# Improving the emotional wellbeing of university students through culturally adapted cognitive and dialectical behavioral group interventions: protocol for two parallel feasibility and effectiveness studies

## TL;DR

This study adapts cognitive and dialectical behavioral therapies for university students in Türkiye to improve mental health and assesses their effectiveness.

## Contribution

The study introduces culturally adapted group CBT and DBT interventions tailored for university students in Türkiye.

## Key findings

- Culturally adapted CBT and DBT interventions were developed for anxiety and emotion regulation in university students.
- Feasibility and effectiveness of the interventions will be evaluated through a structured study protocol.
- Results will guide future large-scale mental health interventions in university settings in the Global South.

## Abstract

University is a period of increased vulnerability to mental health challenges, with anxiety and difficulties in emotion regulation among the most prevalent. Culturally adapted Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) group interventions can support student well-being, yet scalable options remain limited. To address this gap, group CBT for anxiety management and group DBT for emotion regulation were culturally adapted for university students in Türkiye. Adaptations involved revising content and language, removing culturally mismatched elements, and incorporating culturally relevant and age-appropriate material.

This project aims to assess the feasibility and effectiveness of delivering culturally adapted group CBT for anxiety management and group DBT for emotion regulation.

The project includes three steps: (i) a comprehensive systematic review of group CBT and DBT interventions worldwide; (ii) translation, adaptation, localization, and development of 8-session group interventions; and (iii) implementation, data collection, and analysis. Participants are allocated to either the CBT group for anxiety management or the DBT group for emotion regulation.

Standardized measures of anxiety or emotion regulation are administered at baseline, post-intervention, and six-week follow-up for both experimental and waitlist arms. Qualitative data are collected through semi-structured interviews conducted after intervention completion.

In this project, the feasibility and effectiveness of culturally adapted CBT and DBT group interventions for university students in Türkiye will be evaluated. Findings will inform wider-scale application of evidence-based therapies in university counseling centres in Global South and guide the design of a future randomized controlled trial.

NCT07096154 and NCT07096141 on clinicaltrials.gov.

Graphical Abstract

Group Cognitive Behavioral Therapy (CBT) for anxiety management and group Dialectical Behavior Therapy for emotion regulation interventions are culturally adapted to promote mental well-being of university students.