Skip to main content

A Meta-analysis of Universal Mental Health Prevention Programs for Higher Education Students


This meta-analysis investigated the effectiveness of universal mental health prevention programs for higher education students on a range of adjustment outcomes. A systematic literature search identified 103 controlled published and unpublished interventions involving college, graduate, or professional students. As hypothesized, skill-training programs that included a supervised practice component were significantly more effective overall (mean effect size = 0.45, confidence interval (CI) = 0.39 to 0.52) compared to skill-training programs without supervised practice (0.11, CI = −0.01 to 0.22) and psychoeducational (information-only) programs (0.13, CI = 0.06 to 0.21). When comparisons on specific outcomes were possible, skill-training programs including supervised practice were significantly more effective than the other two groups of programs in reducing symptoms of depression, anxiety, stress, and general psychological distress, and in improving social-emotional skills, self-perceptions, and academic behaviors and performance. The magnitude of effects achieved in several outcome areas is comparable to or higher than that reported in other reviews of universal programs, suggesting that skill-training programs for higher education students that incorporate supervised practice now join the ranks of other effective preventive mental health interventions. This review offers several recommendations to improve the experimental rigor of future research.

This is a preview of subscription content, access via your institution.

Fig. 1


  1. Throughout this report, “higher education students” refers generally to students receiving post-secondary education in 2- or 4-year colleges and universities, trade and vocational schools, or various graduate and professional programs (e.g., medical or law school).

  2. A copy of the search terms, journals searched, and coding manual used in this review is available from the first author on request.


References marked with an asterisk indicate studies included in the meta-analysis

  • *Abbott, S. A. (2009). The effect of an existential educational self-awareness intervention on self-awareness in college students. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (3342495).

  • *Abel, H., Abel, A., Smith, R.L. (2012). The effects of a stress management course on counselors-in-training. Counselor Education & Supervision, 51, 64-78. doi:10.1002/j.1556-6978.2012.00005.x.

  • Abel, H. S. (2005). The evaluation of a stress management program for graduate students. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (3160629)

  • American College Health Association [ACHA]. (2013). National college health assessment II: Reference group data report spring 2013. Hanover: American College Health Association.

    Google Scholar 

  • Anderson, L. A., & Whiston, S. C. (2005). Sexual assault education programs: A meta-analytic examination of their effectiveness. Psychology of Women Quarterly, 29, 374–388. doi:10.1111/j.1471-6402.2005.00237.x.

    Article  Google Scholar 

  • *Ando, M. (2011). An intervention program focused on self-understanding and interpersonal interactions to prevent psychosocial distress among Japanese university students. Journal of Adolescence, 34(5), 929-940. doi:10.1016/j.adolescence.2010.12.003.

  • Anshel, M. H. (1996). Effect of chronic aerobic exercise and progressive relaxation on motor performance and affect following acute stress. Behavioral Medicine, 21, 186–196. doi:10.1080/08964289.1996.9933757.

    CAS  Article  PubMed  Google Scholar 

  • *Archer, J. (1986). Stress management: Evaluating a preventive approach for college students. Journal of American College Health, 34, 157-160. doi:10.1080/07448481.1986.9939629.

  • Astin, A. J. (1997). Stress reduction through mindfulness meditation: Effects on psychological symptomatology, sense of control, and spiritual experiences. Psychotherapy and Psychosomatics, 66, 97–106. doi:10.1159/000289116.

    CAS  Article  PubMed  Google Scholar 

  • *Baker, N. C. (2012). Does daily meditation or coherent breathing influence perceived stress, stress effects, anxiety, or holistic wellness in college freshman and sophomores? (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (3506381).

  • Bayram, N., & Bilgel, N. (2008). The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Social Psychiatry and Psychiatric Epidemiology, 43, 667–672. doi:10.1007/s00127-008-0345-x.

    Article  PubMed  Google Scholar 

  • Bewick, B. M., Gill, J., Mulhearn, B., Barkham, M., & Hill, A. J. (2008). Using electronic surveying to assess psychological distress within the UK student population: A multi-site pilot investigation. E-Journal of Applied Psychology, 4, 1–5. doi:10.7790/ejap.v4i2.120.

    Article  Google Scholar 

  • Borenstein, M., Hedges, L. V., Higgins, J., & Rothstein, H. (2005). Comprehensive meta-analysis version 2 [computer software]. Englewood: Biostat.

    Google Scholar 

  • Botvin, G. J., & Griffin, K. W. (2007). School-based programmes to prevent alcohol, tobacco and other drug use. International Review of Psychiatry, 19, 607–615.

