The last decades have been characterized by a growing interest in university students’ mental health. Several studies have amply demonstrated that psychological distress is growing among students worldwide and that a substantial number of university students meet the criteria for different mental disorders during their university years (see Sharp and Theiler, 2018 for a review). Given that most mental disorders first appear in early adulthood, particularly between 17 and 24 years (Kessler et al., 2007; De Girolamo et al., 2019), it is not surprising that data from many epidemiological studies show high levels of psychological problems among college students. Furthermore, attending university can be a stressful experience for many students that can find themselves having to cope with academic pressure and new adult-like responsibilities (Pedrelli et al., 2015; Auerbach et al., 2018; Mortier et al., 2018). High levels of psychological distress are associated with substantial impairment in academic performance (Auerbach et al., 2016; Bruffaerts et al., 2018) and represents a risk factor of dropping out of studies (Kitzrow, 2003; Ishii et al., 2018). Furthermore, mental health problems can increase vulnerability to suicidal thoughts and behaviors (Mortier et al., 2018). Despite high levels of psychological disease, many students rarely ask for help. The low rate for seeking treatment could be due to several factors that constitute the principal barriers to treatment, such as, high costs required for psychological support, stigma or self-stigma, poor mental health literacy and shortage of mental health services (Eisenberg et al., 2007, 2009). Poor help-seeking behavior is a cause of concern especially considering that untreated psychological disorders can lead to a worse outcome (Kisely et al., 2006; Ricky and O’Donnell Siobhan, 2017) and could have a long-term negative impact on a student’s quality of life.

Based on this evidence, the psychological distress that students experience can be considered a public health issue. Moreover, the recent COVID-19 outbreak impacted higher education, forcing once the closure of educational institutions and then the respect of rules such as social distancing and the use of masks (de Oliveira Araújo et al., 2020). The COVID-19 pandemic and the stringent rules to contain the virus spread had deleterious effects on students’ mental health. Indeed, many students reported an increased level of stress, anxiety, and depression during the COVID-19 pandemic (Dawson and Golijani-Moghaddam, 2020; Charbonnier et al., 2021; Di Consiglio et al., 2021b; Fernández-Castillo, 2021; Le Vigouroux et al., 2021). These data are particularly relevant if we consider the students’ mental health conditions before the pandemic (Sharp and Theiler, 2018). The increasing psychological distress showed by students during and after the pandemic reinforced still more the need to improve strategies to promote students’ mental health and prevent mental disorders. As suggested by the World Health Organization (WHO), mental health is not just the absence of mental disorders but is a state of well-being in which the individual can realize his/her-self and cope with the daily demands (World Health Organization [WHO], 2018). From this perspective, mental health promotion and prevention are necessarily related and overlapping: mental health is promoted by increasing well-being and enhancing transversal competencies, and mental disorders are prevented by reducing risk factors (Lahtinen et al., 1999; Saxena et al., 2006). University is an essential part of any health promotion and prevention strategy: it can develop a culture that supports mental health, it can provide students with mental health service, and it can build an environment that facilitates help-seeking behavior (Tsouros et al., 1998; Hughes and Spanner, 2019). For example, to promote well-being in the educational context, the World Health Organization [WHO] (1994) has focused on developing and/or strengthening a series of cognitive, emotional, and relational transversal skills, also called life skills. Life skills include making decisions and solving problems, critical and creative thinking, communication and interpersonal relationships, self-awareness and empathy, and emotion regulation. A broad range of evidence suggested the effectiveness of life skills training among university students in reducing the impact of stressful events, in increasing mental health (Savoji and Ganji, 2013), emotional intelligence (Lolaty et al., 2012), happiness, quality of life and emotion regulation (Mohammadkhani and Hahtami, 2011), in preventing drugs abuse behaviors (Moshki et al., 2014), in decreasing anxiety and depression symptoms (Sobhi-Gharamaleki and Rajabi, 2010).

