A brief intervention decreases student distress

PURPOSE OF THE ARTICLE

Health professions graduate students have experienced substantial increases in stress and anxiety in recent years. This can result in decreased academic performance, poor retention, and burnout. Interventions to help students cope are therefore a critical need for academic institutions. The current study sought to demonstrate the effectiveness of a brief multimodal intervention in reducing student distress.

METHOD

The study was a randomised controlled design that evaluated a brief intervention of cognitive-behavioural therapy, mindfulness, and healthy lifestyle choices. The Depression Anxiety Stress Scale-21 was administered to participants at baseline and two post-intervention time points. Control participants did not participate in any intervention. Participants were recruited from graduate students in first-year classes within the School of Health Professions at UT Southwestern Medical Center.

RESULTS

Analysis revealed an overall mild to moderate decline in Depression Anxiety Stress Scale-21 total scores over three assessment periods for both treatment and control groups, with no statistical differences noted between groups; however, the treatment group's scores declined approximately 6 weeks before the control participants' scores declined.

CONCLUSION

The pattern of change in the two groups suggests that our intervention facilitated the reduction in student anxiety more quickly than would have occurred normally and with sustained results.

A large clinical trial to improve well-being during the transition to college using wearables: The lived experiences measured using rings study

INTRODUCTION

The transition to college is a period of elevated risk for a range of mental health conditions. Although colleges and universities strive to provide mental health support to their students, the high demand for these services makes it difficult to provide scalable, cost-effective solutions.

OBJECTIVE

To address these issues, the present study aims to compare the efficacy of three different treatments using a large cohort of 600 students transitioning to college. Interventions were selected based on their potential for generalizability and cost-effectiveness on college campuses.

METHODS

The study is a Phase II parallel-group, four-arm, randomized controlled trial with 1:1 allocation that will assign 600 participants to one (n = 150 per condition) of four arms: 1) group-based therapy, 2) physical activity program, 3) nature experiences, or 4) weekly assessment condition as a control group. Physiological data will be collected from all participants using a wearable device to develop algorithmic mental and physical health functioning predictions. Once recruitment is complete, modeling strategies will be used to evaluate the outcomes and effectiveness of each intervention.

DISCUSSION

The findings of this study will provide evidence as to the benefits of implementing scalable and proactive interventions using technology with the goal of improving the well-being and success of new college students.

Changing the landscape of mental health among college students: a community case study of a course on learning sustainable well-being

Our society is facing an unprecedented mental health crisis, with nearly one in two people being affected by mental health issues over their lifespan. This trend is especially noticeable among college students, who undergo significant shifts in social, familial, and academic responsibilities. Exacerbating the mental health crisis is the fact that students are facing other societal crises (e.g., climate change). And, in a reciprocal fashion, students experiencing poor mental health are less likely to feel resilient enough to tackle these other crises. In response to these colliding societal crises, we need a comprehensive solution that goes beyond the current models of college mental health services. We propose an alternative preventative mental health approach, which aims to prevent the onset of mental health concerns and build resilience in the face of colliding crises. Specifically, we argue that colleges can aid in building mental health resilience by creating for-credit courses that teach students the skills they need to be conscious, responsible, and resilient human beings. Toward this end, we created an experiential, workshop-style, 1 unit, P/NP course, entitled "Learning Sustainable well-being" (LSW), which guides students to explore, improve, and sustain their mental health. The principles taught in this course combine the wisdoms of several disciplines, including mindfulness, psychology, neuroscience, philosophy, religion, poetry, and cinema. The following community case study reflects on the journey of our "LSW initiative," starting from the creation of the course in 2014 to the current mission of scaling up the offering as part of an institution-wide LSW program. To this end, we describe the LSW course modules/content, our pedagogical approach, potential limitations, and then provide data demonstrating its efficacy in improving student well-being. As a final note, we present the challenges we have faced, and the lessons learned, while on this journey. We hope that presenting this community case study will facilitate the growing dialogue across colleges about creating (and perhaps requiring) courses like LSW in order to improve students' mental health and resilience in the context of other colliding crises.

