e-ISSN 2231-8534
ISSN 0128-7702
Nurul Shuhada Sharif Mudin, Aslina Ahmad, Pau Kee, Muhammad Najib Husman @ Othman and Suhaila Abdul Wahab
Pertanika Journal of Social Science and Humanities, Volume 32, Issue 3, September 2024
DOI: https://doi.org/10.47836/pjssh.32.3.10
Keywords: Cognitive Behavioral Therapy (CBT), stress, systematic literature review (SLR), university students
Published on: 27 September 2024
Despite the growing recognition of mental health challenges among university students, the effectiveness and adaptability of Cognitive Behavioral Therapy (CBT) in these settings, particularly in terms of diverse delivery methods and their impact on outcomes, remains underexplored. This Systematic Literature Review (SLR) rigorously evaluates the efficacy of CBT in reducing stress among university students, utilizing the PRISMA 2020 framework. The review analyzes 27 carefully selected articles, focusing on objective analysis, diverse delivery methods, session and treatment duration, various CBT interventions, and the applied skills and strategies. The findings confirm CBT as an exceptionally effective stress management tool, noted for its adaptability and versatility. The study underscores the importance of online CBT and emphasizes the need for interventions tailored to the diverse needs of students, enhancing their mental well-being. In light of these findings, future research should investigate the mediators and moderators that affect the effectiveness of CBT, assess the long-term impact on academic and mental health outcomes, and explore the sustainability of these interventions. This study contributes to CBT’s theoretical and practical understanding in higher education settings. It lays the groundwork for future explorations to optimize mental health interventions for university students.
Abouzahra, A., Sabraoui, A., & Afdel, K. (2020). Model composition in model driven engineering: A systematic literature review. Information and Software Technology, 125, Article 106316. https://doi.org/10.1016/j.infsof.2020.106316
Agah, J. J., Ede, M. O., Asor, L. J., Ekesionye, E. N., & Ejionueme, L. (2023). Managing examination induced stress among students using FEAR-model of cognitive behavioural intervention: Policy implications for educational evaluators. Current Psychology, 42(4), 3011-3023. https://doi.org/10.1007/s12144-021-01657-z
Ahmad, T. B., & Meriç, M. (2021). The effect of an online psychoeducational stress management program on international students’ ability to cope and adapt. Perspectives in Psychiatric Care, 57(4), 1673-1684. https://doi.org/10.1111/ppc.12735
Ashraf, M., Masroor, U., & Khan, M. J. (2020). Effectiveness of cognitive behavior therapy in reduction of academic stress and enhancement of academic performance in university students. Pakistan Journal of Psychology, 51(2), 3-13.
Asl, R. G., Taghinejad, R., Parizad, N., & Jasemi, M. (2022). The relationship between professional autonomy and job stress among intensive care unit nurses: A descriptive correlational study. Iranian Journal of Nursing and Midwifery Research, 27(2), 119-124. https://doi.org/10.4103/ijnmr.ijnmr_375_20
Azevedo, M. L.D, & Menezes, C. B. (2020). Effects of the mindfulness-based cognitive therapy program on stress, self-efficacy and mindfulness in university students. SMAD Revista Eletrônica Saúde Mental Álcool e Drogas (Edição Em Português), 16(3), 44-54. https://doi.org/10.11606/issn.1806-6976.smad.2020.165513
Benoit, S. (2023). Blended online and face-to-face art therapy. Journal of Applied Arts & Health, 14(1), 101-115. https://doi.org/10.1386/jaah_00130_1
Borjalilu, S., Mazaheri, M. A., & Talebpour, A. (2019). Effectiveness of mindfulness-based stress management in the mental health of Iranian university students: A comparison of blended therapy, face-to-face sessions, and mHealth app (Aramgar). Iranian Journal of Psychiatry and Behavioral Sciences, 13(2), Article e84726. https://doi.org/10.5812/ijpbs.84726
Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11(4), 589-597. https://doi.org/10.1080/2159676X.2019.1628806