    Article  PubMed  Google Scholar 

  • Bouteyre, E., Maurel, M., & Bernaud, J. (2007). Daily hassles and depressive symptoms among first year psychology students in France: The role of coping and social support. Stress & Health: Journal of the International Society for the Investigation of Stress, 23, 93–99. doi:10.1002/smi.1125.

    Article  Google Scholar 

  • *Bradley, B. W., & McCanne, T. R. (1981). Autonomic responses to stress: The effects of progressive relaxation, the relaxation response, and expectancy of relief. Biofeedback & Self Regulation, 6(2), 235-251. doi:10.1007/BF00998872.

  • *Breso, E., Schaufeli, W. B., & Salanova, M. (2011). Can a self-efficacy-based intervention decrease burnout, increase engagement, and enhance performance? A quasi-experimental study. Higher Education, 61, 339-355. doi:10.1007/s10734-010-9334-6.

  • *Brown, S. L. (2001). Teaching preventive mental health skills to functional college students: A comparison of three classroom-based interventions. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (3024905).

  • Burris, J. L., Brechting, E. H., Salsman, J., & Carlson, C. R. (2009). Factors associated with the psychological well-being and distress of university students. Journal of American College Health, 57, 536–543. doi:10.3200/JACH. 57.5.536-544.

    Article  PubMed  Google Scholar 

  • Castillo, L. G., & Schwartz, S. J. (2013). Introduction to the special issue on college student mental health. Journal of Clinical Psychology, 69, 291–297. doi:10.1002/jclp.21972.

    Article  PubMed  Google Scholar 

  • *Charlesworth, E. A., Murphy, S., & Beutler, L. E. (1981). Stress management skill for nursing students. Journal of Clinical Psychology, 37(2), 284-290. doi:10.1002/1097-4679(198104)37:2<284::AID-JCLP2270370210>3.0.CO;2-8.

  • Conley, C. S. (2015). SEL in higher education. In J. A. Durlak, C. E. Domitrovich, R. P. Weissberg, & T. P. Gullotta (Eds.), Handbook of social and emotional learning: Research and practice (pp. 197–212). New York: Guilford.

  • Conley, C., Kirsch, A. C., Dickson, D., & Bryant, F. B. (2014). Developmental trajectories of adjustment and mental health across the first year of college. Emerging Adulthood. doi:10.1177/2167696814521808.

    Google Scholar 

  • Cronce, J. M., & Larimer, M. E. (2011). Individual-focused approaches to the prevention of college student drinking. Alcohol Research & Health, 34, 210–221.

    Google Scholar 

  • Cumming, G., & Finch, S. (2005). Inference by eye: Confidence intervals and how to read pictures of data. American Psychologist, 60, 170–180. doi:10.1037/0003-066X.60.2.170.

    Article  PubMed  Google Scholar 

  • *Deckro, G. R., Ballinger, K. M., Hoyt, M., Wilcher, M., Dusek, J., Myers, P., . . . Benson, H. (2002). The evaluation of a mind/body intervention to reduce psychological distress and perceived stress in college students. Journal of American College Health, 50(6), 281-287. doi:10.1080/07448480209603446.

  • Dennhardt, A. A., & Murphy, J. G. (2013). Prevention and treatment of college student drug use: A review of the literature. Addictive Behaviors, 26, 2607–2618. doi:10.1016/j.addbeh.2013.06.006.

    Article  Google Scholar 

  • *Dickinson, W. L. (2006). Increasing coping resources: An experimental intervention approach. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (3244693).

  • Durlak, J. A. (1997). Successful prevention programs for children and adolescents. New York: Plenum Press. doi:10.1007/978-1-4899-0065-4.

    Book  Google Scholar 

  • Durlak, J. A., Schellinger, K. B., Weissberg, R. P., Dymnicki, A. B., & Taylor, R. D. (2011). The impact of enhancing students’ social and emotional learning: A meta-analysis of school-based universal interventions. Child Development, 82, 405–432. doi:10.1111/j.1467-8624.2010.01564.x.

    Article  PubMed  Google Scholar 

  • Durlak, J. A., Weissberg, R. P., & Pachan, M. (2010). A meta-analysis of after-school programs that seek to promote personal and social skills in children and adolescents. American Journal of Community Psychology, 45, 294–309. doi:10.1007/s10464-010-9300-6.

    Article  PubMed  Google Scholar 

  • Duval, S., & Tweedie, R. (2000). Trim and fill: A simple funnel plot based method of testing and adjusting for publication bias in meta-analysis. Biometrics, 56, 455–463. doi:10.1111/j.0006-341X.2000.00455.x.