A Survey of Group Coordinators in College and University Counseling Centers: Findings and Recommendations

In an era of increasing demands on college counseling centers (CCs), many CCs appoint a group coordinator (GC) to oversee the implementation of a group therapy program. It is common knowledge in the field that this role is essential to develop and maintain a thriving group program, yet little information is available to understand best practices. An exploratory survey of GCs in CCs was conducted to understand the descriptive features of those occupying the role as well as typical responsibilities, resources, and job satisfaction. We analyzed responses from 53 GCs in the US and Canada. Generally, GCs reported managing a wide range of responsibilities and having limited resources (administrative time, reduced caseload) and inconsistent CC staff practices (group training, weekly group meeting). On average, GCs reported moderate satisfaction with their role and resources and high satisfaction with CC leadership. Correlations were found between positive CC culture toward group and staff involvement, groups per semester, GC responsibilities, group program structures, and GC role satisfaction. Rates of group utilization were significantly higher for GCs with two or more administrative hours and for CCs that held a weekly meeting about groups. Staff group involvement, representing strength of CC culture toward group, was significantly higher if the GC held an administrative role. The article concludes with recommendations for best practices for the GC role and directions for future research.

A randomized controlled trial of a smartphone-based application for the treatment of anxiety

AbstractIntroduction: Generalized anxiety disorder (GAD) is prevalent among college students. Smartphone-based interventions may be a low-cost treatment method. Method: College students with self-reported GAD were randomized to receive smartphone-based guided self-help (n = 50), or no treatment (n = 50). Post-treatment and six-month follow-up outcomes included the Depression Anxiety Stress Scales-Short Form Stress Subscale (DASS Stress), the Penn State Worry Questionnaire (PSWQ-11), and the State-Trait Anxiety Inventory-Trait (STAI-T), as well as diagnostic status assessed by the GAD-Questionnaire, 4th edition. Results: From pre- to post-treatment, participants who received guided self-help (vs. no treatment) experienced significantly greater reductions on the DASS Stress (d = -0.408) and a greater probability of remission from GAD (d = -0.445). There was no significant between-group difference in change on the PSWQ-11 (d = -0.208) or STAI-T (d = -0.114). From post to six-month follow-up there was no significant loss of gains on DASS Stress scores (d = -0.141) and of those who had remitted, 78.6% remained remitted. Yet rates of remitted participants no longer differed significantly between conditions at follow-up (d = -0.229). Conclusion: Smartphone-based interventions may be efficacious in treating some aspects of GAD. Methods for improving symptom reduction and long-term outcome are discussed.

The strength of pursuing your values: Valued living as a path to resilience among college students

Although stressful life events (SLEs) frequently relate to negative outcomes, many individuals demonstrate resilience by positively adapting to stressors without significant impairment. Valued living, a key process in the theory underpinning acceptance and commitment therapy is a response style characterized by daily purposeful actions that are linked to important values and may promote resilience in college students. This study examined the main and interactive effects of SLEs and valued living in the prediction of a multidimensional measure of resilience. Results supported a strong positive relationship between resilience and valued living. Further, valued living moderated the association between SLE negative impact scores and resilience (but not the association between cumulative prior year SLEs and resilience). Although SLE negative impact scores were negatively associated with resilience at lower levels of valued living, there was no demonstrated relationship at higher levels of valued living. Implications related to promoting valued living among college students in the service of increasing resilience are discussed.

Self-tracking for Mental Wellness: Understanding Expert Perspectives and Student Experiences

Previous research suggests an important role for self-tracking in promoting mental wellness. Recent studies with college student populations have examined the feasibility of collecting everyday mood, activity, and social data. However, these studies do not account for students' experiences and challenges adopting self-tracking technologies to support mental wellness goals. We present two studies conducted to better understand self-tracking for stress management and mental wellness in student populations. First, focus groups and card sorting activities with 14 student health professionals reveal expert perspectives on the usefulness of tracking for three scenarios. Second, an online survey of 297 students examines personal experiences with self-tracking and attitudes toward sharing self-tracked data with others. We draw on findings from these studies to characterize students' motivations, challenges, and preferences in collecting and viewing self-tracked data related to mental wellness, and we compare findings between students with diagnosed mental illnesses and those without. We conclude with a discussion of challenges and opportunities in leveraging self-tracking for mental wellness, highlighting several design considerations.