Changklang, P., & Ranteh, O. (2023). The effects PF cognitive behavioural therapy on depression, anxiety, stress and self-esteem in public health students, Thailand. Journal of Education and Health Promotion, 12(1), Article 152. https://doi.org/10.4103/jehp.jehp_1274_22
Cozzolino, M., Girelli, L., Vivo, D. R., Limone, P., & Celia, G. (2020). A mind–body intervention for stress reduction as an adjunct to an information session on stress management in university students. Brain and Behavior, 10(6), Article e01651. https://doi.org/10.1002/brb3.1651
El Morr, C., Ritvo, P., Ahmad, F., & Moineddin, R. (2020). Effectiveness of an 8-week web-based mindfulness virtual community intervention for university students on symptoms of stress, anxiety, and depression: Randomized controlled trial. JMIR Mental Health, 7(7), Article e18595. https://doi.org/10.2196/18595
Eneogu, N. D., Ugwuanyi, C. K., & Ugwuanyi, C. S. (2023). Efficacy of cognitive behavioral therapy on academic stress among rural community secondary school economics students: A randomized controlled evaluation. Journal of Rational - Emotive and Cognitive - Behavior Therapy, 42, 245-262. https://doi.org/10.1007/s10942-023-00508-z
Flemming, K., Booth, A., Garside, R., Tunçalp, Ö., & Noyes, J. (2019). Qualitative evidence synthesis for complex interventions and guideline development: Clarification of the purpose, designs and relevant methods. BMJ Global Health, 4(Suppl 1), Article e000882. https://doi.org/10.1136/bmjgh-2018-000882
Hamdan, W., Al Duaijy, L., & Al Sawy, Y. (2021). Effectiveness of bibliotherapy in alleviating examination stress on college students: A quasi-experimental trial. Health Information and Libraries Journal, 38(3), 172-181. https://doi.org/10.1111/hir.12312
Hanani, A., Badrasawi, M., Zidan, S., & Hunjul, M. (2022). Effect of cognitive behavioral therapy program on mental health status among medical student in Palestine during COVID Pandemic. BMC Psychiatry, 22(1), Article 310. https://doi.org/10.1186/s12888-022-03915-1
Higgins, J. P. T., Altman, D. G., Gøtzsche, P. C., Jüni, P., Moher, D., Oxman, A. D., Savović, J., Schulz, K. F., Weeks, L., & Sterne, J. A. C. (2011). The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 343 Article d5928. https://doi.org/10.1136/bmj.d5928
Huberty, J., Green, J., Glissmann, C., Larkey, L., Puzia, M., & Lee, C. (2019). Efficacy of the mindfulness meditation mobile app “calm” to reduce stress among college students: Randomized controlled trial. JMIR MHealth and UHealth, 7(6), Article e14273. https://doi.org/10.2196/14273
Hwang, H., Kim, S. M., Netterstrøm, B., & Han, D. H. (2022). The efficacy of a smartphone-based app on stress reduction: Randomized controlled trial. Journal of Medical Internet Research, 24(2), Article e28703. https://doi.org/10.2196/28703
Joompathong, N., Bunrayong, W., & Chupradit, S. (2022). Stress management programme on the stress of Chiang Mai University students: A pilot study. Journal of Experimental Biology and Agricultural Sciences, 10(4), 879-885. https://doi.org/10.18006/2022.10(4).879.885
Kaplan, V., Düken, M. E., Kaya, R., & Almazan, J. (2023). Investigating the effects of cognitive-behavioral-therapy-based psychoeducation program on university students’ automatic thoughts, perceived stress, and self-efficacy levels. Journal of Research and Health, 13(2), 87-98. https://doi.org/10.32598/JRH.13.2.2125.1
Kiger, M. E., & Varpio, L. (2020). Thematic analysis of qualitative data: AMEE Guide No. 131. Medical Teacher, 42(8), 846-854. https://doi.org/10.1080/0142159X.2020.1755030
Kitchenham, B., & Charters, S. (2007). Guidelines for performing systematic literature reviews in software engineering (Technical Report EBSE-2007-01). School of Computer Science and Mathematics, Keele University.
Kitchenham, B., Brereton, O. P., Budgen, D., Turner, M., Bailey, J., & Linkman, S. (2009). Systematic literature reviews in software engineering–a systematic literature review. Information and Software Technology, 51(1), 7-15.
