Group interventions for the reduction of psychological distress in university students

Butler, John 2021. Group interventions for the reduction of psychological distress in university students. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

Preface This thesis offers information about the use of group interventions to treat and reduce psychological distress in university students. Psychological distress is defined here as various combinations and levels of stress, anxiety, and depression. The number of university students struggling with these conditions appears to be increasing each year and university wellbeing services (UWSs) are struggling with the demand. Two papers presented to help further knowledge in this area. The first is a systematic review and meta-analysis of the topic. This aimed to answer how effective group interventions are in reducing psychological distress for students, as well as what factors might affect this effectiveness. Potentially relevant articles were identified by systematically searching databases (CINAHL, Medline, PsycInfo, SCOPUS, and Web of Science). 28 studies were included in the review, with 26 able to be used in the meta-analysis. Group interventions were varied in their approach with the main categories identified as: cognitive behavioural therapy, mindfulness-based, psychoeducational, acceptance and commitment therapy (ACT), dialectical behavioural therapy, and arts-based. This breadth was purposeful as the paper makes a case for the benefit of transdiagnostic intervention and assessment. As such, the included studies tended use the GHQ, DASS, and SCL-90 for measures of psychological distress. The results suggest that group interventions have a medium effect on reducing distress in students, comparable to that of individual interventions. Potential economic benefits to UWSs are discussed. Additionally, the type of control group used in the study and the time spent in the intervention were found to significantly moderate this effect. There is also preliminary evidence that the frequency of sessions, the training of the group facilitators, and the outcome measures used may be potential moderators. Recommendations for UWSs and future research are tentatively suggested from these findings. The second paper is an empirical study that used a randomised control trial design to explore the effectiveness of a 4-week ACT-based group intervention, Activate Your Life, in reducing the distress of 71 Cardiff University students. The group did prove effective in reducing students’ scores on the GHQ-12, and again the main focus of this paper was to then identify factors that might influence this effectiveness or predict which students do best from it. The idea of doing well from the intervention was explored through the concept of a ‘sudden gain’. This is a large and stable drop in symptoms between measurements that is 5 associated with better outcomes at the end of interventions and during follow-up. Results showed that the amount of skills practice was a moderator of the intervention’s effectiveness, and that session attendance together with students’ readiness to change were good predictors of who might experience a sudden gain. Additionally, an unsuspected finding of equal, if not greater, effectiveness from attending sessions by accessing online recordings was noted. Therefore, suggestions are made for future research to look to replicate these new findings and for UWSs to employ readiness screening and highlight the benefit of participant engagement. Overall, the thesis provides rationale for UWSs to adopt group interventions as a key service provision, as a solution to the increased demand they are facing. Appropriate time and staff training should be devoted to them to allow their full potential to be realised. Nevertheless, the thesis also provides evidence that briefer ACT-based interventions could be effective. If UWSs choose them as an approach for group interventions, they should offer them to participants who are ready to change, and then highlight the importance of skills practice and attendance, whether in person or through recordings.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	22 September 2021
Last Modified:	10 Dec 2022 02:50
URI:	https://orca.cardiff.ac.uk/id/eprint/144334

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