Group therapy for university students: A randomized control trial of dialectical behavior therapy and positive psychotherapy

The present study examined the efficacy of two evidence-based group treatments for significant psychopathology in university students. Fifty-four treatment-seeking participants were randomized to a semester-long dialectical behavior therapy (DBT) or positive psychotherapy (PPT) group treatment. Mixed modeling was used to assess improvement over time and group differences on variables related to symptomatology, adapative/maladaptive skill usage, and well-being/acceptability factors. All symptom and skill variables improved over the course of treatment. There were no statistically significant differences in rate of change between groups. The DBT group evidenced nearly all medium to large effect sizes for all measures from pre-to post-treatment, with mostly small to medium effect sizes for the PPT group. There was a significant difference in acceptability between treatments, with the DBT group demonstrating significantly lower attrition rates, higher attendance, and higher overall therapeutic alliance. While both groups demonstrated efficacy in this population, the DBT group appeared to be a more acceptable and efficacious treatment for implementation. Results may specifically apply to group therapy as an adjunctive treatment because a majority of participants had concurrent individual therapy.

Predictors of Counseling Center Use Among College Students in the United Arab Emirates

College students’ decision to seek counseling is impacted by many factors such as demographic and psychological variables. This study investigated the differences between counseled (40 men and 120 women) and noncounseled (98 men and 111 women) college students from the United Arab Emirates using 3 measures of distress and a number of demographic variables (i.e., gender, marital status, residence, nationality, area of study, and grade point average). The counseled group reported more health concerns, symptoms of anxiety and depression, and psychological distress when compared with the noncounseled. Women reported more psychological distress than men. Discriminant analysis revealed that the most important predictors of whether a student would seek counseling were measures of general health, psychological distress, depression and anxiety, area of study, and gender, in that order. Of the noncounseled students, the majority claimed to be in need of counseling. Findings were discussed within the context of Emirati culture. Findings suggested that seeking psychological help may be stigmatized in Arab culture.

Treating Comorbid Social Anxiety and Major Depression

Depression and social anxiety disorder (SAD) are two of the most common mental health conditions, and often occur together. Depression is usually identified as the presenting problem, which may result in SAD being overshadowed and undertreated among those with this particular comorbidity. In this case study, diagnostic overshadowing results in successful treatment of depression but delayed identification of SAD, causing an attenuated anxiety treatment response. We present recommendations on how clinicians may more thoroughly assess for comorbid Axis I diagnoses, avoid diagnostic overshadowing, and better integrate treatment approaches for SAD–major depressive disorder (MDD) comorbidity. Mechanisms underlying cognitive-behavioral treatments such as behavioral activation and exposure hold particular promise for promoting improvement in SAD and major depression simultaneously.

Investigating the Relationship of Resilience to Academic Persistence in College Students With Mental Health Issues

In this study, the relationships between measures of inter- and intrapersonal resilience and mental health were examined with respect to academic persistence in college students with mental health issues. A sample of 121 undergraduate students with mental health issues was recruited from campus mental health offices offering college counseling, psychiatric support, and disability support at two midwestern universities. Hierarchal (or sequential) regression analysis examined whether the resilience and mental health measures contributed to explaining variance in the response variables of university cumulative grade point average and time to credits completed. The results indicated that intrapersonal resilience was more important and operated differently for students with the most psychological distress. Furthermore, there was a strong statistical correlation between the resilience factors and mental health. The results indicate that a resilience framework may assist college students with mental health issues to cope more effectively with the complexities of college learning and improve college retention.