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Journal of Psychology in Africa
ISSN: 1433-0237 (Print) 1815-5626 (Online) Journal homepage: http://www.tandfonline.com/loi/rpia20
Tomatis® Method comparative efficacy inpromoting self-regulation in tertiary students: Asystematic review
Annelize Bonthuys & Karel Botha
To cite this article: Annelize Bonthuys & Karel Botha (2016) Tomatis® Method comparativeefficacy in promoting self-regulation in tertiary students: A systematic review, Journal of Psychologyin Africa, 26:1, 92-106, DOI: 10.1080/14330237.2016.1149331
To link to this article: https://doi.org/10.1080/14330237.2016.1149331
Published online: 10 Mar 2016.
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The Journal of Psychology in Africa is co-published by NISC (Pty) Ltd and Routledge, Taylor & Francis Group
IntroductionSelf-regulation or the ability of an individual to monitor and evaluate progress towards a specific purpose or goal is critical to effectively managing diverse goals related to academic strategies, identity, health, and interpersonal relationships in the context of higher education (Vandergrift, 2005) . For instance, self-regulated learning predicted academic performance (Lee, Lim, & Grabowski, 2010; Rosário, Núñez, González-Pienda, Valle, Trigo, & Guimarães, 2010; Venter, 2011) . This effect, and related others, are achieved through metacognition or self-monitoring (Lee et al ., 2010; Rosário et al ., 2010) . Self-monitoring, an important mechanism of self-regulation (Calkins & Fox, 2002) is therefore crucial for behavioural control and change . Several approaches have been proposed to promote self- regulation among tertiary students (Adams, Evans, Shreffler, & Beam, 2006; Kwan, Faulkner, & Bray, 2013; Skår, Sniehotta, Molloy, Prestwich, & Araújo-Soarese, 2011), and of which the Tomatis® Method (Du Toit, Du Plessis, & Kirsten, 2011; Kirsten, 2007) is one such approach . The Tomatis® Method has actively been implemented in South African higher education contexts since the 1980s (compare Coetzee, 2001; Du Plessis et al ., 2001; Du Toit et al ., 2011; Kirsten, 2007; Nel, 2005; Neysmith-Roy, 2001; Vercueil, Taljaard, & Du Plessis, 2011), not much is known how it compares with other interventions to promote self-regulation in tertiary students . This study sought to examine the evidence for the Tomatis® Method (Tomatis,
1996) in promoting self-regulation among tertiary students compared to alternative approaches .
The Tomatis® Method Dr Tomatis developed the Tomatis® Method as a ‘sound stimulation and educational intervention that improves listening’ (Tomatis, 1996, p . 197) . The role of the Tomatis® Method is to attain and enhance the balance and integration of listening on an emotional and on a cognitive level for intentional behaviour to be effective and not to be driven by impulsive thoughts, emotions and/or behaviour (Sollier, 2005) . Listening can be described as intentional and attentive hearing on both cognitive and emotional levels in such a way for learning and communicating to be optimised (Solisten, 2009) . In an academic context such as a university or college, students are challenged with multiple cognitive and emotional tasks, which they often fail to manage effectively due to impulsivity, impatience, distractibility and procrastination (Gibbons et al . 2006; Rabin et al . 2011; Steel, 2007), which then results in poor academic performance and high attrition rates . From the Tomatis perspective these academic and learning problems therefore occur when there is poor ‘communication’ between important parts of the ear; the vestibule and the cochlea (Sollier, 2005) .
The function of listening is captured by the self-reflective and self-reactive capabilities required for behavioural change (Bandura, 1991). Self-reflection is defined as the ‘inspection and evaluation of one’s thoughts, feelings and behaviour’ (Grant, Franklin, & Langford,
PROFESSIONAL ISSUES
Tomatis® Method comparative efficacy in promoting self-regulation in tertiary students: A systematic review
Annelize Bonthuys* and Karel Botha
School for Psychosocial Behavioural Sciences, North-West University: Potchefstroom Campus, Potchefstroom, South Africa*Corresponding author email: [email protected]
This systematic review sought to determine the evidence on how the Tomatis® Method, a sound stimulation intervention for improving listening, compares to other self-regulation interventions with tertiary students . We searched studies from the following data bases ‘Academic FileOne, CINAHL, Cochrane Library, Communication & Mass Media Complete, eBook (EBSCOHost), HeinOnline, OAPEN Library, PsychARTICLES, PsychINFO, SocINDEX, ScienceDirect, and Google Scholar; and the North-West University repository’ and for the period spanning 2003 to 2013 . Studies included for the analysis met these criteria: Published between 2003 and 2013; published and written in English, student participant samples from tertiary institutions such as a universities or colleges; programmes or interventions developed and implemented with a positive effect on well-being or self-regulation; application of the Tomatis® Method in a student population, irrespective of an experimental design . A total of 35 articles met the inclusion criteria . The evidence was thematically analysed using narrative analysis . Findings suggest the Tomatis® Method to be superior to alternative self-regulation approaches in decreasing psychosocial and emotional stressors, as well as enhancing well-being of students . The Tomatis® Method was as effective as alternative approaches in promoting self-awareness and self-monitoring . Alternative methods were more effective than the Tomatis® Method in aspects of critical thinking . The Tomatis® Method appears to compare well with other interventions for the promotion of self-regulation among tertiary students .
