Designing and revising a cognitive behavioral group intervention for psychological distress among female university students

Background: Psychological distress in the form of depression and/or anxiety has been found to be common among university students, especially in females. Roughly one in five of Icelandic female university students exhibit elevated psychological distress, yet less than 30% of them do receive professional mental health care. To ameliorate the psychological distress a cognitive behavioral group therapy was designed to target the distress. The purpose of this paper is to describe the main steps in designing the respective intervention and the revisions made by the expert panel based on the validation of the preliminary intervention and the experience of the advanced practice psychiatric nurses therapists. Methods: The intervention design took place in four phases. Initially psychological distress was defined, secondly a literature review was conducted to see if there were effective interventions available to solve the problem. Thirdly the drafting of the intervention took place based on theory and evidence and finally the intervention was validated with quantitative and qualitative methods. The intervention was provided by two advanced practice psychiatric nurses in 4 sessions in groups of 5 to 8 females. An expert panel of 6 psychiatric nurses was formed to guide the intervention design, the delivery of the intervention and intervention validation. Results: The quantitative and qualitative validation of the preliminary intervention showed that psychological distress decreased and was acceptable to participants. Conclusions: The validation of the preliminary intervention provided the expert group with rationale for modifying the content and structure of the intervention in nine categories.