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University students' psychological well-being is a growing public health concern. University life involves major psychological, social, and academic changes, increasing vulnerability to mental health issues. Group-based Dialectical Behaviour Therapy (DBT) has been shown to support student well-being effectively. However, interventions tailored to specific cultural and contextual needs are more likely to be helpful. Western-based therapy models may not fully align with non-Western populations, such as students in Türkiye.
In Türkiye, public mental health services are often limited to short psychiatric consultations, while therapy is typically accessed privately. University counselling centres offering free or low-cost therapy are therefore essential. Cost-effective interventions like group DBT may be especially valuable in these settings. To address this gap, culturally adapted DBT groups should be developed and evaluated for Turkish university students.
This study is part of the UniWELL Project (sister to UniWELL-C) and examines the effectiveness of DBT-informed emotion regulation groups for Turkish students. Any Bogazici University student aged 18+ is eligible. Exclusion criteria include severe mental illness, high risk of harm to self/others, or scoring below threshold on the Difficulties in Emotion Regulation Scale (DERS-16), as these students may require more individual support.
The study includes participation in an 8-session DBT-informed group. Participants are expected to benefit from free psychological support, guided reflection, and shared experiences with peers. The research will also contribute to the evidence base for culturally adapted interventions.
There are some risks: participants may feel overwhelmed during the sessions or while completing questionnaires. If so, support will be provided by a clinical psychology master's student and/or the group facilitator, under supervision of an experienced clinical psychologist. If a participant's risk increases, they will be referred to psychiatric services. An emergency contact will be requested to ensure safety if needed.
The study will take place at Bogazici University through the Translational Clinical Psychology Lab, in collaboration with BUREM. It is expected to run for at least one year, possibly extending up to three years. The study is partially funded by the Bogazici Scientific Research Projects Unit (20022). Dr Ayse Akan (t-clinpsylab@bogazici.edu.tr) is the study lead and main contact.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| DBT Experimental Arm | Experimental | An 8-session Dialectical Behaviour Therapy informed emotional regulation group psychotherapy will be offered to the experimental group of about 40 university students who volunteered and scored above the threshold on the Difficulties in Emotion Regulation Scale (DERS-16). |
|
| DBT Waitlist Arm | No Intervention | DBT waitlist control |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| DBT-informed Group Psychotherapy for Emotion Regulation | Behavioral | An 8-session Dialectical Behaviour Therapy informed emotion regulation psychotherapy group. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Difficulties in Emotion Regulation Scale (DERS-16) | Difficulties in Emotion Regulation Scale (DERS-16) is a questionnaire that measures different aspects of difficulties in emotion, including emotional awareness, clarity, acceptance, impulse control, and goal-directed behavior during emotional distress. Each item is scored on a 5-point Likert scale, from 1 (almost never) to 5 (almost always), resulting in a total score range of 16 to 80. Higher scores indicate greater difficulties in emotion regulation. | Baseline, immediately after the intervention, and follow-up 6 weeks after the completion intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Borderline Evaluation of Severity Over Times (BEST) | The Borderline Evaluation of Severity Over Times (BEST) is a tool that measures the severity and progression of thoughts, feelings, and behaviors that are typical of Borderline Personality Disorder. Each item is rated on a 5-point Likert scale, where 1 indicates none/rarely and 5 indicates almost always, resulting in a total score range between 12 and 72. Higher scores indicate more severe symptoms. The scale also provides information about positive behaviors separately. |
| Measure | Description | Time Frame |
|---|---|---|
| Group Session Rating Scale (GSRS) | Group Session Rating Scale (GSRS) is a brief 4-item scale used for assessing the members' evaluation of each session regarding the therapeutic relationship, goals and topics, approach or method, and overall experience. Each item is rated on a visual analog scale from 0 to 10, resulting in a total score between 0 and 40. Higher scores indicate more satisfaction with the group session. |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ayse Akan, DClinPsych | Contact | +902123597054 | ayse.akan@bogazici.edu.tr |
| Name | Affiliation | Role |
|---|---|---|
| Ayse Akan, DClinPsych | Bogazici University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Bogazici University Student Guidance and Psychological Counselling Centre (BUREM) | Recruiting | Istanbul | 34342 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41873829 | Derived | Akan A, Korkut NH. Improving the emotional wellbeing of university students through culturally adapted cognitive and dialectical behavioral group interventions: protocol for two parallel feasibility and effectiveness studies. Transl Behav Med. 2026 Jan 7;16(1):ibag010. doi: 10.1093/tbm/ibag010. |
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The anonymised quantitative data will be kept securely on a password protected drive for 10 years and will be shared with peer-reviewers if requested, while the qualitative interview transcripts will also be kept securely on a password protected drive but they will not be shared with peer-reviewers (will be only open to the research team) until it is deleted after 10 years. Some of the research team may use these data in secondary analysis projects.
