Mindfulness and Acceptance Applied in Colleges Through Web-Based Guided Self-Help

描述（由申请人提供）：近一半的大学生有可诊断的心理健康问题（布兰科等人，2008年）。大学咨询中心（CCC）面临着来自大学，学生和家长的服务需求日益增加，以满足学生的治疗需求（Beamish，2005），在日益严重的情况下，资源不断减少（Gallagher，2009）。需要创新的，具有成本效益的解决方案，可以提高治疗效果与一系列提出的问题，同时减少辅导员的工作量。拟议的项目旨在通过开发基于网络的指导自助版本的接受和承诺疗法（ACT; Hayes，Strosahl和Wilson，1999年）来满足这些需求，这是一种基于证据的跨诊断疗法，已被发现通过针对经验性回避，避免不想要的情绪和消极思想的倾向来有效治疗一系列心理健康问题（Hayes等人，2006年）。ACT方案将提供一种手段，对在CCC环境中遇到的一系列问题进行有效的治疗，而在线指导自助形式将减少咨询师为每个客户提供的工作量，提高成本效益并减少等待名单。该产品将通过一系列自助模块治疗学生，并培训CCC辅导员如何实施引导自助干预。第一阶段将侧重于开发两个自助模块（正念和接受）以及一个辅导员门户网站，以审查学生对该计划的使用情况，并接受有关实施ACT指导自助的培训。焦点小组与寻求治疗的学生和重点访谈辅导员将被用来更好地适应这些人群的计划内容和设计。原型自助和辅导员门户网站将进行评估的可用性与思考出声程序，然后由20名辅导员和60名客户（每个CCC辅导员3名学生客户）的前后可行性试验。第二阶段将扩展该计划，包括12个自助模块，涵盖ACT的主要概念：正念，接受，融合，注意自我，价值观和承诺行动，承诺行动模块中的目标内容是基于初步评估和顾问判断的特定问题领域。将进一步开发辅导员门户网站，以提供与每个模块有关的培训材料，以便与学生以及学生之间进行更多的互动（例如，添加移动的技术;为学生创建主持论坛）并允许高级的节省时间的特征（例如，生成关于学生使用该程序的报告，该报告可以作为进度记录归档）。这些组成部分将共同为大学生提供一个全面的自助干预，以及一个门户网站，辅导员监测和支持学生的进步。第二阶段产品将在一项随机试验中进行评估，该试验涉及各种高等教育环境、ACT辅导员的专业知识水平以及不同的项目功能。 公共卫生相关性：大学咨询中心预计将为越来越多的学生提供服务，提出越来越严重的问题，尽管同时减少或停滞的可用资源。拟议的项目旨在提高大学咨询中心的能力，有效和高效地治疗学生提出了一系列的心理健康问题，同时减少辅导员的工作量，通过开发一个基于网络的指导自助程序。相当大比例的美国人口在他们生命中的某个时刻都在上大学，改善大学咨询治疗计划可能会产生广泛的公共卫生影响。

DESCRIPTION (provided by applicant): Nearly half of all college students have a diagnosable mental health problem (Blanco et al., 2008). College counseling centers (CCCs) are faced with increasing demands for services from Universities, students and parents to meet the treatment needs of their students (Beamish, 2005), in the context of increasingly severe cases and declining resources (Gallagher, 2009). Innovative, cost effective solutions are needed that can improve treatment effectiveness with a range of presenting problems while reducing counselor workloads. The proposed project seeks to meet these needs by developing a web-based guided self-help version of Acceptance and Commitment Therapy (ACT; Hayes, Strosahl and Wilson, 1999), an evidence-based transdiagnostic therapy that has been found to effectively treat a range of mental health problems by targeting experiential avoidance, the tendency to avoid unwanted emotions and negative thoughts (Hayes et al., 2006). An ACT program would provide a means of implementing effective treatment for the range of problems encountered in the CCC setting, while the online guided self-help format would reduce counselors' workload for each client, improving cost- effectiveness and reducing waiting lists. This product would both treat students through a series of self-help modules and train CCC counselors in how to implement the guided self-help intervention. Phase I will focus on developing two self-help modules (mindfulness and acceptance) as well as a counselor portal to review students' use of the program and to receive training on implementing ACT guided self-help. Focus groups with treatment seeking students and focused interviews with counselors will be used to better adapt program content and design for these populations. The prototype self-help and counselor portals will be evaluated in terms of usability with think aloud procedures followed by a pre-post feasibility trial with 20 counselors and 60 clients (3 student clients per CCC counselor). Phase II will expand the program to include 12 self-help modules across the main ACT concepts: mindfulness, acceptance, defusion, noticing self, values, and committed action, with targeted content in the committed action module for specific problem areas based on initial assessment and counselor judgment. The counselor portal will be further developed to provide access to training material in relation to each module, to allow for greater interactions with and between students (e.g., addition of mobile technologies; creating a moderated forum for students) and to allow for advanced time-saving features (e.g., generating reports on student use of the program which can be filed as progress notes). These components together will provide a comprehensive self-help intervention for college students as well as a portal for counselors to monitor and support students' progress. The Phase II product will be evaluated in a randomized trial across various higher education settings, counselor expertise levels with ACT, and different program features. PUBLIC HEALTH RELEVANCE: College counseling centers are expected to serve an increasingly higher number of students, presenting with increasingly more severe problems, despite a concurrent reduction in or stagnation of available resources. The proposed project seeks to improve college counseling centers' ability to effectively and efficiently treat students presenting with a range of mental health problems, while reducing counselor workloads, by developing a web-based guided self- help program. A substantial percentage of the US population is in college at some point in their lives, and improving college counseling treatment programs could have a broad public health impact.