Effectiveness of adapted self-help plus (SH+) to reduce psychological distress among university students in Indonesia (APRESIASI): protocol of a randomized controlled trial

Abstract Background University students in Indonesia are exposed to stressors such as high academic task load, financial strains, and relationship problems. Therefore, they are at risk of developing symptoms of common mental disorders, such as depression and anxiety (i.e., psychological distress). H...

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Main Authors: Dhini Andriani, Fredrick D. Purba, Anke B. Witteveen, Neily Zakiyah, Marit Sijbrandij
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Psychology
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Online Access:https://doi.org/10.1186/s40359-025-03026-y
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author Dhini Andriani
Fredrick D. Purba
Anke B. Witteveen
Neily Zakiyah
Marit Sijbrandij
author_facet Dhini Andriani
Fredrick D. Purba
Anke B. Witteveen
Neily Zakiyah
Marit Sijbrandij
author_sort Dhini Andriani
collection DOAJ
description Abstract Background University students in Indonesia are exposed to stressors such as high academic task load, financial strains, and relationship problems. Therefore, they are at risk of developing symptoms of common mental disorders, such as depression and anxiety (i.e., psychological distress). However, there is a gap between the number of mental health professionals and the number of students in need of a psychological intervention. Self-Help Plus (SH+), a guided group-based stress management intervention developed by the WHO, was adapted to the population and context to address barriers in accessing mental health care among students in Indonesia. The aim of the APRESIASI study is to assess the effectiveness and cost-effectiveness of SH + in reducing psychological distress among university students in Indonesia. Methods The SH + intervention will be tested in a pragmatic superior randomized controlled trial (RCT) with two parallel arms. SH + will be tested among Indonesian university students with symptoms of psychological distress (Patient Health Questionnaire-9; PHQ-9 ≥ 5.5 < 20). The participants (n = 296) will be randomized into either the intervention group that receives SH + with enhanced care as usual (ECAU), or into the ECAU only with a 1:1 allocation ratio. The primary outcome is the reduction in psychological distress assessed with the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) at three-month follow-up. The secondary outcomes are symptoms of depression, anxiety, perceived stress, functioning, resilience, quality of life, identified problems, treatment acceptability, and cost-effectiveness. Discussion To our knowledge, SH + is the first a transdiagnostic, face-to-face, and group-based intervention to be tested for its effectiveness in reducing psychological distress in Indonesia. If shown to be effective, SH + has the potential to be scaled up across university settings. Trial registration ISRCTN15761598, 14/07/2023.
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spelling doaj-art-e7179619775d46d882141ee51bf9e7462025-08-20T03:46:15ZengBMCBMC Psychology2050-72832025-07-0113111210.1186/s40359-025-03026-yEffectiveness of adapted self-help plus (SH+) to reduce psychological distress among university students in Indonesia (APRESIASI): protocol of a randomized controlled trialDhini Andriani0Fredrick D. Purba1Anke B. Witteveen2Neily Zakiyah3Marit Sijbrandij4Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit AmsterdamDepartment of Psychology, Faculty of Psychology, Universitas PadjadjaranDepartment of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit AmsterdamDepartment of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas PadjadjaranDepartment of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit AmsterdamAbstract Background University students in Indonesia are exposed to stressors such as high academic task load, financial strains, and relationship problems. Therefore, they are at risk of developing symptoms of common mental disorders, such as depression and anxiety (i.e., psychological distress). However, there is a gap between the number of mental health professionals and the number of students in need of a psychological intervention. Self-Help Plus (SH+), a guided group-based stress management intervention developed by the WHO, was adapted to the population and context to address barriers in accessing mental health care among students in Indonesia. The aim of the APRESIASI study is to assess the effectiveness and cost-effectiveness of SH + in reducing psychological distress among university students in Indonesia. Methods The SH + intervention will be tested in a pragmatic superior randomized controlled trial (RCT) with two parallel arms. SH + will be tested among Indonesian university students with symptoms of psychological distress (Patient Health Questionnaire-9; PHQ-9 ≥ 5.5 < 20). The participants (n = 296) will be randomized into either the intervention group that receives SH + with enhanced care as usual (ECAU), or into the ECAU only with a 1:1 allocation ratio. The primary outcome is the reduction in psychological distress assessed with the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) at three-month follow-up. The secondary outcomes are symptoms of depression, anxiety, perceived stress, functioning, resilience, quality of life, identified problems, treatment acceptability, and cost-effectiveness. Discussion To our knowledge, SH + is the first a transdiagnostic, face-to-face, and group-based intervention to be tested for its effectiveness in reducing psychological distress in Indonesia. If shown to be effective, SH + has the potential to be scaled up across university settings. Trial registration ISRCTN15761598, 14/07/2023.https://doi.org/10.1186/s40359-025-03026-ySelf-help plus (SH+)University studentsIndonesiaPsychological distress
spellingShingle Dhini Andriani
Fredrick D. Purba
Anke B. Witteveen
Neily Zakiyah
Marit Sijbrandij
Effectiveness of adapted self-help plus (SH+) to reduce psychological distress among university students in Indonesia (APRESIASI): protocol of a randomized controlled trial
BMC Psychology
Self-help plus (SH+)
University students
Indonesia
Psychological distress
title Effectiveness of adapted self-help plus (SH+) to reduce psychological distress among university students in Indonesia (APRESIASI): protocol of a randomized controlled trial
title_full Effectiveness of adapted self-help plus (SH+) to reduce psychological distress among university students in Indonesia (APRESIASI): protocol of a randomized controlled trial
title_fullStr Effectiveness of adapted self-help plus (SH+) to reduce psychological distress among university students in Indonesia (APRESIASI): protocol of a randomized controlled trial
title_full_unstemmed Effectiveness of adapted self-help plus (SH+) to reduce psychological distress among university students in Indonesia (APRESIASI): protocol of a randomized controlled trial
title_short Effectiveness of adapted self-help plus (SH+) to reduce psychological distress among university students in Indonesia (APRESIASI): protocol of a randomized controlled trial
title_sort effectiveness of adapted self help plus sh to reduce psychological distress among university students in indonesia apresiasi protocol of a randomized controlled trial
topic Self-help plus (SH+)
University students
Indonesia
Psychological distress
url https://doi.org/10.1186/s40359-025-03026-y
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