Lee, T. Y., Hsieh, T. C., Sung, H. C., & Chen, W. L. (2019). Internet-delivered cognitive behavior therapy for young Taiwanese female nursing students with irritable bowel syndrome-a cluster randomized controlled trial. International Journal of Environmental Research and Public Health, 16(5), Article 708. https://doi.org/10.3390/ijerph16050708
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., John, P. A., Clarke, M., Devereaux, P., Kleijnen, J., & Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration. Journal of Clinical Epidemiology, 62(10), e1-e34. https://doi.org/10.1016/j.jclinepi.2009.06.006
Maloney, E., Dowling, C., Deehan, T., & O’ Reilly, G. (2022). Comparing people’s experience of therapy for complex trauma across three modalities: Face-to-face, mixed, and online. OBM Integrative and Complementary Medicine, 7(4). https://doi.org/10.21926/obm.icm.2204051
Marins, M. da R., Daher, D. V., Pinto, A. A., Cardoso, R. da S. S., & Sá, S. P. C. (2020). Art therapy and education between peers connecting the group: An experience report. Revista Brasileira de Enfermagem, 73(5), Article e20180958. https://doi.org/10.1590/0034-7167-2018-0958
Modrego-Alarcón, M., López-del-Hoyo, Y., García-Campayo, J., Pérez-Aranda, A., Navarro-Gil, M., Beltrán-Ruiz, M., Morillo, H., Delgado-Suarez, I., Oliván-Arévalo, R., & Montero-Marin, J. (2021). Efficacy of a mindfulness-based programme with and without virtual reality support to reduce stress in university students: A randomized controlled trial. Behaviour Research and Therapy, 142, Article 103866. https://doi.org/10.1016/j.brat.2021.103866
Mohamed, M. A. (2022). The effect of applying the cognitive-behavioral therapy program on psychological stress and improving the achievement motivation of first-and second-year university students in Egypt. Research Journal Specific Education, (71), 27-48. https://doi.org/10.21608/mbse.2022.156809.1237
Murad, O. S. (2021). Effectiveness of a cognitive-behavioral therapy program on reducing psychological stress and improving achievement motivation among university students. Universal Journal of Educational Research, 9(6), 1316-1322. https://doi.org/10.13189/ujer.2021.090621
Naini, R., Wibowo, M. E., & Mulawarman, M. (2021). Efficacy of online group counseling with mindfulness-based cognitive approach to enhance students’ humility. Islamic Guidance and Counseling Journal, 4(1), 78-90. https://doi.org/10.25217/igcj.v4i1.1280
Newcombe, B. C., Olthuis, J. V., MacLean, M., Hamilton, R., & McAulay, T. (2023). CBT + exercise vs treatment as usual in treating anxiety and depression in university students: A pilot study. Journal of College Student Mental Health, 38(2), 311-327. https://doi.org/10.1080/87568225.2023.2181255
Oh, Y., & Cho, E. (2020). Effects and traits of online narrative group counseling using video conferencing modality: Comparing with face-to-face group counseling. The Journal of the Convergence on Culture Technology, 6(4), 401-409. https://doi.org/10.17703/JCCT.2020.6.4.401
Okoli, C. (2015). A guide to conducting a standalone systematic literature review. Communications of the Association for Information Systems, 37, 879-910. https://doi.org/10.17705/1CAIS.03743
Page, M. J., Mckenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-wilson, E., Mcdonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, Article n71. https://doi.org/10.1136/bmj.n71
Parsons, D., Gardner, P., Parry, S., & Smart, S. (2022). Mindfulness-based approaches for managing stress, anxiety and depression for health students in tertiary education: A scoping review. Mindfulness, 13, 1-16. https://doi.org/10.1007/s12671-021-01740-3
Pasaribu, P. E., & Zarfiel, M. D. (2019). Cognitive behavioral therapy treatment for reducing stress: A case study of self-acceptance in an early adult college student. Advances in Social Science, Education and Humanities Research, 229, 631-644. https://doi.org/10.2991/iciap-18.2019.54
Purkayastha, S., Addepally, S. A., & Bucher, S. (2020). Engagement and usability of a cognitive behavioral therapy mobile app compared with web-based cognitive behavioral therapy among college students: Randomized heuristic trial. JMIR Human Factors, 7(1), Article e14146. https://doi.org/10.2196/14146