Keywords: academic performance, intra- and interpersonal relationships, learning, listening, motivation, self-regulation, Tomatis® Method, well-being
Journal of Psychology in Africa, 2016Vol . 26, No . 1, 92–106, http://dx .doi .org/10 .1080/14330237 .2016 .1149331© 2016 Africa Scholarship Development Enterprize
Journal of Psychology in Africa 93
2002, p . 821) . In other words, individuals are basically listening to their own inner voice during self-reflection. Self-reaction on the other hand is the process of taking action based on ‘external sources of influence’ (Bandura, 1991, p . 249) . Literature reports that good listening skills are crucial for self-monitoring on both the cognitive and emotional levels (Berger, 2011; Levelt, as cited in Robinson-Riegler & Robinson-Riegler, 2012; Särkämö et al ., 2008) . Enhancing listening skills would therefore have a positive impact on self-monitoring . Using the Tomatis® Method, the study by Du Toit et al . (2011) found positive results with regard to participants’ ‘mood states, tendency towards increased vigour, and extraversion’ (Du Toit et al ., 2011, p . 263) . Participants reported behavioural and emotional changes with regard to enhanced extraversion to be ‘more outgoing, assertive, active, talkative, cheerful, energetic and optimistic’ (Du Toit et al ., 2011, p . 264) .
Alternative approaches to promoting self-regulation in tertiary studentsMindfulness training is associated with greater changes in self-efficacy, which was then associated with enhanced academic performance and psychological well-being (Bresó, Schaufeli, & Salanova, 2011; Caldwell, et al ., 2010, 2011; Collard et al ., 2008; Davidson, et al ., 2012; Poddar, et al ., 2012; Pool, & Qualter, 2012) .
Multidirectional learning motivation is another approach that promotes self-regulation through association with core self-evaluation (CSE), which influences learning performance by ‘boosting self-regulatory processes, generating increased levels of both motivational and emotional control’ (Kim, Oh, Chiaburu, & Brown, 2012, p . 266) .
Training critical thinking and metacognitive feedback and control were also found to be important factors for improving self-regulation and learning achievement (Alwehaibi, 2012; Lee et al ., 2010) . The regulation and control of perceived and intended behaviour have further been addressed by application of the Theory of Planned Behaviour (TPB) (Adams et al ., 2006) .
Motivational Interviewing (MI) taught students self-confrontation, which increased awareness of thoughts, feelings and behaviour related to drinking and other substance-related problematic behaviour (LaBrie, Thompson, Huchting, Lac, & Buckley, 2007) . Biofeedback was used by Vitasari, Abdul Wahab, Othman, and Awang (2010) as an alternative intervention strategy for promoting self-regulation .
Goal of the studyA systematic review was conducted to explore the available evidence on the Tomatis® Method and promoting self-regulation in tertiary students and how it compares to other interventions with similar aims . According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement (Moher, Liberati, Tetzlaff, & Altman, 2009), this systematic review applied an evidence-informed method ‘to identify, select, and critically appraise relevant research’ (p . 1) . Extracted data were then compared, evaluated and summarised to obtain transparent and reproducible results and
conclusions (Smith, Devane, Begley, & Clarke, 2011) . Systematic reviews are conducted through application of strict scientific pre-specified and reproducible methods, minimise researcher bias and provide reliable conclusions and identify gaps in knowledge (Centre for Reviews and Dissemination, 2008) .
The core question this study wants to answer is: What evidence for the efficacy of the Tomatis® Method in promoting self-regulation among tertiary students compares to alternative approaches? Findings would be important for the development of effective intervention methods for supporting self-regulation in tertiary students .
