Wellness and resilience for college and beyond: protocol for a quasi-experimental pilot study investigating a dialectical behaviour therapy skill-infused college course

Carla D Chugani, Barbara Fuhrman, Kaleab Z Abebe, Janine Talis, Elizabeth Miller, Robert W S Coulter, Carla D Chugani, Barbara Fuhrman, Kaleab Z Abebe, Janine Talis, Elizabeth Miller, Robert W S Coulter

Abstract

Introduction: College students' mental health problems and suicidal behaviour are serious, persistent and prevalent public health issues. With the need for mental health support greatly exceeding the availability of on-campus treatment, a recent trend on college campuses is to offer courses designed to teach students strategies for developing mental health or resilience. While these courses are exceptionally popular among students, a paucity of research investigates the health outcomes associated with participation. The purpose of this study is to investigate the acceptability, appropriateness, feasibility and preliminary effectiveness of a college course grounded in skills from dialectical behaviour therapy (DBT) titled, 'Wellness and Resilience for College and Beyond'.

Methods and analysis: During the spring and fall 2020 semesters, the course will be offered on five campuses in Southwestern Pennsylvania and West Virginia. The course consists of 15 weekly 2.5-hour lessons, weekly homework assignments and a final examination with content drawn from DBT, acceptance and commitment therapy and positive psychology. Undergraduate students aged 18-24 will self-select into the course and control subjects receiving 'university as usual' will be recruited to serve as a comparison group. Students who receive the course will complete measures of course acceptability, appropriateness and feasibility. All study participants will complete measures of adaptive coping skills use, emotion dysregulation and suicidality.

Ethics and dissemination: All of the study procedures were approved as an exempt protocol for evaluation of educational curricula by the University of Pittsburgh Human Research Protections Office (HRPO); the study was approved as a research study by the institutional review board (IRB) of the fifth study site. The University of Pittsburgh HRPO served as the IRB of record for all except one study site, which required standard IRB review. Data from this study will be disseminated via conference presentations, peer-reviewed publications and via our online stakeholder learning collaborative.

Trial registration number: NCT04338256.

Keywords: education & training (see medical education & training); mental health; public health.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

