu\u00edlez-Orden A, Peris-Baquero O, Ferreres-Gal\u00e1n V, Prado-Abril J, Rossellini AJ. Multidimensional emotional disorders inventory: Reliability and validity in a Spanish clinical sample. J Affect Disord. 2023;320:65\u201373. https:\/\/doi.org\/10.1016\/j.jad.2022.09.140.","journal-title":"J Affect Disord"},{"issue":"1","key":"3347_CR49","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1037\/pas0000649","volume":"31","author":"AJ Rosellini","year":"2019","unstructured":"Rosellini AJ, Brown TA, The Multidimensional Emotional Disorder Inventory (MEDI). Assessing transdiagnostic dimensions to validate a profile approach to emotional disorder classification. Psychol Assess. 2019;31(1):59\u201372. https:\/\/doi.org\/10.1037\/pas0000649.","journal-title":"Psychol Assess"},{"key":"3347_CR50","first-page":"325","volume":"26","author":"E Echebur\u00faa","year":"2000","unstructured":"Echebur\u00faa E, Corral P, Fern\u00e1ndez-Montalvo J. Maladjustment Inventory (MI): Psychometric properties in clinical contexts [Article in Spanish]. Anal Modif Conducta. 2000;26:325\u201340.","journal-title":"Anal Modif Conducta"},{"key":"3347_CR51","doi-asserted-by":"publisher","unstructured":"Osma J, Qu\u00edlez-Orden A, Ord\u00f3\u00f1ez J, Peris-Baquero \u00d3, Echebur\u00faa E. Psychometric properties of the Maladjustment Inventory in a Spanish clinical and student sample. BMC Psychol. 2024;12(1). https:\/\/doi.org\/10.1186\/s40359-024-02133-6.","DOI":"10.1186\/s40359-024-02133-6"},{"key":"3347_CR52","first-page":"171","volume":"60","author":"JL V\u00e1zquez-Barquero","year":"1997","unstructured":"V\u00e1zquez-Barquero JL, Gaite L, Cuesta MJ, Garc\u00eda-Usieto E, Knapp M, Beecham J. Spanish version of the CSRI: a mental health cost evaluation interview. Arch Neurobiol (Madr). 1997;60:171\u201384.","journal-title":"Arch Neurobiol (Madr)"},{"issue":"3","key":"3347_CR53","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/0149-7189(79)90094-6","volume":"2","author":"DL Larsen","year":"1979","unstructured":"Larsen DL, Attkisson C, Hargreaves WA, Nguyen TD. Assessment of client\/patient satisfaction: Development of a general scale. Eval Program Plann. 1979;2(3):197\u2013207. https:\/\/doi.org\/10.1016\/0149-7189(79)90094-6.","journal-title":"Eval Program Plann"},{"issue":"2","key":"3347_CR54","doi-asserted-by":"publisher","first-page":"175","DOI":"10.3758\/bf03193146","volume":"39","author":"F Faul","year":"2007","unstructured":"Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175\u201391. https:\/\/doi.org\/10.3758\/bf03193146.","journal-title":"Behav Res Methods"},{"key":"3347_CR55","doi-asserted-by":"publisher","first-page":"153","DOI":"10.2147\/CLEP.S146397","volume":"10","author":"ML Bell","year":"2018","unstructured":"Bell ML, Whitehead AL, Julious SA. Guidance for using pilot studies to inform the design of intervention trials with continuous outcomes. Clin Epidemiol. 2018;10:153\u20137.","journal-title":"Clin Epidemiol"},{"issue":"1","key":"3347_CR56","doi-asserted-by":"publisher","first-page":"100203","DOI":"10.1016\/j.ijchp.2020.11.002","volume":"21","author":"J Corpas","year":"2021","unstructured":"Corpas J, Moriana JA, Vencesl\u00e1 JF, G\u00e1lvez-Lara M. Brief psychological treatments for emotional disorders in primary and specialized care: A randomized controlled trial. Int J Clin Health Psychol. 2021;21(1):100203. https:\/\/doi.org\/10.1016\/j.ijchp.2020.11.002.","journal-title":"Int J Clin Health Psychol"},{"key":"3347_CR57","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.jpsychires.2018.08.005","volume":"104","author":"SJ Steele","year":"2018","unstructured":"Steele SJ, Farchione TJ, Cassiello-Robbins C, Ametaj A, Sbi S, Sauer-Zavala S, et al. Efficacy of the Unified Protocol for transdiagnostic treatment of comorbid psychopathology accompanying emotional disorders compared to treatments targeting single disorders. J Psychiatr Res. 2018;104:211\u20136. https:\/\/doi.org\/10.1016\/j.jpsychires.2018.08.005.","journal-title":"J Psychiatr Res"},{"key":"3347_CR58","doi-asserted-by":"publisher","unstructured":"Bates D, M\u00e4chler M, Bolker B, Walker S. Fitting linear mixed-effects models using lme4. J Stat Softw. 2015;67(1). https:\/\/doi.org\/10.18637\/jss.v067.i01.","DOI":"10.18637\/jss.v067.i01"},{"key":"3347_CR59","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2021","unstructured":"R Core Team. R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2021."},{"key":"3347_CR60","volume-title":"IBM SPSS Statistics for Windows [Software]. Version 25.0. Armonk","author":"IBM Corp","year":"2017","unstructured":"Corp IBM. IBM SPSS Statistics for Windows [Software]. Version 25.0. Armonk. (NY): IBM Corp; 2017."},{"key":"3347_CR61","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v048.i02","volume":"48","author":"Y Rosseel","year":"2012","unstructured":"Rosseel Y, Lavaan. An R package for structural equation modeling. J Stat Softw. 