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（Blanco et al., 2008）。大学咨询中心（CCCs）面临着越来越多的来自大学、学生和家长的服务需求，以满足学生的治疗需求（Beamish, 2005），在日益严重的病例和资源下降的背景下（Gallagher, 2009）。创新，成本效益的解决方案是需要的，可以提高治疗效果与一系列呈现的问题，同时减少咨询师的工作量。拟议的项目旨在通过开发基于网络的自助版接受和承诺疗法（ACT; Hayes， Strosahl和Wilson， 1999）来满足这些需求，这是一种基于证据的跨诊断疗法，已被发现可以有效地治疗一系列心理健康问题，通过针对经验回避，避免不想要的情绪和消极想法的倾向（Hayes等人，2006）。ACT项目将提供一种手段，对在CCC环境中遇到的一系列问题实施有效的治疗，而在线指导自助形式将减少咨询师对每个客户的工作量，提高成本效益并减少等候名单。该产品将通过一系列自助模块对学生进行治疗，并培训CCC辅导员如何实施引导自助干预。第一阶段将重点开发两个自助模块（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，并接受实施ACT指导自助的培训。寻求治疗的学生的焦点小组和咨询师的重点访谈将被用来更好地适应这些人群的项目内容和设计。自助和咨询师门户的原型将在可用性方面进行评估，并采用“大声思考”程序，随后对20名咨询师和60名客户（每位CCC咨询师3名学生客户）进行事后可行性试验。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、化解、注意自我、价值观和承诺行动，并根据初步评估和咨询师的判断，在承诺行动模块中针对具体问题领域提供有针对性的内容。辅导员门户网站将进一步开发，以提供与每个模块相关的培训材料，允许与学生之间进行更多的互动（例如，增加移动技术；为学生创建一个主持论坛），并允许先进的节省时间的功能（例如，生成学生使用程序的报告，可以作为进度记录归档）。这些组成部分将为大学生提供一个全面的自助干预，同时也为辅导员提供一个监控和支持学生进步的门户。II期产品将在一项随机试验中进行评估，该试验涉及不同的高等教育环境、ACT咨询师的专业水平和不同的项目特点。

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.