Improving Emotional Wellbeing of University Students: Emotion Regulation

Difficulties in Emotion Regulation Scale (DERS-16) is a questionnaire that measures different aspects of difficulties in emotion, including emotional awareness, clarity, acceptance, impulse control, and goal-directed behavior during emotional distress. Each item is scored on a 5-point Likert scale, from 1 (almost never) to 5 (almost always), resulting in a total score range of 16 to 80. Higher scores indicate greater difficulties in emotion regulation.

The Borderline Evaluation of Severity Over Times (BEST) is a tool that measures the severity and progression of thoughts, feelings, and behaviors that are typical of Borderline Personality Disorder. Each item is rated on a 5-point Likert scale, where 1 indicates none/rarely and 5 indicates almost always, resulting in a total score range between 12 and 72. Higher scores indicate more severe symptoms. The scale also provides information about positive behaviors separately.

Depression Anxiety Stress Scale (DASS-42) is a questionnaire that measures the negative emotional states depression, anxiety and stress. Each subscale is scored separately. Each item is rated on a 4-point Likert scale from 0 (did not apply to me at all) to 3 (applied to me very much or most of the time). Scores for each subscale range from 0 to 42, and the combined total scale ranges from 0 to 126. Higher scores indicate more severity. The severity is categorized into "normal", "mild", "moderate", "severe", and "extremely severe".

The Generalised Anxiety Disorder - 7 Scale (GAD7) is a questionnaire used to screen for Generalised Anxiety Disorder and assess the severity of anxiety symptoms. Each item is rated on a 4-point Likert scale from 0 (not at all) to 3 (nearly every day), resulting in a total score ranging from 0 to 21. Higher scores indicate more severity. The severity is categorized into "minimal", "mild", "moderate", and "severe".

The Patient Health Questionnaire (PHQ9) is a scale used for assessing the presence and the severity of depression. Each item is rated on a 4-point Likert scale from 0 (not at all) to 3 (nearly every day), resulting in a total score that ranges from 0 to 27. Higher scores indicate more severity of depressive symptoms. The severity is categorized into "minimal", "mild", "moderate", "moderately severe" and "severe".

Outcome Rating Scale (ORS) is a brief 4-item scale used for assessing the members' overall functioning in key areas: individual well-being, interpersonal relationships, social role, and overall well-being. Each item is rated on a visual analog scale from 0 to 10, resulting in a total score between 0 and 40. Higher scores indicate better overall functioning and well-being.

Participants who completed their groups will also be invited to attend a semi-structured interview for in-depth qualitative feedback when they finish the intervention. Below are the sample questions to be asked to the participants:

• Could you tell us a little about the process (your mental health difficulties) that led you to apply to this group?
• Were you satisfied with the group?
• Which parts of the group were useful to you?
• Which parts of the group need to change (what you didn't like)?
• How was your relationship with the therapist and assistants?
• How was your relationship with the other participants of the group?
• What was the most important thing you learned from the group?
• Are there any other things that stood out to you?
• Would you recommend this group to other students with similar problems?
• Do you think this group should be an ongoing service provided by the university?

Group Session Rating Scale (GSRS) is a brief 4-item scale used for assessing the members' evaluation of each session regarding the therapeutic relationship, goals and topics, approach or method, and overall experience. Each item is rated on a visual analog scale from 0 to 10, resulting in a total score between 0 and 40. Higher scores indicate more satisfaction with the group session.

The client feedback form is a 4-point self-report scale with a free-text box for additional comments. It is used to gather information about participants' experiences with the group facilitator and the intervention. The form includes questions about the therapeutic process, the structure of the sessions, the therapist's approach, and whether the support was helpful.