References

    1. Turner JC, Leno EV, Keller A. Causes of mortality among American college students: a pilot study. J College Stud Psychother 2013;27:31–42. 10.1080/87568225.2013.739022
    1. American College Health Association American College Health Association - National College Health Assessment II: Reference Group Executive Summary Fall 2015. Hanover, MD: American College Health Association, 2016.
    1. Auerbach RP, Alonso J, Axinn WG, et al. . Mental disorders among college students in the world Health organization world mental health surveys. Psychol Med 2016;46:2955–70. 10.1017/S0033291716001665
    1. Reetz D, Krylowicz B, Bershad C, et al. . The association for university and College counseling directors annual survey, 2015.
    1. Kessler RC, Amminger GP, Aguilar-Gaxiola S, et al. . Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry 2007;20:359–64. 10.1097/YCO.0b013e32816ebc8c
    1. Curtin SC, Heron M. Death rates due to suicide and homicide among persons aged 10-24: United States, 2000-2017. NCHS Data Brief 2019;352:1–8.
    1. Santos L. The science of well-being Syllabus: what you will learn from this course, 2020. Available: [Accessed 26 Mar 2020].
    1. Schiraldi GR, Brown SL. Primary prevention for mental health: results of an exploratory cognitive-behavioral College course. J Prim Prev 2001;22:55–67. 10.1023/A:1011040231249
    1. Akeman E, Kirlic N, Clausen AN, et al. . A pragmatic clinical trial examining the impact of a resilience program on college student mental health. Depress Anxiety 2020;37:202–13. 10.1002/da.22969
    1. Life Design Lab Case studies: designing your life, 2019. Available: [Accessed 16 Dec 2019].
    1. Linehan MM. Cognitive behavioral treatment of borderline personality disorder. New York, NY: Guildford Press, 1993.
    1. Miller A, Rathus J, Linehan MM. Dialectical behavior therapy with suicidal adolescents. New York, NY: Guilford Press, 2006.
    1. Perepletchikova F, Axelrod SR, Kaufman J, et al. . Adapting Dialectical behaviour therapy for children: towards a new research agenda for paediatric suicidal and Non-Suicidal Self-Injurious behaviours. Child Adolesc Ment Health 2011;16:116–21. 10.1111/j.1475-3588.2010.00583.x
    1. Linehan MM, Schmidt H, Dimeff LA, et al. . Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence. Am J Addict 1999;8:279–92. 10.1080/105504999305686
    1. Linehan MM, Korslund KE, Harned MS, et al. . Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: a randomized clinical trial and component analysis. JAMA Psychiatry 2015;72:475–82. 10.1001/jamapsychiatry.2014.3039
    1. Linehan MM, Comtois KA, Murray AM, et al. . Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Arch Gen Psychiatry 2006;63:757–66. 10.1001/archpsyc.63.7.757
    1. Chen EY, Matthews L, Allen C, et al. . Dialectical behavior therapy for clients with binge-eating disorder or Bulimia nervosa and borderline personality disorder. Int J Eat Disord 2008;41:505–12. 10.1002/eat.20522
    1. Muhomba M, Chugani CD, Uliaszek AA, et al. . Distress tolerance skills for college students: a pilot investigation of a brief DBT group skills training program. J College Stud Psychother 2017;31:247–56. 10.1080/87568225.2017.1294469
    1. Chugani CD, Ghali MN, Brunner J. Effectiveness of short term dialectical behavior therapy skills training in college students with cluster B personality disorders. J College Stud Psychother 2013;27:323–36. 10.1080/87568225.2013.824337
    1. Chugani CD. A review of dialectical behavior therapy in college counseling settings: findings and implications for practice. Journal of College Student Psychotherapy 2015;29:120–31.
    1. Panepinto AR, Uschold CC, Olandese M, et al. . Beyond borderline personality disorder: Dialectical behavior therapy in a College counseling center. J College Stud Psychother 2015;29:211–26. 10.1080/87568225.2015.1045782
    1. Meaney-Tavares R, Hasking P. Coping and regulating emotions: a pilot study of a modified dialectical behavior therapy group delivered in a College counseling service. J Am Coll Health 2013;61:303–9. 10.1080/07448481.2013.791827
    1. Engle E, Gadischkie S, Roy N, et al. . Dialectical behavior therapy for a College population: applications at SARAH Lawrence college and beyond. J College Stud Psychother 2013;27:11–30. 10.1080/87568225.2013.739014