Rackoff, G. N., Fitzsimmons-Craft, E. E., Taylor, C. B., Eisenberg, D., Wilfley, D. E., & Newman, M. G. (2022). A randomized controlled trial of internet-based self-help for stress during the COVID-19 pandemic. Journal of Adolescent Health, 71(2), 157-163. https://doi.org/10.1016/j.jadohealth.2022.01.227
Recabarren, R. E., Gaillard, C., Guillod, M., & Martin-Soelch, C. (2019). Short-term effects of a multidimensional stress prevention program on quality of life, well-being and psychological resources. A randomized controlled trial. Frontiers in Psychiatry, 10, Article 88. https://doi.org/10.3389/fpsyt.2019.00088
Ritvo, P., Ahmad, F., Morr, C. El, Pirbaglou, M., & Moineddin, R. (2021). A mindfulness-based intervention for student depression, anxiety, and stress: Randomized controlled trial. JMIR Mental Health, 8(1), Article e23491. https://doi.org/10.2196/23491
Rodriguez, M., Eisenlohr-Moul, T. A., Weisman, J., & Rosenthal, M. Z. (2021). The use of task shifting to improve treatment engagement in an internet-based mindfulness intervention among Chinese university students: Randomized controlled trial. JMIR Formative Research, 5(10), Article e25772. https://doi.org/10.2196/25772
Shaffril, H. A. M., Ahmad, N., Samsuddin, S. F., Samah, A. A., & Hamdan, M. E. (2020). Systematic literature review on adaptation towards climate change impacts among indigenous people in the Asia Pacific regions. Journal of Cleaner Production, 258, Article 120595. https://doi.org/10.1016/j.jclepro.2020.120595
Shaffril, H. A. M., Samah, A. A., & Kamarudin, S. (2021). Speaking of the devil: A systematic literature review on community preparedness for earthquakes. Natural Hazards, 108(3), 2393-2419. https://doi.org/10.1007/s11069-021-04797-4
Shahrokhian, N., Hassanzadeh, S., Razini, H. H., & Ramshini, M. (2022). The effects of cognitive-behavioral therapy (CBT) in well-being and perceived stress in adolescents with low academic performance during the COVID-19 pandemic. International Journal of Sport Studies for Health, 4(2), 45-52. https://doi.org/10.61838/kman.intjssh.4.2.6
Sharma, M., Kanekar, A., Batra, K., Hayes, T., & Lakhan, R. (2022). Introspective meditation before seeking pleasurable activities as a stress reduction tool among college students: A multi-theory model-based pilot study. Healthcare, 10(4), Article 614. https://doi.org/10.3390/healthcare10040614
Shearin, S. M., & Brewer-Mixon, K. (2020). Effectiveness of a short education series to reduce anxiety for health professions graduate students: A pilot study. Journal of Physical Therapy Education, 34(1), 12-18. https://doi.org/10.1097/JTE.0000000000000124
Terp, U., Bisholt, B., & Hjärthag, F. (2022). A feasibility study of a cognitive behavioral based stress management intervention for nursing students: Results, challenges, and implications for research and practice. BMC Nursing, 21, Article 30. https://doi.org/10.1186/s12912-021-00761-6
Tomoiaga, C., & David, O. (2022). The efficacy of guided and unguided game-based cognitive-behavioral therapy in reducing distress in college students. Games for Health Journal: Research, Development, and Clinical Applications, 11(6), 403-413. https://doi.org/10.1089/g4h.2021.0195
Weiner, L., Berna, F., Nourry, N., Severac, F., Vidailhet, P., & Mengin, A. C. (2020). Efficacy of an online cognitive behavioral therapy program developed for healthcare workers during the COVID-19 pandemic: The REduction of STress (REST) study protocol for a randomized controlled trial. Trials, 21, Article 870. https://doi.org/10.1186/s13063-020-04772-7
Whittemore, R., & Knafl, K. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing, 52(5), 546-553. https://doi.org/10.1111/j.1365-2648.2005.03621.x
Wong, K. P., Bonn, G., Tam, C. L., & Wong, C. P. (2018). Preferences for online and/or face-to-face counseling among university students in Malaysia. Frontiers in Psychology, 9, Article 64. https://doi.org/10.3389/fpsyg.2018.00064
Yusop, Y. M., A. Rahman, N., Zainudin, Z. N., Ismail, A., Othman, W. N. W., & Sumari, M. (2020). The effectiveness of cognitive behavioral therapy in group counselling. International Journal of Academic Research in Business and Social Sciences, 10(9), 359-379. https://doi.org/10.6007/ijarbss/v10-i9/7648
Zhang, Z., Li, Y., Sun, S., & Tang, Z. (2022). Intervention effect of group counseling based on positive psychology on psychological crisis of college student. Computational Intelligence and Neuroscience. https://doi.org/10.1155/2022/3132016
ISSN 0128-7702
e-ISSN 2231-8534
Related Articles