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7860 Mission Center Ct, Suite 209
San Diego, CA, 92108


At The Center for Stress and Anxiety Management, our psychologists have years of experience. Unlike many other providers, our clinicians truly specialize in the diagnosis and treatment of anxiety and related problems. Our mission is to apply only the most effective short-term psychological treatments supported by extensive scientific research. We are located in Rancho Bernardo, Carlsbad, and Mission Valley.

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Read our award-winning blogs for useful information and tips about anxiety, stress, and related disorders.


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Unified Protocol: Cutting Edge Treatment (2 of 2)

Jill Stoddard

by Lucas Myers

Today, we continue our introduction to a powerful new therapeutic treatment for depression and anxiety disorders... ALL of the anxiety disorders.

One of Dr. Michelle Lopez's clients was astounded to learn that the very techniques she was using to reduce her anxiety in the moment were actually increasing her anxiety in the long term, making it even more difficult to manage. Her initial reaction “This is so counterintuitive!” was soon forgotten as the multiple anxiety disorders including generalized anxiety, panic disorder, and PTSD that she had been living with for years began to lose their grip on her life.


So how does the UP work? There are a number of skills that a client learns from the therapist that cumulatively comprise treatment. The client will learn to record experiences, set goals and maintain motivation, understand emotions, recognize and track emotional responses, observe emotions and reactions to these emotions, understand how thoughts influence feelings, understand the connection between behavior and emotions, learn to identify and change unhelpful patterns of avoidance, and recognize and master physical sensations. Although this might sound like a lot, the truth is that these skills are all interrelated and as therapy goes on, the client learns to combine new skills in order to face unpleasant emotions in the context in which they arise.

Emotions are responses to our thoughts and environment that motivate us to behave in certain ways. These emotion driven behaviors are adaptive in both nature and function, but can sometimes develop in harmful ways. During therapy, patterns of context, behavior, and consequences are identified. As the therapist and client work together to understand how uncomfortable emotions arise, reactions to these emotions can be replaced with more healthy and adaptive responses.

Next, client and therapist work on building motivation for change. As motivation increases, an increased sense of self-efficacy leads to empowerment and the client is ready to practice non-judgmental emotional awareness, learning to focus on the here and now and observe both the emotion and the reaction which follows it. This increased awareness allows a critical evaluation of the emotionally loaded beliefs and assumptions that lead to problematic behavior. This leads to more flexible thinking and sets the stage for breaking the negative pattern of distress. The client is now ready to actively start countering the maladaptive emotionally driven behaviors. After polishing skills to overcome harmful patterns of behavior, the therapist will prepare the client to start testing and practicing these skills by gradually exposing the patient to stressful situations that evoke distress. In the final stage of treatment, the client and therapist review all the new skills that they have learned and practiced, discuss continuing challenges, and put in place plans to maintain treatment gains.

For many clients, the end of this 12-16 week treatment program is just the beginning of change experienced as a result of the UP. Consistent with scientific research on the UP, Dr. Lopez's clients report that they continue to improve well after they completed treatment.

How can the UP be effective in treating so many conditions? The genius of the UP is that every step is designed to be flexible. An expert therapist like Dr. Lopez can emphasize specific skills to tailor the treatment to every individual client, situation, and range of symptoms. Likewise, the UP targets the shared aspects of emotional disorders, making it effective across anxiety and mood disorders.

The UP can be used as a preventative treatment for those more susceptible (i.e., family history of anxiety or depression) as well as for those with mild, moderate, or severe symptoms of anxiety who have postponed seeking treatment. The point is that it’s never too early or too late to learn the skills necessary to overcome anxiety and/or depression.

Remember, if you or someone you know suffers from an anxiety disorder, such as social anxiety, panic, agoraphobia, generalized anxiety, PTSD, OCD, or depression, professional support is available. If you are in the San Diego area and you would like to speak with Dr. Lopez, or one of our other qualified therapists, you may contact the Center for Stress and Anxiety Management at 858-354-4077 or To learn more about Dr. Lopez, read her bio in the “About Us” section. To see a list of other mental health conditions that we specialize in, click here.

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Tags: PTSDSan Diegodepressionanxiety disordersOCDagoraphobiasocial anxietypanicgeneralized anxiety