Randomised control trial of a low-intensity cognitive-behaviour therapy intervention to improve mental health in university students

Objective - University students have high rates of clinical and subclinical depression and anxiety symptoms, low rates of face-to-face help-seeking, and high rates of Internet use. Low-intensity cognitive-behaviour therapy (LI-CBT) that incorporates e-resources has potential for increasing access to help by distressed students. Method - This article reports the first randomised controlled trial of LI-CBT in a university context, comparing it with self-help information only. Results - Only 11% of distressed students agreed to participate in treatment, and only 58% of LI-CBT participants attended any sessions. Almost all of the 107 participants were female, with an average age of 23 and high average distress. Intention-to-treat analyses using mixed models regressions showed that LI-CBT participants had greater reductions in depression and anxiety than controls who received self-help information only, but only over the first 2 months. Correction for baseline levels eliminated these effects, although differential improvements for anxiety and stress were seen if analyses were restricted to LI-CBT participants who attended sessions. LI-CBT also resulted in differential reductions in perceived connection to the university perhaps because of greater usage of staff resources by controls. Conclusions - Results provide some support for a potential role for LI-CBT within universities, but suggest that marketing and engagement strategies may need refinement to maximise its uptake and impact