The goal of this clinical trial is to learn if an adapted version of Self-Help Plus (SH+), a stress management program developed by the World Health Organization, can reduce stress and improve well-being in international students at a U.S. university. The main questions it aims to answer are:
Does SH+ reduce perceived stress, anxiety, and depressive symptoms in international students? Does SH+ improve feelings of social support, self-efficacy, and adjustment in a new cultural environment?
Participants will:
Attend a two-day in-person workshop that includes animated videos, interactive activities, and group discussions.
Complete three surveys (before the workshop, right after, and six weeks later) about stress, mood, and well-being.
Optionally, take part in a short interview to share feedback about their experience.
Enrolled as an international student at The New School
Age 18 years or older
Willing to provide informed consent and complete study assessments
Score of ≥3 on the PHQ-4, indicating at least mild distress
Severe psychiatric conditions requiring immediate intervention (e.g., active psychosis, severe mood disorders)
Visual, hearing, or neurocognitive impairments that prevent engagement with the intervention
Having an advanced degree in psychology or mental health-related fields (to prevent prior knowledge bias)
Score of 2 or higher on PHQ-4 Item 3 or Item 4 (frequent thoughts of self-harm or severe distress)
Single group
Digitized SH+
BehavioralDigitized SH+ is a group-based, stress management program (adapted from the original Self-Help Plus intervention developed by the World Health Organization), that utilizes animated videos and group discussions to teach participants skills such as Grounding, Unhooking (from difficult thoughts), Being Kind (to self and others), Identifying Values, and Making Room for Difficult Thoughts and Feelings.
Perceived Stress Scale (PSS-10)
Self-reported perceived stress levels. Higher scores indicate greater perceived stress. Range: 0-40 Higher scores= worse outcome (greater perceived stress) Cutoffs: 0-13 low, 14-26 moderate, 27-40 high
Patient Health Questionnaire (PHQ-9)
Range: 0-27 Higher scores = worse outcome (greater depression severity). Cutoffs: 1-4 minimal, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe.
General Anxiety Disorder (GAD-7)
Range: 0-21 Higher scores = worse outcome (greater anxiety severity) Cutoffs: 0-4 minimal, 5-9 mild, 10-14 moderate, 15-21 severe
Self-Measure for Loneliness (UCLA Loneliness Scale)
Range: 0-60 (20 items, scored 0-3) Higher scores = worse outcome (greater loneliness/social isolation).
Social Support (SSQ)
Range varies (depends on individual): self-reported number of people available for support + satisfaction rating). Higher scores = better outcome (greater perceived support and satisfaction).
Self-Efficacy (General Self-Efficacy Scale)
Range: 10-40 (10 items, scored 1-4). Higher scores = better outcome (greater self-efficacy/confidence in coping).
Psychological Adjustment (BASE-6)
Range: 6-42 (six items, each scored 1-7). Higher scores = worse outcome (greater emotional distress and adjustment difficulty).
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