MethodThis review was conducted in accordance with the guidelines for systematic reviews in social sciences (Petticrew & Roberts, 2006) . A narrative empirical synthesis (Popay et al ., 2006) was used for integration of results from the retrieved studies (Evidence for Policy and Practice Information and Co-ordinating Centre [EPPI], 2010) .
Search strategy Two main searches were conducted: (a) first, the North-West University One Search portal was used to search published articles from 2003 until 2013 . This portal searched within 262 databases of which the following, which are relevant to and/or specialised for the discipline of psychology, were included: Academic FileOne, CINAHL, Cochrane Library, Communication & Mass Media Complete, eBook (EBSCOHost), HeinOnline, OAPEN Library, PsychARTICLES, PsychINFO, SocINDEX, ScienceDirect, and Google Scholar; and (b) the entire North-West University repository was searched to include unpublished masters’ and doctoral studies relevant to the topic of the study .
To obtain a list of potentially relevant articles, the following keyword combinations were searched for self-regulation: ‘Self-regulation’ OR ‘self-control’ OR ‘self-monitoring’ [Title]; AND ‘programme’ OR ‘intervention’ [Title]; AND ‘psychology’ OR ‘psychological’ [Title]; AND ‘well-being’ [Title]; AND ‘university’ OR ‘college’ [Title]; AND ‘students’ [Title].
For the Tomatis® Method the following keyword combinations were searched: ‘Tomatis’ [Title]; AND ‘programme’ OR ‘intervention’ [Title]; AND ‘university” OR ‘college’ [Title]; AND ‘students’ [Title].
Retrieved references were limited by full text only, language, which are English only, and as mentioned above, date of publication in the case of published studies . Although earlier research on the Tomatis® Method was mainly published in French, the researcher considered that critical research and books have been translated into English . This process was duplicated by two additional reviewers, who are experienced researchers on self-regulation and the Tomatis® Method respectively, to enhance reliability and validity of the process .
Inclusion and exclusion criteriaAll titles and abstracts were initially assessed to investigate the relevance of identified articles . For inclusion in the
Bonthuys & Botha94
review, articles were required to have been published between 2003 and 2013, capturing the most recent research within the tertiary education context . The articles had to be published or written in English and participant samples had to be from student populations, attending any tertiary institution such as a university or college . Studies with programmes or interventions developed and implemented, with a positive effect on well-being or self-regulation within student populations, were included . Articles reporting on the struggles of student life and student behaviour were excluded if only theoretically based . If guidelines were provided for development of a programme or intervention for students, but no implementation or evaluation of such a programme was done, it was also excluded . Any articles reporting on the application of the Tomatis® Method in a student population were included, irrespective of an experimental design with a control group due to the limited retrieved articles within this area . After screening titles and abstracts, articles were fully retrieved if they met the inclusion requirements, after which articles were assessed for quality and finally, data was extracted . A flowchart (Figure 1) was produced to illustrate the inclusion and exclusion of articles identified for this review .
Data extraction The following information was extracted from the strong and moderate quality studies (Petticrew & Roberts, 2006): author(s), year of publication, size of the sample, context in which the study was conducted, age range of sample, programme objectives, results and limitations of the study (See Table 1 for the complete data extraction) . A narrative synthesis was conducted for this review due to the heterogeneity of participants, the nature of interventions, and results obtained (Petticrew & Roberts, 2006) .
Quality assessment The selection criteria for this study included both qualitative and quantitative designs, however only one qualitative study was identified as relevant, and was assessed by means of an adapted list of questions developed by Spencer, Ritchie, Lewis, and Dillon (2003) . It was excluded on the basis of the sample not representing a larger population and only consisting of one participant, who was also the first researcher of the study .
The quality assessment tool for quantitative studies (Thomas, 2003) was used to critically appraise the quality of all relevant quantitative articles retrieved (Higgins & Green, 2009) . According to Petticrew and Roberts (2006),
Records identified through database searching
(n = 4014)
Additional records identified through other sources
(n = 0)
Iden
tific
atio
nSc
reen
ing
Elig
ibili
tyIn
clud
ed
Records after duplicates removed (n = 3979)
Records screened (n = 3979)
Full-text articles assessed for eligibility (n = 213)
Studies included in qualitative synthesis (n = 35)
Studies included in quantitative synthesis (meta-analysis)
(n = not applicable for this systematic review)
Records excluded based on titles and abstracts(n = 3766)
Full-text articles excluded, with reasons
1) Not relevant context: (n = 78)
2) Theoretical base only, no intervention or programme implemented or evaluated:
(n = 93)
3) Weak in quality:(n = 7)
Figure 1: PRISMA flow diagram
Journal of Psychology in Africa 95T
able
1: Q
ualit
ativ
e sy
nthe
sis o
f res
earc
h fin
ding
s
Ref
eren
ce
nC
onte
xt
Age
in Y
ears
Prog
ram
me
Obj
ectiv
es
Res
ults
L
imita
tions
Ace
e &
W
eins
tein
(2
010)
82In
tro to
stat
s co
urse
, psy
ch
dept
of a
un
iver
sity
in th
e U
.S .A
.