    CAS  Article  PubMed  Google Scholar 

  • Eisenberg, D., Golberstein, E., & Hunt, J. B. (2009). Mental health and academic success in college. The BE Journal of Economic Analysis and Policy, 9(1) (Contributions): Article 40.

  • Elliott, S. N., Frey, J. R., & Davies, M. (2015). Systems for assessing and improving students’ social skills to achieve academic competence. In J. A. Durlak, C. E. Domitrovich, R. P. Weissberg, & T. P. Gullotta (Eds.), Handbook of social and emotional learning: Research and practice (pp. 301–319). New York: Guilford.

  • *Fabis, S. J. (2005). Determining the efficacy of resiliency training and conventional stress management instruction in a university student population. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (3194808).

  • *Finkelstein, C., Brownstein, A., Scott, C., & Lan, Y. L. (2007). Anxiety and stress reduction in medical education: An intervention. Medical Education, 41, 258-264. doi:10.1111/j.1365-2929.2007.02685.x.

  • *Flinchbaugh, C. L., Moore, E. G. W., Chang, Y. K., & May, D. R. (2012). Student well-being interventions: The effects of stress management techniques and gratitude journaling in the management education classroom. Journal of Management Education, 36, 191-219. doi:10.1177/1052562911430062.

  • *Foley, J., & Stone, G. L. (1988). Stress inoculation with nursing students. Western Journal of Nursing Research, 10(4), 435-448. doi:10.1177/019394598801000407.

  • *Fontana, A. M., Hyra, D., Godfrey, L., & Cermak, L. (1999). Impact of a peer-led stress inoculation training intervention on state anxiety and heart rate in college students. Journal of Applied Biobehavioral Research, 4(1), 45-63. doi:10.1111/j.1751-9861.1999.tb00054.x.

  • Frattaroli, J. (2006). Experimental disclosure and its moderators: A meta-analysis. Psychological Bulletin, 132, 823–865. doi:10.1037/0033-2909.132.6.823.

    Article  PubMed  Google Scholar 

  • *Fulton, M. A. (1990). The effects of relaxation training and meditation on stress, anxiety, and subjective experience in college students. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (9016622).

  • Galbraith, N. D., & Brown, K. E. (2011). Assessing intervention effectiveness for reducing stress in student nurses: Quantitative systematic review. Journal of Advanced Nursing, 67, 709–721. doi:10.1111/j.1365-2648.2010.05549.x.

    Article  PubMed  Google Scholar 

  • Givens, J. L., & Tjia, J. (2002). Depressed medical students’ use of mental health services and barriers to use. Academic Medicine, 77, 918–921. doi:10.1097/00001888-200209000-00024.

    Article  PubMed  Google Scholar 

  • Godin, J. (2010). The effect of the enneagram on psychological well-being and unconditional self-acceptance of young adults. (Unpublished doctoral dissertation). Retrieved from Graduate Theses and Dissertations. (11816).

  • Griffin, J. A., Umstattd, M. R., & Usdan, S. L. (2010). Alcohol use and high-risk sexual behavior among collegiate women: A review of research on alcohol myopia theory. Journal of American College Health, 58, 523–532. doi:10.1080/07448481003621718.

    Article  PubMed  Google Scholar 

  • Grimm, G. (1996). The efficacy of personal health classes and behavioral contracting in reducing health risks among college students. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (9708010).

  • *Heaman, D. (1995). The quieting response (QR): A modality for reduction in psychophysiologic stress in nursing students. Journal of Nursing Education, 34(1), 5-10. doi:10.1016/S0882-5963(05)80049-1.

  • Hedges, L. V., & Olkin, I. (1985). Statistical methods for meta-analysis. New York: Academic Press.

    Google Scholar 

  • Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. BMJ, 327, 557–560. doi:10.1136/bmj.327.7414.557.

    PubMed Central  Article  PubMed  Google Scholar 

  • *Hill, L., Smith, N., & Jasmin, S. (1981). Modularized stress management for reduction of predicted illness. Journal of American College Health, 30(2), 68-74. doi:10.1080/07448481.1981.9938881.

  • *Hirokawa, K., Yagi, A., & Miyata, Y. (2002). An examination of the effects of stress management training for Japanese college students for social work. International Journal of Stress Management, 9(2), 113-123. doi:10.1023/A:1014906820573.

  • *Hoffmann Gurka, A. C. (2005). Mindfulness meditation for college students: A study of its utility and promotion of its practice post treatment. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (3201922).

