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等人，2008年)。在日益严重的病例和日益减少的资源的背景下，大学咨询中心(CCCS)面临着来自大学、学生和家长对服务的日益增长的需求，以满足他们学生的治疗需求(Beamish，2005)。需要创新的、具有成本效益的解决方案，以提高治疗效果，解决一系列提出的问题，同时减少咨询人员的工作量。该项目旨在通过开发基于网络的自助版本的接受与承诺疗法(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，已被发现通过针对经验回避、避免不想要的情绪和负面想法的倾向而有效地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，有效地处理在CCC环境中遇到的一系列问题，而在线指导自助形式将减少每个客户的辅导员的工作量，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对待学生，并培训CCC辅导员如何实施指导性自助干预。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，以审查学生使用该计划的情况，并接受关于实施ACT引导自助的培训。与寻求治疗的学生组成的焦点小组以及与辅导员的重点访谈将被用于更好地调整节目内容和设计，以适应这些人群。原型自助和辅导员门户将在可用性方面进行评估，使用有声思考程序，然后对20名辅导员和60名客户(每个CCC辅导员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、灌输、注意自我、价值观和承诺行动，根据初始评估和辅导员判断，在承诺行动模块中针对特定问题领域提供有针对性的内容。将进一步开发辅导员门户，以提供与每个模块有关的培训材料，以便加强与学生之间的互动(例如，增加移动技术；为学生创建一个有节制的论坛)，并提供先进的节省时间的功能(例如，生成学生使用方案的报告，可作为进度说明存档)。这些组成部分将为大学生提供全面的自助干预，也将成为辅导员监控和支持学生进步的门户。第二阶段的产品将在不同的高等教育环境、具有ACT的顾问专业水平和不同的计划功能的随机试验中进行评估。 与公共健康相关：大学咨询中心预计将为越来越多的学生提供服务，出现越来越严重的问题，尽管可用资源同时减少或停滞不前。拟议中的项目旨在通过开发基于网络的指导自助计划，提高大学咨询中心有效和高效地治疗出现一系列心理健康问题的学生的能力，同时减少咨询师的工作量。相当大比例的美国人在人生的某个阶段都在上大学，而改善大学心理咨询治疗项目可能会对公共健康产生广泛的影响。

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.