21 .4
3 (a
vera
ge)
To d
esig
n a
valu
e-re
appr
aisa
l in
terv
entio
n an
d in
vest
igat
e its
ef
fect
s on
self-
repo
rt m
easu
res .
VR
inte
rven
tion
was
eff
ectiv
e at
hel
ping
stud
ents
to p
lace
gr
eate
r im
porta
nce
on th
e ta
sks,
incr
ease
d th
ough
ts o
n us
eful
ness
of d
evel
opin
g kn
owle
dge
in t
he a
ttain
men
t of f
utur
e go
als .
The
VR
inte
rven
tion
was
pow
erfu
l eno
ugh
to in
fluen
ce
stud
ents
’ cho
ices
4 w
eeks
afte
r rec
eivi
ng th
e in
terv
entio
n .
Perc
eptio
n an
d ch
oice
beh
avio
r can
be
mod
ified
thro
ugh
self-
regu
latio
n in
terv
entio
ns . P
reex
istin
g va
lue
perc
eptio
ns a
bout
le
arni
ng c
an b
e im
prov
ed b
y pr
esen
ting
mes
sage
s and
gui
ding
st
uden
ts in
usi
ng se
lf-re
gula
tory
stra
tegi
es to
exp
lore
the
valu
e of
lear
ning
.
Incr
ease
d nu
mbe
r of s
ectio
ns (a
t le
ast 1
0) w
ould
allo
w fo
r bet
wee
n cl
ass v
aria
nce
to b
e m
odel
ed
hier
arch
ical
ly w
ith p
artic
ipan
ts
at a
low
er le
vel .
The
sam
ple
was
pr
imar
ily w
omen
.
Ada
m e
t al
(200
6)
34Fr
eshm
an a
t a
univ
ersi
ty_
Exam
ine
the
effe
cts o
f a
TPB
-bas
ed, p
eer e
duca
tion
inte
rven
tion
for b
inge
dr
inki
ng o
n be
havi
oral
atti
tude
s, su
bjec
tive
norm
s, pe
rcei
ved
beha
vior
al c
ontro
l, an
d be
havi
oral
in
tent
ions
.
Cur
ricul
um a
nd a
im o
f the
inte
rven
tion
base
d on
the
Theo
ry
of P
lann
ed B
ehav
ior,
addr
essi
ng g
ap o
f pre
viou
s atte
mpt
s to
alte
r drin
king
beh
avio
r due
to la
ck o
f the
oret
ical
form
atio
n .
Cur
ricul
um d
eliv
ered
by
a tra
ined
und
ergr
ad p
eer h
ealth
ed
ucat
or, m
ore
likel
y to
eng
age
fres
hmen
aro
und
alco
hol
beha
vior
.
Non
-ran
dom
ized
and
rela
tivel
y sm
all s
ampl
e, n
o co
mpa
rison
gr
oup,
inte
rven
tion
rela
tivel
y lo
w
inte
nsity
Alw
ehai
bi
(201
2)
802n
d ye
ar c
olle
ge
stud
ents
20 (m
ean)
Inve
stig
ate
the
effe
ct o
f a
prop
osed
crit
ical
thin
king
pro
gram
on
dev
elop
ing
criti
cal t
hink
ing
skill
s .
Gra
phic
org
aniz
ers a
nd th
inki
ng m
aps c
ould
hav
e co
ntrib
uted
to
the
supe
riorit
y of
the
criti
cal t
hink
ing
inst
ruct
ion
and
lead
s to
succ
essf
ul im
prov
emen
t in
test
resu
lts a
nd q
ualit
y in
dica
tors
(H
yerle
, 200
0) .