In line with these considerations, the last decades have been characterized by a growing spread of promoting and preventing intervention among university students (Conley et al., 2013; Cuijpers et al., 2021). For example, but not limited to, such interventions are effective in increasing positive mental health and decreasing depression and anxiety symptoms (Bendtsen et al., 2020), in reducing distress (Galante et al., 2018), in promoting self-compassion, social connectedness, resilience, and flourishing (Long et al., 2021) and in enhancing self-acceptance, positive relations with others, optimism, and self-esteem (Marrero et al., 2016). Most of these interventions have been developed to overcome the costs and the limits of the traditional form of intervention, such as one-to-one in-person treatment, provided in a clinical setting and administered by a highly trained mental health professional (Kazdin, 2019). More specifically, these models of treatment, generally developed as internet-based intervention or group intervention, can reach a more significant number of people, and could represent an effective solution to address the issue of mental health among students. Both internet-based intervention and group intervention have a series of advantages: internet-based intervention, generally delivered via computer or smartphone, allows access to a series of resources at any time and from all places, speedily and easily; it guarantees anonymity, privacy, and confidentiality and it is a low-priced tool (Barak and Grohol, 2011; Montagni et al., 2020). Moreover, internet-based intervention is particularly leading among young people, especially students, since they represent one of the largest consumers of digital devices (Lenhart et al., 2010). As well as that previously described, group interventions are generally cost-effective; consequently, they can increase the accessibility to services and reduce barriers to treatment. Moreover, unlike internet-based interventions, they have the advantage of allowing students to interact with others and to promote relationships between group members working together toward common goals. Some factors, such as socializing techniques and interpersonal learning that are crucial elements of group interventions (Yalom, 1985), may be essential for university students to improve social skills to develop more positive and effective relationships, both in personal and professional contexts. Several studies have shown that group interventions in college students are effective for the treatment of depression (Church et al., 2012), for the development of resilience and coping techniques (Houston et al., 2017), for facilitating the transition of students to the first year of university (Oppenheimer, 1984), to promote social support, self-efficacy, understanding of one’s own and other’s emotions (Ando, 2011). As exposed, both modalities have a series of advantages, however, although to some extent effective, most of these programs focus on specific issues or disorders, thus underestimating the relevance of comorbidity among mental disorders (Kessler et al., 2005; Roca et al., 2009; Nock et al., 2010), between mental and medical conditions (Alegria et al., 2001; Daré et al., 2019; Kelly et al., 2019) and the interaction among risk factors, protective factors, and stressful events (Belsky and Pluess, 2009). Moreover, such interventions foster a mechanistic view of the understanding of the human being, which contrasts with the biopsychosocial model of health and the development of personalized interventions (Frazier, 2020). For these reasons, a change of strategy appears necessary. Such interventions should aim to globally promote health and psychological well-being, in terms of individual’s resources, abilities and strengths, together with a transdiagnostic approach (Mansell et al., 2009): it can be helpful in early intercepting psychopathological trajectories and prevent the risk of developing mental disorders and psychological distress. Based on these considerations, we developed NoiBene, a comprehensive and wide-ranging intervention that aims to promote well-being and prevent various forms of psychological distress by targeting some of the main risk and maintaining factors for mental disorders (Di Consiglio et al., 2021a). NoiBene has been developed on evidence-based approaches such as Positive Psychology (Seligman et al., 2005), Cognitive–Behavioral Therapies (CBT; Dobson and Dobson, 2018), and Nonviolent Communication (NVC; Rosenberg and Chopra, 2015). Positive psychology promotes adaptive human functioning by fostering positive emotions, behaviors, and character strengths that allow individuals to build a life of meaning and purpose (Seligman et al., 2005). CBTs, especially Acceptance and Commitment Therapy (Hayes et al., 2009) and Self-Compassion Therapy (Gilbert, 2009), are expanding their target from the mere reduction of symptomatology to the development of skills that contribute to mental health and well-being, such as self-acceptance and commitment to personal values. Lastly, NVC is a method based on judgment-free observation and recognition of feelings and needs that aim to promote empathic communication fostering positive interpersonal relationships (Rosenberg and Chopra, 2015). NoiBene integrates these theoretical and intervention models: the aim is to operate according to a promotion and prevention approach. Especially, the program aims (1) to improve mental health and well-being, (2) to increase positive and flexible behaviors, (3) to improve those life skills mainly related to psychological well-being and self-realization (e.g., emotional awareness, assertive communication, goal setting), (4) to promote the commitment to the satisfaction of personal needs and values, (5) to enhance strategies to adequately handle academic challenges, (6) to weaken some of the main risk and maintaining factors for mental disorders (i.e., repetitive thinking, perfectionism and experiential avoidance).

