Development and evaluation of an internet-based cognitive behavioral intervention program for reducing psychological distress of Chinese university students in Hong Kong

The mental health of university students has always been a concern in the higher education system. University students are vulnerable to mental health problems as they face a variety of challenges in university life. However, university counseling services are often inadequate to meet their mental health needs, especially in Hong Kong. In recent years, the advent of internet-based psychosocial intervention has rapidly ensued, and hailed as a possible solution as it is highly cost-effective yet has promising efficacy, with internet-based cognitive behavioral intervention (iCBI) as the most prevalent means. Nevertheless, this kind of internet-based intervention is underdeveloped in Hong Kong. Moreover, prevention is better than treatment. Given the high costs of treating mental illness for individuals and society as a whole, it is important to develop early intervention programs to prevent at-risk populations from developing various mental health problems (Cukrowicz, Smith, Hohmeister & Joiner, 2009).

This project therefore aims to develop and evaluate a culturally appropriate iCBI program to reduce the psychological distress and improve the mental health of Chinese university students in Hong Kong. Participants will be openly recruited from the 8 public universities in Hong Kong and those with mild to moderate levels of psychological distress as assessed by an online pre-program questionnaire will be invited to take part in this project. A waiting-list control group design will be adopted to conduct a randomized controlled trial. Two hundred and eighty Chinese students will participate, with 140 in the immediate treatment group (i.e. the iCBI program) and the remaining 140 in a waiting-list control group. The iCBI program will include 8 online modules of CBI and 1 final review session with a telephone follow-up by a qualified cognitive behavioral therapist. The program will feature an interactive design with multi-media contents, and includes mood checks, informational briefings, case demonstrations, interactive exercises, and online homework and feedback. An outcome measurement package will be administered at pre-test, post-test and 3-month follow-up for both the experimental and control groups. Repeated measures MANCOVA will be conducted to test the effectiveness of the program at both the cognitive and affective levels. The findings of this project will provide empirical evidence of the effectiveness of iCBI for Chinese university students. Most importantly, in the long run, the program will be a valuable supplementary resource for Hong Kong university counselors to better address the needs of their student clients.