  • *Holzworth-Munroe, A., Munroe, M. S., & Smith, R. E. (1985). Effects of a stress management training program on first and second year medical students. Journal of Medical Education, 60, 418-419.

  • Hunt, J., & Eisenberg, D. (2010). Mental health problems and help-seeking behavior among college students. Journal of Adolescent Health, 93, 3–10. doi:10.1016/j.jadohealth.2009.08.008.

    Article  Google Scholar 

  • *Johansson, N. (1991). Effectiveness of a stress management program in reducing anxiety and depression in nursing students. Journal of American College Health, 40(3), 125-129. doi:10.1080/07448481.1991.9936268.

  • *Jones, L. V. (2004). Enhancing psychosocial competence among black women in college. Social Work, 49(1), 75-84. doi:10.1300/J009v24n03_04.

  • Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delacorte Press.

    Google Scholar 

  • *Kanji, N., White, A., & Ernst, E. (2006). Autogenic training to reduce anxiety in nursing students: Randomized controlled trial. Journal of Advanced Nursing, 53, 729-735. doi:10.1111/j.1365-2648.2006.03779.x.

  • *Kelly, J. A., Bradlyn, A. S., Dubbert, P. M., & St. Lawrence, J. S. (1982). Stress management training in medical school. Journal of Medical Education, 57, 91-99. doi:10.1097/00001888-198202000-00003.

  • Kerr, S., Johnson, V. K., Gans, S. E., & Krumrine, J. (2004). Predicting adjustment during the transition to college: Alexithymia, perceived stress, and psychological symptoms. Journal of College Student Development, 45, 593–611. doi:10.1353/csd.2004.0068.

    Article  Google Scholar 

  • *Kiecolt-Glaser, J. K., Glaser, R., Strain, E. C., Stout, J. C., Tarr, K. L., Holliday, J. E., & Speicher, C. E. (1986). Modulation of cellular immunity in medical students. Journal of Behavioral Medicine, 9(1), 5-21. doi:10.1007/BF00844640.

  • *Kim, G. H., Kim, K., & Park, H. (2011). Outcomes of a program to reduce depression. Western Journal of Nursing Research, 33(4), 560-576. doi:10.1177/0193945910386249.

  • *Kindlon, D. J. (1983). Comparison of use of meditation and rest in treatment of test anxiety. Psychological Reports, 53(3), 931-938. doi:10.2466/pr0.1983.53.3.931.

  • *Kovtun, O. (2011). International student adaptation to a U.S. college: A mixed methods exploration of the impact of a specialized first-year course at a large midwestern institution. Journal of Student Affairs Research and Practice, 48, 349-366. doi:10.2202/1949-6605.6336.

  • *Lamothe, D., Currie, F., Alisat, S., Sullivan, T., Pratt, M., Pancer, S. M., & Hunsberger, B. (1995). Impact of a social support intervention on the transition to university. Canadian Journal of Community Mental Health, 14(2), 167-180.

  • Larimer, M. E., & Cronce, J. M. (2007). Identification, prevention, and treatment revisited: Individual-focused college drinking prevention strategies 1999-2006. Addictive Behaviors, 32, 2439–2468. doi:10.1016/j.addbeh.2007.05.006.

    Article  PubMed  Google Scholar 

  • *Lee, C. C. (2009). An experimental evaluation of "culture and coping: Asian American approaches"--A psychoeducation curriculum to enhance Asian American student coping. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (512950).

  • *Leggett, D. K. (2010). Effectiveness of a brief stress reduction intervention for nursing students in reducing physiological stress indicators and improving well-being and mental health. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (3432848).

  • *Lindquist, C. U., & Lowe, S. R. (1978). A community-oriented evaluation of two prevention programs for college freshman. Journal of Counseling Psychology, 23, 53-60. doi:10.1037/0022-0167.25.1.53.

  • Lipsey, M. W., & Wilson, D. B. (1993). The efficacy of psychological, educational, and behavioral treatment: Confirmation from meta-analysis. American Psychologist, 48, 1181–1209.

    CAS  Article  PubMed  Google Scholar 

  • Lipsey, M. W., & Wilson, D. B. (2001). Practical meta-analysis. Thousand Oaks: Sage Publications.

    Google Scholar 

  • *Lynch, S., Gander, M.L., Kohls, N., Kudielka, B., & Walach, H. (2011). Mindfulness-based coping with university life: A non-randomized wait-list-controlled pilot evaluation. Stress and Health, 27, 365-375. doi:10.1002/smi.1382.

