Effectiveness of face-to-face Transdiagnostic Treatment (Unified Protocol) on Emotion Regulation, Experiential Avoidance, Social Adjustment, and Resilience in Students with Test Anxiety

The study aims to investigate the effectiveness of face-to-face transdiagnostic group therapy on test anxiety in students, focusing on emotion regulation, experiential avoidance, social adjustment, and resilience."

This study is a parallel-group, double-blind (assessor and statistical analyst-blinded), randomized controlled trial conducted on 40 female students in grades 10 to 12 in Zanjan City. Web-based randomization was utilized for the randomization process in this study."

This study is a double-blind clinical trial conducted in Zanjan city among female high school students in grades 10 to 12. After obtaining the necessary approvals and randomly selecting schools, 40 students with moderate to severe test anxiety are divided into two groups: in-person treatment, and waitlist contrl group.Data collectors and outcome assessors remain unaware of group assignments to maintain objectivity and accuracy of the results.

Inclusion Criteria Age: 15 to 18 years Moderate to severe test anxiety No severe psychiatric disorders No Cognitive Behavioral Therapy (CBT) received in the past five years. Stability of effective medications (if applicable) Exclusion Criteria Absence from more than three consecutive sessions Lack of satisfaction with treatment Worsening of individual problems Non-participation in assessment stages

Face-to-Face Transdiagnostic Treatment Group: In-person sessions focus on managing exam anxiety and enhancing emotional skills using the UP Control Group: Participants receive no intervention during the study period.

reduce test anxiety and experiential avoidance ,Improving emotion regulation skills, Increasing social adjustment and resilience in students

Due to the lack of approval from the Ministry of Education (or: educational authorities) to conduct the protocol online, the protocol was implemented solely face-to-face."

This study is a parallel-group, double-blind (assessor and analyst-blinded), randomized controlled trial, targeting female students in grades 10 to 12 in Zanjan City. In this section, we will provide a detailed explanation of the randomization process using web-based randomization. Randomization Method (Sampling & Screening) Cluster Sampling & Screening: Initially, two city districts and then two schools will be randomly selected. Students will be screened using the Sarason Test Anxiety Questionnaire, followed by K-SADS-PL diagnostic interviews for those with moderate (scores 13-20) or severe (score 20+) anxiety. Randomization Units and Selection Randomization Units: Eligible students are the units. From the screened pool, 40 eligible students will be randomly selected using web-based randomization and will complete baseline questionnaires (Sarason, STAI, DERS, AAQ-II, Sinha & Singh Adjustment, CD-RISC). Stratified Randomization Stratified Randomization: Stratified randomization will not be employed in this study. However, if necessary, strata based on characteristics like anxiety levels or age could be considered. Randomization Tool Web-Based Randomization: Web-based randomization will be utilized for both the random selection of the 40 participants and their subsequent random assignment. This tool ensures transparent, online, bias-reducing allocation. Random Sequence Generation and Group Allocation Random Sequence & Allocation: After selection and baseline assessment, the 40 participants will be randomly assigned via web-based randomization to one of two groups: the in-person transdiagnostic integrative therapy group (n=20) or the waitlist control group (n=20). The in-person group will be divided into two sub-groups of 10 for facilitation. Allocation Concealment and Blinding Allocation Concealment & Blinding: The web-based randomization sequence will be concealed until assignment. Outcome assessments will be by a blind assessor, and data analysis by a blind analyst. Therapists and participants will be aware of group assignments.

Blinding of Data Collectors Individuals responsible for data collection will remain unaware of the group assignments. This ensures that the data collection process is conducted without bias. Blinding of Outcome Assessors Those evaluating the results of the study will also be blind to the group assignments. This is crucial for maintaining objectivity in the assessment of outcomes.