Non
e re
porte
d
And
o (2
011)
222
(111
IG
, 111
C
G)
Japa
nese
un
iver
sity
st
uden
ts
_Ev
alua
ted
the
impa
ct o
f a
prev
entiv
e in
terv
entio
n pr
ogra
m
focu
sed
on se
lfund
erst
andi
ng
and
inte
rper
sona
l int
erac
tions
to
prev
ent p
sych
osoc
ial d
istre
ss .
Bot
h fe
mal
e an
d m
ale
stud
ents
in th
e tre
atm
ent g
roup
repo
rted
a si
gnifi
cant
incr
ease
in so
cial
self-
effic
acy
in in
terp
erso
nal
rela
tions
hips
from
Tim
e 1
to T
ime
2, n
o si
gnifi
cant
cha
nges
in
the
cont
rol g
roup
. Anx
iety
sign
ifica
ntly
dec
reas
ed fr
om T
ime
1 to
Tim
e 2,
and
no
diff
eren
ce in
dep
ress
ion
was
not
ed in
the
fem
ale
treat
men
t gro
up . A
nxie
ty a
nd d
epre
ssio
n si
gnifi
cant
ly
incr
ease
d in
the
fem
ale
cont
rol g
roup
. The
inte
rven
tion
prog
ram
ef
fect
ivel
y pr
even
ted
som
e as
pect
s of p
sych
osoc
ial d
istre
ss .
Smal
l, on
e-sc
hool
rese
arch
pa
rtici
patio
n, th
e sh
ort o
bser
vatio
n pe
riod,
and
its d
esig
n . S
ome
diff
eren
ces o
f the
targ
eted
va
riabl
es in
the
two
grou
ps
befo
re th
e in
terv
entio
n . L
imite
d nu
mbe
r of c
lass
es a
nd la
ck o
f tru
e ra
ndom
izat
ion .
B
endt
sen
et a
l (2
012)
5227
Uni
vers
ity in
Sw
eden
_
To e
valu
ate
the
effe
ctiv
enes
s of
elec
troni
c sc
reen
ing
and
brie
f in
terv
entio
n .
Ove
rall,
44 .
69%
targ
eted
com
plet
ed fo
llow
-up .
Attr
ition
was
si
mila
r in
grou
ps 1
and
2 a
nd lo
wer
in g
roup
3 . I
nten
tion-
to-tr
eat
anal
yses
rega
rdle
ss o
f bas
elin
e dr
inki
ng st
atus
reve
aled
foun
d no
di
ffer
ence
s bet
wee
n gr
oups
in a
ll al
coho
l par
amet
ers a
t 2-m
onth
fo
llow
-up .
Per
-pro
toco
l ana
lyse
s of g
roup
s 1 a
nd 2
sugg
este
d po
ssib
le sm
all b
enef
icia
l eff
ects
on
wee
kly
cons
umpt
ion
due
to to
feed
back
. Sm
all b
enef
its m
ay fo
llow
the
actu
al u
ptak
e of
fe
edba
ck in
terv
entio
n in
stud
ents
who
are
risk
y dr
inke
rs, t
he
prec
ise
targ
et g
roup
.
The
appr
oach
use
d in
volv
es
dece
ptio
n, c
onsi
der w
heth
er
less
-eth
ical
ly p
robl
emat
ic m
etho
ds
coul
d be
use
d .
Bonthuys & Botha96
Ref
eren
ce
nC
onte
xt
Age
in Y
ears
Prog
ram
me
Obj
ectiv
es
Res
ults
L
imita
tions
Bow
man
et a
l (2
007)
20
7 T1
, 10
9 T2
U
nder
grad
st
uden
ts o
f un
iver
sity
20 .1
0 (m
ean)
Thi
s stu
dy a
ttem
pts t
o re
plic
ate,
in
par
t, re
sear
ch th
at te
sted
th
e M
ozar
t Eff
ect o
n lis
teni
ng
com
preh
ensi
on a
bilit
ies .
Als
o in
clud
ed in
this
stud
y is
an
exam
inat
ion
of c
ontro
l gro
up
issu
es in
cur
rent
day
rese
arch
.
