Symposia
Transdiagnostic
Emily E. Bernstein, Ph.D.
Clinical Psychologist
Massachusetts General Hospital, Harvard Medical School
Somerville, Massachusetts
Nicole LeBlanc, Ph.D.
Postdoctoral Scholar
Massachusetts General Hospital
Needham, Massachusetts
Richard J. McNally, Ph.D.
Professor
Harvard University
Cambridge, MA
Background: University students are at substantial risk for developing or worsening psychopathology. This risk is notably heightened in graduate students, who are experiencing severe anxiety, depression, and psychological distress at disproportionately high rates compared to undergraduates and peers who are not in school. Targeted interventions that can mitigate causal risk factors or burgeoning mental health problems have the potential to make a large impact. Brief, skills-based interventions are particularly promising for their accessibility and scalability.
Methods: We developed and administered virtually a single-session group intervention tailored for this population. Using a transdiagnostic framework, we emphasized the adaptive nature of emotions—even strong, negative ones—and chose core CBT skills from the Unified Protocol to increase emotional, cognitive, and behavioral flexibility. The workshop was delivered by trained graduate students, leveraging a peer-to-peer connection.
Results: The program demonstrated strong feasibility and acceptability, with attendance rates >85% and high acceptability, satisfaction, and credibility scores. Participants exhibited improvements in depression and anxiety symptoms and emotion regulation (emotional avoidance, coping self-efficacy), even at 24-weeks follow-up and during the COVID-19 pandemic, ps< .05. A majority of students reported practicing skills at least a few times each week across the follow-up period (means range from 3.2-3.98), but also consistently reported wanting to practice more. More frequent practice of skills predicted larger gains in self-efficacy, p < .05. The biggest barriers to skills use were forgetting, time constraints, and difficulty implementing a skill when experiencing stress or another strong emotion. Expectations that the skills would help and remembering how to use skills were infrequently identified as barriers.
Conclusions: Graduate students have seldom been beneficiaries of university-based clinical research. Furthermore, most campus mental health centers do not have the capacity to provide services to the many students who need or could benefit from them. This intervention offers much needed, meaningful support. Moreover, results provide helpful insights for brief interventions more broadly. We will highlight and discuss patterns of different skills use, barriers to further engagement with material, and therefore opportunities for ongoing, light touch support (e.g., digital materials, boosters).