  • *Lyons, M.D., & Lufkin, B. (1967). Evaluation of tension control courses for college women. The Research Quarterly of the American Association for Health, Physical Education, and Recreation, 38(4), 663-670.

  • *MacLeod, A.K., Coates, E., & Hetherton, J. (2008). Increasing well-being through teaching goal-setting and planning skills: Results of a brief intervention. Journal of Happiness Studies, 9, 185-196. doi:10.1007/s10902-007-9057-2.

  • *Mattanah, J.F., Ayers, J.F., Brand, B.L., Brooks, L.J., Quimby, J.L., & McNary, S.W. (2010). A social support intervention to ease the college transition: Exploring main effects and moderators. Journal of College Student Development, 51(1), 93-108. doi:10.1353/csd.0.0116.

  • *McEntee, D.J., & Halgin, R.P. (1999). Cognitive group therapy and aerobic exercise in the treatment of anxiety. Journal of College Student Psychotherapy, 13(3), 37-55. doi:10.1300/J035v13n03_04.

  • *McGee, M. A. (1998). Spiritual health and its relation to levels of perceived stress among a sample of university students. (Unpublished doctoral dissertation). Retrieved from Digital Dissertation Consortium. (9780599100114).

  • *McWhirter, B.T., Okey, J., Roth, S., & Herlache, L. (1995). Evaluation of a college level stress management course. College Student Journal, 29(2), 227-233.

  • *Mitchell, R.E., Matthews, J.R., Grandy, T.G., & Lupo, J.V. (1983). The question of stress among first-year medical students. Journal of Medical Education, 58(5), 367-372. doi:10.1097/00001888-198305000-00001.

  • *Moss, S. B. (2003). The effects of cognitive behavior therapy, meditation, and yoga on self-ratings of stress and psychological functioning in college students. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (3103673).

  • *Mullins, C. H. (1994). The effects of three stress reduction strategies. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (9434902).

  • *Nathan, R.F., Nixon, F.E., Robinson, L.A., Bairnsfather, L., Allen, J.H., & Hack, M. (1987). Effects of a stress management course on grades and health of first-year medical students. Journal of Medical Education, 62(6), 514-517. doi:10.1097/00001888-198706000-00011.

  • *Nelis, D., Quoidbach, J., Mikolajczak, M., & Hansenne, M. (2009). Increasing emotional intelligence: (How) is it possible? Personality and Individual Differences, 47, 36-41. doi:10.1016/j.paid.2009.01.046.

  • *Nicholson, T., Belcastro, P.A., & Duncan, D.F. (1989). An evaluation of a university stress management program. College Student Journal, 23(1), 76-81.

  • Nicholson, T., Duncan, D. F., Hawkins, W., Belcastro, P. A., & Gold, R. (1988). Stress treatment: Two aspirins, fluids, and one more workshop. Professional Psychology: Research and Practice, 19, 637–641. doi:10.1037/0735-7028.19.6.637.

    Article  Google Scholar 

  • *Oman, D., Shapiro, S.L., Thoresen, C.E., Plante, T.G., & Flinders, T. (2008). Meditation lowers stress and supports forgiveness among college students: A randomized controlled trial. Journal of American College Health, 56(5), 569-578. doi:10.3200/JACH.56.5.569-578.

  • *Oppenheimer, B.T. (1984). Short-term small group intervention for college freshmen. Journal of Counseling Psychology, 31(1), 45-53. doi:10.1037/0022-0167.31.1.45.

  • *Ostaniewicz, A. J. (1999). Transitions '98: Evaluation of a support group program for first-year university students. (Unpublished master's thesis). Retrieved from Theses and Dissertations (Comprehensive). (685).

  • *Owens, K. B. (1991). An integrative self-enhancement and basic-skill program and its impact on students' global self-esteem, academic self-concept, and academic performance. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (9125563).

  • Payton, J. W., Graczyk, P. A., Wardlaw, D. M., Bloodworth, M., Tompsett, C. J., & Weissberg, R. P. (2000). Social and emotional learning: A framework for promoting mental health and reducing risk behavior in children and youth. Journal of School Health, 70, 179–185. doi:10.1111/j.1746-1561.2000.tb06468.x.

    CAS  Article  PubMed  Google Scholar 

  • *Perna, F.M., Kumar, M., Cruess, D.G., & Schneiderman, N. (1998). Cognitive-behavioral intervention effects on mood and cortisol during exercise training. Annals of Behavioral Medicine, 20(2), 92-98. doi:10.1007/BF02884454.