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The data supporting this study's findings will be available from the corresponding author upon reasonable request, starting immediately after publication. Data will be maintained and available for 10 years after the last data collection.
Being a peer-reviewer / researcher.
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| ID | Term |
|---|---|
| D000080103 | Emotional Regulation |
| D000092862 | Psychological Well-Being |
| ID | Term |
|---|---|
| D000068356 | Self-Control |
| D012919 | Social Behavior |
| D001519 | Behavior |
| D010549 | Personal Satisfaction |
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Single-centre interventional non-blinded mixed-methods non-randomised pre-post design with a waitlist control and 6 weeks follow-up feasibility and psychotherapy effectiveness study.
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| Baseline, immediately after the intervention, and follow-up 6 weeks after the completion intervention |
| Depression Anxiety and Stress Scale (DASS-42) | Depression Anxiety Stress Scale (DASS-42) is a questionnaire that measures the negative emotional states depression, anxiety and stress. Each subscale is scored separately. Each item is rated on a 4-point Likert scale from 0 (did not apply to me at all) to 3 (applied to me very much or most of the time). Scores for each subscale range from 0 to 42, and the combined total scale ranges from 0 to 126. Higher scores indicate more severity. The severity is categorized into "normal", "mild", "moderate", "severe", and "extremely severe". | Baseline, immediately after the intervention, and follow-up 6 weeks after the completion of the intervention |
| Generalised Anxiety Disorder-7 (GAD7) | The Generalised Anxiety Disorder - 7 Scale (GAD7) is a questionnaire used to screen for Generalised Anxiety Disorder and assess the severity of anxiety symptoms. Each item is rated on a 4-point Likert scale from 0 (not at all) to 3 (nearly every day), resulting in a total score ranging from 0 to 21. Higher scores indicate more severity. The severity is categorized into "minimal", "mild", "moderate", and "severe". | Baseline, immediately after the intervention, and follow-up 6 weeks after the completion of the intervention |
| Patient Health Questionnaire (PHQ9) | The Patient Health Questionnaire (PHQ9) is a scale used for assessing the presence and the severity of depression. Each item is rated on a 4-point Likert scale from 0 (not at all) to 3 (nearly every day), resulting in a total score that ranges from 0 to 27. Higher scores indicate more severity of depressive symptoms. The severity is categorized into "minimal", "mild", "moderate", "moderately severe" and "severe". | Baseline, immediately after the intervention, and follow-up 6 weeks after the completion of the intervention |
| Outcome Rating Scale (ORS) | Outcome Rating Scale (ORS) is a brief 4-item scale used for assessing the members' overall functioning in key areas: individual well-being, interpersonal relationships, social role, and overall well-being. Each item is rated on a visual analog scale from 0 to 10, resulting in a total score between 0 and 40. Higher scores indicate better overall functioning and well-being. | From enrollment to the end of treatment at 8 weeks |
| Qualitative data | Participants who completed their groups will also be invited to attend a semi-structured interview for in-depth qualitative feedback when they finish the intervention. Below are the sample questions to be asked to the participants:
| Up to 12 weeks following the completion of the intervention |
| From enrollment to the end of treatment at 8 weeks |
| Feedback Form | The client feedback form is a 4-point self-report scale with a free-text box for additional comments. It is used to gather information about participants' experiences with the group facilitator and the intervention. The form includes questions about the therapeutic process, the structure of the sessions, the therapist's approach, and whether the support was helpful. | Immediately after the intervention |
| Translational Clinical Psychology Lab | Recruiting | Istanbul | 34342 | Turkey (Türkiye) |
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