Subj
ects
who
list
ened
to sl
ow (a
lpha
- A
) Moz
art m
usic
wer
e be
tter p
repa
red
to li
sten
than
thos
e w
ho li
sten
ed to
fast
(bet
a -
B) M
ozar
t mus
ic . M
ozar
t A g
roup
scor
ed h
ighe
r tha
n th
e ot
her
mus
ic-li
sten
ing
grou
ps, P
artic
ipan
ts in
the
sile
nce
and
cros
swor
d co
ntro
l gro
ups s
core
d si
gnifi
cant
ly h
ighe
r tha
n th
e ro
ck a
nd ro
ll gr
oup,
but
not
hig
her t
han
the
Moz
art B
con
trol g
roup
Res
ults
in
dica
te th
at b
eing
invo
lved
in a
n ac
tivity
that
pro
duce
s alp
ha
brai
n w
ave
patte
ms (
such
as l
iste
ning
to M
ozar
t A m
usic
, m
edita
ting,
or c
ompl
etin
g cr
ossw
ord
puzz
les)
may
pre
pare
st
uden
ts to
list
en to
cla
ss m
ater
ial b
ette
r tha
n ot
her a
ctiv
ities
.
Non
e re
porte
d
Bre
so´,
Scha
ufel
i &
Sal
anov
a (2
010)
71 (E
G
= 21
, St
ress
ed
CG
= 2
3,
Hea
lthy
CG
= 2
7)
Uni
vers
ity
stud
ents
18
-26
To d
ecre
ase
the
anxi
ety
the
stud
ents
cop
ed w
ith b
efor
e ex
ams
in o
rder
to in
crea
se th
eir b
elie
fs o
f se
lf-ef
ficac
y .
Self-
effic
acy,
eng
agem
ent a
nd p
erfo
rman
ce in
crea
sed
in th
e in
terv
ened
gro
up . D
ecre
ases
in B
urno
ut in
bot
h in
terv
ened
and
st
ress
ed c
ontro
l gro
ups,
not i
n th
e he
alth
y co
ntro
l gro
up, o
ver
time .
Impr
oved
per
form
ance
in a
ll of
the
grou
ps in
T2,
the
‘‘he
alth
y’’ c
ontro
l gro
up p
erfo
rmed
bes
t . Th
e in
terv
entio
n ha
d th
e ex
pect
ed e
ffec
t onl
y on
self-
effic
acy
and
enga
gem
ent,
and
not f
or b
urno
ut .
Onl
y us
ed se
lf-re
porti
ng . S
tude
nts
in th
e in
terv
ened
gro
up k
new
th
at th
e in
terv
entio
n fo
cuse
d on
se
lf-ef
ficac
y, b
urno
ut, e
ngag
emen
t an
d pe
rfor
man
ce, t
hey
mig
ht h
ave
answ
ered
with
a ‘p
ositi
ve b
ias .’
A
smal
l sam
ple
size
.C
aldw
ell e
t al
(201
0)
166
(P
80, T
38,
G
48)
Stud
ents
enr
olle
d fo
r ele
ctiv
e ph
ysic
al a
ctiv
ity
cour
ses
18 -
41
(mea
n 21
.29)
Exam
ined
whe
ther
min
dful
ness
in
crea
sed
thro
ugh
parti
cipa
tion
in m
ovem
ent b
ased
cou
rses
and
w
heth
er c
hang
es in
self-
regu
lato
ry
self-
effic
acy,
moo
d, a
nd p
erce
ived
st
ress
med
iate
d th
e re
latio
nshi
p be
twee
n in
crea
sed
min
dful
ness
an
d be
tter s
leep
.
Parti
cipa
tion
in P
ilate
s, Ta
iji q
uan
or G
YR
OK
INES
IS®
sh
owed
incr
ease
s in
over
all m
indf
ulne
ss . C
hang
es in
act
ing
with
aw
aren
ess a
nd o
bser
ving
sens
atio
ns, p
erce
ptio
ns,
thou
ghts
and
feel
ings
var
ied
by c
lass
, but
eac
h cl
ass d
id sh
ow
incr
ease
s in
mul
tiple
asp
ects
of m
indf
ulne
ss . I
ncre
ases
in
min
dful
ness
ass
ocia
ted
with
impr
oved
slee
p, se
lf-re
gula
tory
, se
lf-ef
ficac
y, m
ood,
and
per
cept
ion
of st
ress
. The
eff
ect o
f in
crea
ses i
n m
indf
ulne
ss o
n sl
eep
qual
ity w
as m
edia
ted
thro
ugh
four
var
iabl
es: T
iredn
ess,
Neg
ativ
e A
rous
al, R
elax
atio
n an
d Pe
rcei
ved
Stre
ss . I
ncre
ased
min
dful
ness
has
impo
rtant
men
tal
and
beha
vior
al h
ealth
impl
icat
ions
, for
moo
d an
d sl
eep
qual
ity
spec
ifica
lly .