Data will be processed using SPSS (IBM) version 27. Descriptive analysis will be run for all the sociodemographic and academic variables, on data related to the satisfaction questionnaires and on SCL-90-R and MCMI-III scores. Chi-Square tests will be used to investigate differences between participants in the three conditions on baseline demographic variables and gender variables. With the same aim, a series of Student’s t-test will be run on age variable and on all baseline measures. If the test will provide significant p-values, effect sizes will be calculated considering Cohen’s d (small > 0.20, medium > 0.50, large > 0.80). If some variables will result significantly different between conditions, they will be included as covariant in the further analysis. A series of mixed models of analysis of variance (ANOVAs) will be run to investigate the efficacy of the intervention on the PWBI, WEMWBS, TAS-20, SIB, MPS, LOSC, RRS, PSWQ, and AAQ scores, as a function of the factor between CONDITION (NB-G vs. NB-WB vs. WLC) and the factor within TIME (Baseline vs. Post-Intervention vs. Follow-Up). The level of significance was set at p < 0.05. Effect sizes will be calculated using partial eta squared and it will be interpreted based on benchmarks suggested by Cohen (2013): n² = 0.01, small effect size; n² = 0.06, medium effect size; n² = 0.14 large effect size. The post hoc analyses of significant interaction will be conducted using the Bonferroni post hoc test.

Mostly, mental health disorders have the first onset by 24 years (Kessler et al., 2007; De Girolamo et al., 2019). University years, which coincide with this critical period, represent a crucial moment in every student’s life. Recent evidence suggested that mental health problems are prevalent among university students (Auerbach et al., 2018). Such problems may affect students’ lives and lead to a personal, relationship, and academic difficulties (Alonso et al., 2018; Bruffaerts et al., 2018). Over the past decades, the awareness about the importance of implementing strategies for promotion and prevention has exponentially grown. In this field, we developed the NoiBene intervention, a program to improve students mental health and well-being, and to prevent mental health disorders.

We expect that participants in the NoiBene conditions will show a higher level of mental and psychological well-being after the intervention than the waiting list condition. Indeed, NoiBene includes a series of interventions to increase some fundamental life skills, such as emotional awareness, assertiveness, and goal setting, elements that have an important role in determining mental health (Savoji and Ganji, 2013). Moreover, it provides a series of interventions focusing on self-acceptance-related emotions, an important factor that positively affects mental health (Rash et al., 2011; Weiss et al., 2016). Lastly, the NoiBene conditions include a psychoeducation about healthy lifestyles; students are then encouraged to link them with their own values and to set goals according to them. A broad range of evidence suggests that healthy lifestyle interventions are associated with mental health and well-being improvements (Dale et al., 2014). We also predicted that participants in the NoiBene condition will improve their academic performance and satisfaction. Indeed, the NoiBene program includes contents about the study method, and it could contribute to improving their performance and study skills (Meneghetti et al., 2016). Moreover, the psychological well-being of university students is an important factor in successfully dealing with the demands of academic life. High levels of well-being promote the adoption of more adaptive coping strategies, such as positive reappraisal of the problems and help-seeking behaviors (Freire et al., 2016). Furthermore, higher levels of well-being positively impact personal growth and academic achievements (Bowman, 2010; Bordbar et al., 2011; Yu et al., 2018). We hypothesized that participants in the NoiBene conditions will decrease levels of repetitive thinking, perfectionism, and experiential avoidance (Di Consiglio et al., 2021a). We expect that the reduction of these dysfunctional process can reduce the level of specific symptoms such as anxiety and depression and can buffer against the development of future mental disorders (Frank and Davidson, 2014).