  • *Pool, L.D., & Qualter, P. (2012). Improving emotional intelligence and emotional self-efficacy through a teaching intervention for university students. Learning and Individual Differences, 22, 306-312. doi:10.1016/j.lindif.2012.01.010.

  • *Porter, S., & Johnson, A. (2008). Increasing paramedics students' resiliency to stress: Assessing correlates and the impact of intervention. College Quarterly, 11(3), 1-14.

  • *Pratt, M.W., Bowers, C., Terzian, B., Hunsberger, B., Mackey, K., Thomas, N., . . . Rog, E. (2000). Facilitating the transition to university: Evaluation of a social support discussion intervention program. Journal of College Student Development, 41(4), 427-441.

  • *Price, C. (1998). The effect of a holistic wellness course on community college students' wellness behaviors. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertation and Theses. (9936291).

  • Pritchard, M. E., Wilson, G. S., & Yamnitz, B. (2007). What predicts adjustment among college students? A longitudinal panel study. Journal of American College Health, 56, 15–21. doi:10.3200/JACH. 56.1.15-22.

    Article  PubMed  Google Scholar 

  • *Ratanasiripong, P., Ratanasiripong, N., & Kathalae, D. (2012). Biofeedback intervention for stress and anxiety among nursing students: A randomized controlled trial. ISRN Nursing, 1-5. doi:10.5402/2012/827972.

  • Reavley, N., & Jorm, A. F. (2010). Prevention and early intervention to improve mental health in higher education students: A review. Early Intervention in Psychiatry, 4, 132–142. doi:10.1111/j.1751-7893.2010.00167.x.

    Article  PubMed  Google Scholar 

  • Regehr, C., Glancy, D., & Pitts, A. (2013). Interventions to reduce stress in university students: A review and meta-analysis. Journal of Affective Disorders, 148, 1–11. doi:10.1016/j.jad.2012.11.026.

    Article  PubMed  Google Scholar 

  • *Reynolds, E.K., MacPherson, L., Tull, M.T., Baruch, D.E., & Lejuez, C.W. (2011). Integration of the brief behavioral activation treatment for depression (BATD) into a college orientation program: Depression and alcohol outcomes. Journal of Counseling Psychology, 58, 555-564. doi:10.1037/a0024634.

  • Rodgers, K. C. (2012). A review of multicomponent interventions to prevent and control tobacco use among college students. Journal of American College Health, 60, 257–261. doi:10.1080/07448481.2011.587486.

    Article  PubMed  Google Scholar 

  • *Rose, R.L., & Veiga, J.F. (1984). Assessing the sustained effects of a stress management intervention on anxiety and locus of control. Academy of Management Journal, 27(1), 190-198. doi:10.2307/255967.

  • *Rosenzweig, S., Reibel, D.K., Greeson, J.M., Brainard, G.C., & Hojat, M. (2003). Mindfulness-based stress reduction lowers psychological distress in medical students. Teaching and Learning in Medicine, 15(2), 88-92. doi:10.1207/S15328015TLM1502_03.

  • *Russler, M.F. (1991). Multidimensional stress management in nursing education. Journal of Nursing Education, 30(8), 341-346. doi:10.1109/IEMBS.1991.684419.

  • Salas, E., & Cannon-Bowers, J. A. (2001). The science of training: A decade of progress. Annual Review of Psychology, 52, 471–499. doi:10.1146/annurev.psych.52.1.471.

    CAS  Article  PubMed  Google Scholar 

  • *Schrader, P., & Brown, S. (2008). Evaluating the first year experience: Students' knowledge, attitudes, and behaviors. Journal of Advanced Academics, 19(2), 310-343. doi:10.1177/1043659608322422.

  • *Sears, S.R., & Kraus, S. (2009). I think therefore I om: Cognitive distortions and coping style as mediators for the effects of mindfulness meditation on anxiety, positive and negative affect, and hope. Journal of Clinical Psychology, 65(6), 561-573. doi:10.1002/jclp.20543.

  • Shapiro, S. L., Brown, K. W., & Astin, J. (2011). Toward the integration of meditation into higher education: A review of research evidence. Teachers College Record, 113, 495–528.

    Google Scholar 

  • *Shapiro, S.L., Brown, K.W., & Biegel, G.M. (2007). Teaching self-care to caregivers: Effects of mindfulness-based stress reduction on the mental health of therapists in training. Training and Education in Professional Psychology, 1(2), 105-115. doi:10.1037/1931-3918.1.2.105.

