Metacognitive Bibliotherapy for Anxiety, Depression, and Metacognitions in University Students

This study tests whether reading a structured self-help book (bibliotherapy) can reduce anxiety, depression and stress and change unhelpful thinking patterns in medical and health-sciences students. Students in health programs face heavy academic and clinical demands and are at increased risk of emotional distress. A thinking style called the Cognitive Attentional Syndrome (worry, rumination, threat monitoring and unhelpful coping) is thought to link stress to anxiety and depression. Metacognitive therapy targets this thinking style, and low-intensity self-help books may make these principles accessible to students. A total of 165 students at İstanbul Nişantaşı University will be randomly assigned to one of three groups: two groups each receive a different self-help book and read it at their own pace over 8 weeks, and the third group (waitlist) receives the books after the study ends. All participants complete short online questionnaires (DASS-21, CAS-1, MCQ-30) at the start, at week 4 and at week 8, and receive brief telephone calls at weeks 2, 4 and 6 to confirm participation.

Inclusion Criteria: * Age 18 years or older * Currently enrolled as a student in a medicine or health-sciences program (medicine, psychology, nursing and dentistry) at İstanbul Nişantaşı University * Sufficient proficiency in reading and understanding Turkish * Access to an internet-connected device to complete online forms * Electronic informed consent Exclusion Criteria: * Currently receiving active psychiatric treatment (psychotherapy or psychotropic medication) * Change in psychotropic medication within the last 6 months * Having previously read either of the study books * Diagnosis of bipolar disorder * Acute psychotic symptoms or current suicide risk