Moreover, we believe that the group protocol could be even more effective than the guided web-based protocol in improving assertiveness (Conley et al., 2013), since the group protocol ensures supervised skills practice over multiple sessions, an essential component of successful training (Salas and Cannon-Bowers, 2001; Gresham, 2002; Taylor et al., 2005). Moreover, some unique characteristics of the group can foster this positive change. For example, the group ensure a positive environment where the member can interact in an adaptive manner and can engage in positive relationship; also, the group context ensure the modeling process both from the Tutor and from other member and imitative behaviors are an important source of learning (Yalom, 1985; Johnson et al., 2005) unlike the individual guided intervention. However, we believe that it is important to consider that students can benefit from the NB-G or NB-WB differently based on their specific behavioral and motivational patterns. For example, values are an important broad motivator of actions and affect prosocial behavior (Schwartz, 1992). Values such as benevolence and conformity promote cooperative and supportive social relations. Indeed, these values motivate actions to promote the welfare of others and to avoid adverse outcomes for self. Conversely, values such as security and power usually oppose prosocial behavior since they motivate to maintain a stable and protective environment and emphasize self-interest (Schwartz, 2010). Students guided by such values could be more motivated to participate and benefit more from a group intervention or from a guided self-help intervention, respectively. This consideration is significant if we also consider the clinical utility of these interventions. This dimension concerns the extent to which the intervention will be effective in a real-world practical setting (American Psychological Association, 1995). Moreover, when proposing an intervention, it is important to consider not only the best available intervention but also the individual characteristics and preferences (American Psychological Association Presidential Task Force on Evidence-Based Practice, 2006). Therefore, outside a controlled empirical context, we expect that students will report a preference toward a group or guided self-help intervention based on personal characteristics.

Students in the NoiBene conditions will receive a series of theoretical information about well-being and factors that contribute to mental health or mental disorders. We expect that this increasing knowledge would foster a better attitude toward help-seeking behavior (Jorm et al., 1997; Gulliver et al., 2010). Moreover, we will conduct psychodiagnostics interviews and feedback meetings with students reporting high levels of psychological distress. In the case of psychopathology, we will have the opportunity to give personalized feedback about students’ symptomatology, discuss their personal barriers that hinder the help-seeking behavior, and inform them about how and where to find help in the area. It could be an efficacious strategy to encourage the request for help (Gulliver et al., 2010; Di Consiglio et al., 2021b).

In conclusion, NoiBene presents a series of strengths and practical implications. Although interventions targeting specific areas of functioning are important, NoiBene has the advantage that it is a comprehensive program built on a eudemonic (Ryff and Keyes, 1995) and hedonic (Kahneman et al., 1999) approach to well-being. Indeed, NoiBene aims to promote self-realization and foster positive affect. Moreover, NoiBene focuses on a series of essential transversal competence (e.g., emotional awareness, assertiveness, goal setting), covering a range of variables necessary for mental health. Second, most of the preventing trials are focused on specific issues such as depression, anxiety, and stress (see Cuijpers et al., 2021 for a review). NoiBene has been developed on a transdiagnostic approach: it considers three of the main factors occurring in many mental health disorders such as repetitive thinking, perfectionism, and experiential avoidance (Frank and Davidson, 2014). It means that the activities that NoiBene proposes do not focus on specific symptoms or disorders but instead focus on dysfunctional processes that may contribute to the development of psychopathology. For this reason, we expect that it can be helpful the reduce the risk of the development of different mental disorders. Lastly, it is important to consider that besides negative consequences on individual students’ quality of life, the high prevalence of mental disorders and psychological distress among students is also critical for universities. Indeed, it can hurt academic performance and participation (Eisenberg et al., 2007; Reavley and Jorm, 2010; Buchanan, 2012), and protracted psychological distress leads to reduced self-efficacy, motivation, and academic satisfaction (Lipson and Eisenberg, 2018). Moreover, emotional problems seem to be the most common reason students drop out during the first year of university (Baik et al., 2015). Therefore, NoiBene could provide the opportunity to integrate health into university culture and foster a positive environment that can implicate benefits for students and the entire university community.

MDC and AC: conceptualization. MDC, SM, CS, TP, CV, and AC: methodology and writing—review and editing. AC: supervision. MDC, SM, CS, and AC: writing—original draft. All authors have read and agreed to the published version of the manuscript.

MDC, SM, CS, and AC are members of the NoiBene Team and contributed to the development of NoiBene. AC is the scientific director of NoiBene. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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