Mediators and Moderators of Therapeutic Change in the Unified Protocol for Women Experiencing Homelessness

Background The general aim of the study was to examine potential mediators and moderators in an adaptation of the Unified Protocol for Homeless Women (UPHW). Methods We conducted a secondary analysis in a sample of 80 homeless women participated in the study: 37 in the UPHW and 43 in the waitlist control condition. The assessment before and after the program included primary outcomes (anxiety and depression) and secondary outcomes, including different mediators (positive and negative affect, well-being, and social support) and moderators (demographics, homelessness, physical function, drug and alcohol abuse). Results The UPHW showed significant improvements on anxiety and depression outcomes at post-intervention compared to waitlist control condition. Negative affect was the only significant mediator of the relationship between the UPHW and reductions in anxiety and depression symptoms. Physical functioning was the only significant moderator of the relationship between the UPHW and depression symptoms. Conclusion To our knowledge this is the first study examining potential mediators and moderators of change in an evidence-based psychological treatment in a population experiencing homelessness. Findings suggest that transdiagnostic protocols may be a promising approach to improving psychological outcomes in this population.