It m
ay b
e ea
sier
for s
tude
nts t
o be
m
indf
ul w
hen
they
are
slee
ping
be
tter a
nd o
ther
fact
ors a
ccou
nt
for i
mpr
ovem
ents
in sl
eep
qual
ity
at th
e en
d of
the
sem
este
r . Th
e de
velo
pmen
t of m
indf
ulne
ss
may
als
o be
par
t of a
nor
mal
de
velo
pmen
tal p
roce
ss in
col
lege
st
uden
ts .
Cal
dwel
l et a
l (2
011)
20
8 (E
G
76, C
G
132)
Publ
ic u
nive
rsity
st
uden
ts18
–48
Det
erm
ine
whe
ther
par
ticip
ants
in
taiji
quan
cla
sses
wou
ld
repo
rt in
crea
ses i
n m
indf
ulne
ss
grea
ter t
han
that
of a
com
paris
on
grou
p, a
nd w
heth
er c
hang
es in
m
indf
ulne
ss w
ere
asso
ciat
ed
with
impr
ovem
ents
in m
ood,
pe
rcei
ved
stre
ss, s
elf-
regu
lato
ry
self-
effic
acy,
and
slee
p qu
ality
.
Incr
ease
s in
tota
l min
dful
ness
scor
es o
ccur
red
only
in th
e ta
ijiqu
an g
roup
. All
wel
lbei
ng v
aria
bles
show
ed a
pat
tern
of i
mpr
ovem
ent i
n th
e ta
ijiqu
an g
roup
, with
eith
er st
abili
ty o
r dec
line
over
tim
e in
th
e co
ntro
l gro
up . I
ncre
ases
in m
indf
ulne
ss w
ere
sign
ifica
ntly
co
rrel
ated
with
impr
ovem
ents
on
all w
ellb
eing
m
easu
res a
nd w
ith sl
eep
qual
ity . R
elat
ive
to a
recr
eatio
n co
ntro
l gr
oup,
taiji
quan
cla
sses
for c
olle
ge st
uden
ts a
re a
ssoc
iate
d w
ith
incr
ease
d m
indf
ulne
ss a
nd im
prov
ed sl
eep
qual
ity, m
ood,
and
pe
rcei
ved
stre
ss, b
ut n
ot se
lf-re
gula
tory
self-
effic
acy .
Sele
ctio
n bi
as d
ue to
lack
of
rand
om a
ssig
nmen
t to
the
two
grou
ps
Journal of Psychology in Africa 97
Ref
eren
ce
nC
onte
xt
Age
in Y
ears
Prog
ram
me
Obj
ectiv
es
Res
ults
L
imita
tions
Col
lard
, Avn
y &
Bon
iwel
ly
(200
8)
15C
ouns
ellin
g st
uden
ts a
t un
iver
sity
_A
ddre
ss th
e ga
p in
the
liter
atur
e co
nsid
erin
g em
piric
al e
vide
nce
in su
ppor
t of t
he a
ssum
ptio
n th
at
Min
dful
ness
is th
e m
edia
ting
fact
or in
the
posi
tive
outc
omes
of
Min
dful
ness
Bas
ed C
ogni
tive
Ther
apy
(MB
CT)
and
Min
dful
ness
B
ased
Stre
ss R
educ
tion
(MB
SR)
prog
ram
mes
, and
to fu
rther
ex
amin
e th
e lin
k be
twee
n M
indf
ulne
ss a
nd S
ubje
ctiv
e W
ell
Bei
ng .
Parti
cipa
nts’
leve
l of M
indf
ulne
ss si
gnifi
cant
ly in
crea
sed
by
the
end
of th
e M
BC
T pr
ogra
mm
e . P
ositi
ve A
ffec
t rem
aine
d un
chan
ged;
Neg
ativ
e A
ffec
t sig
nific
antly
dec
reas
ed . I
ncre
ase
in p
artic
ipan
ts’ S
atis
fact
ion
With
Life
but
faile
d to
reac
h a
stat
istic
ally
sign
ifica
nt le
vel;
Min
dful
ness
and
Neg
ativ
e A
ffec
t w
ere
sign
ifica
ntly
neg
ativ
ely
corr
elat
ed, w
hile
Min
dful
ness
and
Sa
tisfa
ctio
n W
ith L
ife w
ere
not f
ound
to b
e as
soci
ated
. A lo
nger
pr
actic
e tim
e of
Min
dful
ness
dur
ing
the
prog
ram
me
was
foun
d to
be
sign
ifica
ntly
cor
rela
ted
with
a h
ighe
r lev
el o
f Min
dful
ness
at
the
end
of th
e pr
ogra
mm
e .