2012;48:1\u201336.","journal-title":"J Stat Softw"},{"key":"3347_CR62","volume-title":"Statistical power analysis for the behavioral sciences","author":"J Cohen","year":"1988","unstructured":"Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale (NJ): Lawrence Erlbaum Associates; 1988.","edition":"2"},{"issue":"1","key":"3347_CR63","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/1477-7525-1-80","volume":"1","author":"L Prieto","year":"2003","unstructured":"Prieto L, Sacrist\u00e1n JA. Problems and solutions in calculating quality-adjusted life years (QALYs). Health Qual Life Outcomes. 2003;1(1):80. https:\/\/doi.org\/10.1186\/1477-7525-1-80.","journal-title":"Health Qual Life Outcomes"},{"key":"3347_CR64","volume-title":"Qualitative Data Analysis [Software]","author":"UMAXQDA Kuckartz","year":"2007","unstructured":"Kuckartz UMAXQDA. Qualitative Data Analysis [Software]. Berlin: VERBI Software; 2007."},{"issue":"6","key":"3347_CR65","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.1111\/jep.13546","volume":"27","author":"\u00d3 Peris-Baquero","year":"2021","unstructured":"Peris-Baquero \u00d3, Osma J, Gil-LaCruz M, Mart\u00ednez-Garc\u00eda L. Acceptability of and intention to use the Unified Protocol delivered in group format in the Spanish Public Health System. J Eval Clin Pract. 2021;27(6):1299\u2013309. https:\/\/doi.org\/10.1111\/jep.13546.","journal-title":"J Eval Clin Pract"},{"key":"3347_CR66","doi-asserted-by":"publisher","unstructured":"Aparicio AM, M\u00e9ndez ES. Personalized Psychological Treatments: Clinical Guidelines. Psychol Papers. 2019;41(1). https:\/\/doi.org\/10.23923\/pap.psicol2020.2915.","DOI":"10.23923\/pap.psicol2020.2915"},{"key":"3347_CR67","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1186\/s12875-019-1005-9","volume":"20","author":"M Ricou","year":"2019","unstructured":"Ricou M, Marina S, Vieira PM, Duarte I, Sampaio I, Regalado J, Can\u00e1rio C. Psychological intervention at a primary health care center: predictors of success. BMC Fam Pract. 2019;20:116. https:\/\/doi.org\/10.1186\/s12875-019-1005-9.","journal-title":"BMC Fam Pract"},{"issue":"5","key":"3347_CR68","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1016\/j.semerg.2014.06.001","volume":"41","author":"S S\u00e1nchez-Reales","year":"2014","unstructured":"S\u00e1nchez-Reales S, Tornero-G\u00f3mez M, Mart\u00edn-Oviedo P, Redondo-Jim\u00e9nez M, Del-Arco-J\u00f3dar R. Psicolog\u00eda Cl\u00ednica en Atenci\u00f3n Primaria: descripci\u00f3n de un a\u00f1o de asistencia. Med Fam SEMERGEN. 2014;41(5):254\u201360. https:\/\/doi.org\/10.1016\/j.semerg.2014.06.001.","journal-title":"Med Fam SEMERGEN"},{"issue":"2","key":"3347_CR69","doi-asserted-by":"publisher","first-page":"183","DOI":"10.33000\/mlspr.v5i2.1143","volume":"5","author":"AI Burguillos","year":"2022","unstructured":"Burguillos AI. Caracter\u00edsticas sociodemogr\u00e1ficas y s\u00edntomas psicopatol\u00f3gicos de pacientes atendidos por psicolog\u00eda cl\u00ednica en atenci\u00f3n primaria. MLS Psychol Res. 2022;5(2):183\u2013200. https:\/\/doi.org\/10.33000\/mlspr.v5i2.1143.","journal-title":"MLS Psychol Res"}],"container-title":["BMC Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12875-026-03347-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-026-03347-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-026-03347-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T12:03:42Z","timestamp":1781870622000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12875-026-03347-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,2]]},"references-count":69,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3347"],"URL":"https:\/\/doi.org\/10.1186\/s12875-026-03347-w","relation":{},"ISSN":["2731-4553"],"issn-type":[{"value":"2731-4553","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,2]]},"assertion":[{"value":"24 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study will be performed in line with the principles of the Declaration of Helsinki. The study was approved by the ethics and research committee of the Hospital Universitario de la Plana (02\/2025), Hospital Comarcal de Vinar\u00f2s (PI_25\/001), Hospital General Universitario de Castell\u00f3 (REV-AGO-03-25), CEIm \u00c1rea de Salud de Zamora (711), CEIm de Atenci\u00f3n Primaria del \u00c1rea IV de Asturias (2025.510), IDIAP Jordi Gol (25\/115-P), and the CEIm de las \u00c1reas de Salud de Valladolid (Hospital Universitario R\u00edo Hortega; acta n\u00ba 1 de 2026, 21\/01\/2026). Approval will be granted by the Ethics Committee of all collaborating centers.All participants will consent to participate and will sign the informed consent form.All changes to this original study protocol (current protocol version; 24\n                      th\n                      October 2025) will be communicated to the aforementioned Ethics Committee for their approval and will be shown in clinicaltrials.gov.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"243"}}