    1. Neacsiu AD, Eberle JW, Kramer R, et al. . Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: a pilot randomized controlled trial. Behav Res Ther 2014;59:40–51. 10.1016/j.brat.2014.05.005
    1. Ritschel LA, Lim NE, Stewart LM. Transdiagnostic applications of DBT for adolescents and adults. Am J Psychother 2015;69:111–28. 10.1176/appi.psychotherapy.2015.69.2.111
    1. Ritschel LA, Cheavens JS, Nelson J. Dialectical behavior therapy in an intensive outpatient program with a mixed-diagnostic sample. J Clin Psychol 2012;68:221–35. 10.1002/jclp.20863
    1. Wilks C, Yin Q, Ang SY, et al. . Internet-Delivered Dialectical behavioral therapy skills training for suicidal and heavy episodic drinkers: protocol and preliminary results of a randomized controlled trial. JMIR Res Protoc 2017;6:e207. 10.2196/resprot.7767
    1. Dimeff LA, Linehan MM. Dialectical behavior therapy for substance abusers. Addict Sci Clin Pract 2008;4:39–47. 10.1151/ascp084239
    1. Linehan MM. Dbt skills training manual. 2 ed New York, NY: Guilford Press, 2015.
    1. Seligman ME, Csikszentmihalyi M. Positive psychology. An introduction. Am Psychol 2000;55:5–14. 10.1037/0003-066X.55.1.5
    1. Hayes SC, Levin ME, Plumb-Vilardaga J, et al. . Acceptance and commitment therapy and contextual behavioral science: examining the progress of a distinctive model of behavioral and cognitive therapy. Behav Ther 2013;44:180–98. 10.1016/j.beth.2009.08.002
    1. Chugani CD, Mazza J, Miller E, et al. . Preliminary investigation of a College course designed to promote student mental healthIn preparation.
    1. Mazza J, Dexter-Mazza E, Miller A, et al. . Dbt skills in schools: skills training for emotional problem solving for adolescents (DBT STEPS-A. New York, NY: Guilford Press, 2016.
    1. Weiner BJ, Lewis CC, Stanick C, et al. . Psychometric assessment of three newly developed implementation outcome measures. Implement Sci 2017;12:108. 10.1186/s13012-017-0635-3
    1. Neacsiu AD, Rizvi SL, Vitaliano PP, et al. . The dialectical behavior therapy ways of coping checklist: development and psychometric properties. J Clin Psychol 2010;66:n/a–82. 10.1002/jclp.20685
    1. Stein AT, Hearon BA, Beard C, et al. . Properties of the Dialectical behavior therapy ways of coping checklist in a diagnostically diverse partial Hospital sample. J Clin Psychol 2016;72:49–57. 10.1002/jclp.22226
    1. Kaufman EA, Xia M, Fosco G, et al. . The difficulties in emotion regulation scale short form (DERS-SF): validation and replication in adolescent and adult samples. J Psychopathol Behav Assess 2016;38:443–55. 10.1007/s10862-015-9529-3
    1. 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 2004;26:41–54. 10.1023/B:JOBA.0000007455.08539.94
    1. Osman A, Bagge CL, Gutierrez PM, et al. . The suicidal behaviors Questionnaire-Revised (SBQ-R): validation with clinical and nonclinical samples. Assessment 2001;8:443–54. 10.1177/107319110100800409
    1. Bowen DJ, Kreuter M, Spring B, et al. . How we design feasibility studies. Am J Prev Med 2009;36:452–7. 10.1016/j.amepre.2009.02.002
    1. Moore CG, Carter RE, Nietert PJ, et al. . Recommendations for planning pilot studies in clinical and translational research. Clin Transl Sci 2011;4:332–7. 10.1111/j.1752-8062.2011.00347.x
    1. Leon AC, Davis LL, Kraemer HC. The role and interpretation of pilot studies in clinical research. J Psychiatr Res 2011;45:626–9. 10.1016/j.jpsychires.2010.10.008
    1. Kistin C, Silverstein M. Pilot studies: a critical but potentially misused component of interventional research. JAMA 2015;314:1561–2. 10.1001/jama.2015.10962
    1. Kraemer HC, Mintz J, Noda A, et al. . Caution regarding the use of pilot studies to guide power calculations for study proposals. Arch Gen Psychiatry 2006;63:484–9. 10.1001/archpsyc.63.5.484
    1. Tickle-Degnen L. Nuts and bolts of conducting feasibility studies. Am J Occup Ther 2013;67:171–6. 10.5014/ajot.2013.006270
    1. Thabane L, Ma J, Chu R, et al. . A tutorial on pilot studies: the what, why and how. BMC Med Res Methodol 2010;10:1. 10.1186/1471-2288-10-1
    1. Benedetto U, Head SJ, Angelini GD, et al. . Statistical primer: propensity score matching and its alternatives. Eur J Cardiothorac Surg 2018;53:1112–7. 10.1093/ejcts/ezy167
    1. Chetwin A. Multi-stakeholders’ attitudes and perceptions towards adopting an early autism intervention. Available: [Accessed 24 May 2019].

Source: PubMed

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