  • *Shapiro, S.L., Oman, D., Thoresen, C.E., Plante, T.G., & Flinders, T. (2008). Cultivating mindfulness: Effects on well-being. Journal of Clinical Psychology, 64(7), 840-862. doi:10.1002/jclp.20491.

  • *Shapiro, S.L., Schwartz, G.E., & Bonner, G. (1998). Effects of mindfulness-based stress reduction on medical and premedical students. Journal of Behavioral Medicine, 21, 581-599. doi:10.1023/A:1018700829825.

  • *Sheehy, R., & Horan, J.J. (2004). Effects of stress inoculation training for 1st-year law students. International Journal of Stress Management, 11(1), 41-55. doi:10.1037/1072-5245.11.1.41.

  • Sher, K. J., Wood, P. K., & Gotham, H. J. (1996). The course of psychological distress in college: A prospective high-risk study. Journal of College Student Development, 37, 42–51.

    Google Scholar 

  • *Shestopal, A. L. (1998). Psychological effects of physical exercise and yoga. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (9841923).

  • Shiralkar, M. T., Harris, T., Eddins-Folensbee, F. F., & Coverdale, J. H. (2013). A systematic review of stress management programs for medical students. Academic Psychiatry, 37, 15–22. doi:10.1176/appi.ap.12010003.

    Article  Google Scholar 

  • *Sirridge, K. M. (2010). Efficacy of an emotional role play intervention versus a problem-solving approach on stress levels and affect experienced by college freshmen. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (3397285).

  • *Somers, J. E. (1991). The effects of a program of instructional counseling for optimism. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (9129573).

  • *Steinhardt, M., & Dolbier, C. (2008). Evaluation of a resilience intervention to enhance coping strategies and protective factors and decrease symptomatology. Journal of American College Health, 56(4), 445-453. doi:10.3200/JACH.56.44.445-454.

  • Stice, E., Shaw, H., & Marti, C. N. (2007). A meta-analytic review of eating disorder prevention programs: Encouraging findings. Annual Review of Clinical Psychology, 3, 207–231. doi:10.1146/annurev.clinpsy.3.022806.091447.

    Article  PubMed  Google Scholar 

  • *Sullivan, C. J. (2010). Academic self-regulation, academic performance, and college adjustment: What is the first-year experience for college students? (Unpublished doctoral dissertation). Retrieved from ERIC. (512950).

  • Surtees, P. G., Wainwright, N. W. J., & Pharoah, P. D. P. (2002). Psychosocial factors and sex differences in high academic attainment at Cambridge University. Oxford Review of Education, 28, 21–38. doi:10.1080/03054980120113616.

    Article  Google Scholar 

  • *Swafford, C. W. (1992). The presence of anxiety in first-year associate degree nursing students and the effectiveness of a stress management program. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (9233587).

  • *Tardd, A. C. (1987). The effects of rational self counseling as an independent study course. (Unpublished doctoral dissertation). Virginia Polytechnic Institute and State University, Virginia.

  • *Tavakoli, S., Lumley, M.A., Hijazi, A.M., Slavin-Spenny, O.M., & Parris, G.P. (2009). Effects of assertiveness training and expressive writing on acculturative stress in international students: A randomized trial. Journal of Counseling Psychology, 56(4), 590-596. doi:10.1037/a0016634.

  • Taylor, P. J., Russ-Eft, D. F., & Chan, D. W. (2005). A meta-analytic review of behavior modeling training. Journal of Applied Psychology, 90, 692–709. doi:10.1037/0021-9010.90.4.692.

    Article  PubMed  Google Scholar 

  • *Tieu, T. (2008). The effects of a transition to university intervention program on adjustment and identity development. (Unpublished doctoral dissertation). Retrieved from Dissertations and Theses (Comprehensive). (1064).

  • Towbes, L. C., & Cohen, L. H. (1996). Chronic stress in the lives of college students: Scale development and prospective prediction of distress. Journal of Youth and Adolescence, 25, 199–217. doi:10.1007/BF01537344.

    Article  Google Scholar 

  • *Türküm, A.S. (2007). Differential effects between group counseling and group guidance in conducting a coping with stress training program for Turkish university students. International Journal for the Advancement of Counseling, 29, 69-81. doi:10.1007/s10447-006-9029-y.

  • *Turner, J. T. (1991). The effect of a biofeedback and stress management course on college student anxiety and academic performance. (Unpublished doctoral dissertation). University of Northern Colorado, Colorado.

  • *Utz, S.W. (1994). The effect of instructions on cognitive strategies and performance in biofeedback. Journal of Behavioral Medicine, 17, 291-308. doi:10.1007/BF01857954.

  • Van Daele, T., Hermans, D., Van Audenhove, C., & Van den Bergh, O. (2012). Stress reduction through psychoeducation: A meta-analytic review. Health Education & Behavior, 39, 474–485. doi:10.1177/1090198111419202.

    Article  Google Scholar 

  • *Waldo, M. (1982). Relationship skills workshops in university residence halls: A preventive intervention. Paper presented at the annual convention of the American Psychological Association. Washington, DC.

  • *Walker, R., & Frazier, A. (1993). The effect of a stress management educational program on the knowledge, attitude, behavior, and stress level of college students. Wellness Perspectives, 10(1), 52-60.

  • *Walters, J. E. (1991). The effects of a stress management program on anxiety and academic performance with adult males in post-secondary vocational training. (Unpublished doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (9129194).

  • *Wang, N., Wilhite, S.C., Wyatt, J., Young, T., & Bloemker, G. (2012). Impact of a college freshman social and emotional learning curriculum on student learning outcomes: An exploratory study. Journal of University Teaching & Learning Practice, 9, 1-20.

  • Weisz, J. R., Sandler, I. N., Durlak, J. A., & Anton, B. S. (2005). Promoting and protecting youth mental health through evidence-based prevention and treatment. American Psychologist, 60, 628–648.

    Article  PubMed  Google Scholar 

  • *Whitehouse, W.G., Dinges, D.F., Orne, E.C., Keller, S.E., Bates, B.L., Bauer, N.K., . . . Orne, M.T. (1996). Psychosocial and immune effects of self-hypnosis training for stress management throughout the first semester of medical school. Psychosomatic Medicine, 58, 249-263. doi:10.1097/00006842-199605000-00009.

  • Wilson, D. B., Gottfredson, D. C., & Najaka, S. S. (2001). School-based prevention of problem behaviors: A meta-analysis. Journal of Quantitative Criminology, 17, 247–272. doi:10.1023/A:1011050217296.

    Article  Google Scholar 

  • Wintre, M. G., & Yaffe, M. (2000). First-year students’ adjustment to university life as a function of relationships with parents. Journal of Adolescent Research, 15, 9–37. doi:10.1177/0743558400151002.

    Article  Google Scholar 

  • Winzelberg, A.J., & Luskin, F.M. (1999). The effect of a meditation training in stress levels in secondary school teachers. Stress Medicine, 15(2), 69-77. doi:10.1002/(SICI)1099-1700(199904)15:2<69::AID-SMI787>3.0.CO;2-W.

  • Yager, Z., & O’Dea, J. A. (2008). Prevention programs for body image and eating disorders on university campuses: A review of large, controlled interventions. Health Promotion International, 23, 173–189. doi:10.1093/heapro/dan004.

    Article  PubMed  Google Scholar 

  • Yorgason, J. B., Linville, D., & Zitzman, B. (2008). Mental health among college students: Do those who need services know about and use them? Journal of American College Health, 57, 173–181. doi:10.3200/JACH. 57.2.173-182.

    Article  PubMed  Google Scholar 

  • *Zavertnik, J.E., Huff, T.A., & Munro, C.L. (2010). Innovative approach to teaching communication skills to nursing students. Journal of Nursing Education, 49, 65-71. doi:10.3928/01484834-20090918-06.

  • Zivin, K., Eisenberg, D., Gollust, S. E., & Ezra, G. (2009). Persistence of mental health problems and needs in a college student population. Journal of Affective Disorders, 117, 180–185. doi:10.1016/j.jad.2009.01.001.

    Article  PubMed  Google Scholar 

  • *Zuroff, D.C., & Schwarz, J.C. (1978). Effects of transcendental meditation and muscle relaxation on trait anxiety, maladjustment, locus of control, and drug use. Journal of Consulting and Clinical Psychology, 46, 264-271. doi:10.1037/0022-006X.46.2.264.

Download references


Special thanks to Daniel Dickson, Ashley Rolnik, Alison Stoner, and the many research assistants who provided valuable assistance with this project. This research was supported, in part, by an internal research grant from Loyola University Chicago.

Conflict of Interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Colleen S. Conley.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Conley, C.S., Durlak, J.A. & Kirsch, A.C. A Meta-analysis of Universal Mental Health Prevention Programs for Higher Education Students. Prev Sci 16, 487–507 (2015).

Download citation

  • Published:

  • Issue Date:

  • DOI:


  • Mental health
  • Meta-analysis
  • Promotion
  • Prevention
  • Higher education