Pre-
disp
ositi
on o
f the
par
ticip
ants
in
self-
refle
ctin
g m
ight
hav
e as
sist
ed in
pic
king
up
quic
kly
and
effe
ctiv
ely
the
skill
of M
indf
ulne
ss,
rela
ting
to th
eir p
rofe
ssio
nal a
nd
pers
onal
live
s . Sm
all s
ampl
e an
d no
con
trol g
roup
with
dro
p ou
ts .
Bas
elin
e as
sess
men
ts n
ot d
one,
th
eref
ore
the
robu
stne
ss o
f the
fin
ding
s can
not b
e as
serte
d w
ithou
t fu
rther
repl
icat
ion .
Cun
ning
ham
et
al (2
012)
37U
nive
rsity
st
uden
ts
_Ev
alua
te w
heth
er p
rovi
ding
vo
lunt
ary
acce
ss to
web
-bas
ed
pers
onal
ized
feed
back
in
terv
entio
ns w
ould
hav
e an
im
pact
on
drin
king
.
Ther
e is
a n
eed
to c
ondu
ct m
ore
prag
mat
ic tr
ials
of t
he p
oten
tial
real
-wor
ld in
fluen
ce o
f web
-bas
ed p
erso
naliz
ed fe
edba
ck
inte
rven
tions
bef
ore
we
can
conf
iden
tly m
ake
the
clai
m th
at
thes
e in
terv
entio
ns w
ill h
ave
an im
pact
on
prob
lem
drin
king
in
col
lege
stud
ents
whe
n th
ese
inte
rven
tions
are
off
ered
in a
vo
lunt
ary
parti
cipa
tion
man
ner .
The
stud
y w
as u
nder
pow
ered
, th
eref
ore
muc
h lo
wer
sam
ple
size
th
an w
as a
ntic
ipat
ed .
Dav
idso
n et
al
(201
2)43
1st y
ear s
tude
nts
of a
n un
derg
rad
colle
ge
25 .2
7 (m
ean)
Exa
min
e th
e ou
tcom
es o
f a
focu
sed
wor
ksho
p ta
rget
ing
the
prom
otio
n of
hop
e, se
nse
of
cohe
renc
e, a
nd se
lf-ef
ficac
y fo
r en
hanc
ing
stud
ents
’ aca
dem
ic
adju
stm
ent a
s exp
ress
ed th
roug
h th
eir g
rade
s .
Stud
ents
’ sco
res w
ere
sign
ifica
ntly
hig
her f
ollo
win
g th
e in
terv
entio
n on
the
hope
and
self-
effic
acy
mea
sure
s com
pare
d to
initi
al sc
ores
.Hig
her s
core
s on
self-
effic
acy
and
SOC
afte
r 1
mon
th . T
he la
rge
and
sign
ifica
nt im
med
iate
incr
ease
in th
e ho
pe m
easu
re a
fter t
he w
orks
hop
lost
its s
igni
fican
ce d
urin
g th
e m
onth
that
pas
sed
betw
een
asse
ssm
ents
.Par
ticip
ants
who
had
ac
hiev
ed h
igh
hope
scor
es fo
llow
ing
the
wor
ksho
p m
aint
aine
d th
ose
high
scor
es . S
elf-
effic
acy
scor
es a
fter 1
mon
th re
duce
d so
mew
hat y
et re
mai
ned
sign
ifica
ntly
diff
eren
t fro
m sc
ores
be
fore
the
wor
ksho
p .
Wor
ksho
p w
as to
o sh
ort .
Sam
ple
sele
ctio
n dr
awn
from
a si
ngle
smal
l co
llege
, ind
ivid
uals
vol
unte
ered
to
parti
cipa
te in
the
stud
y .
Den
erin
g &
Sp
ear (
2012
)45
3U
CLA
Acc
ess t
o C
are
proj
ect
18-2
4 Pr
elim
inar
y ev
iden
ce o
f the
ef
fect
iven
ess o
f the
Alc
ohol
, Sm
okin
g, a
nd S
ubst
ance
In
volv
emen
t Scr
eeni
ng T
est
(ASS
IST)
and
ASS
IST-
linke
d br
ief i
nter
vent
ion
in a
col
lege
m
enta
l hea
lth c
linic
.
Slig
ht re
duct
ions
in th
e ra
tes a
nd n
umbe
r of d
ays (
in th
e pr
ior 3
0 da
ys) o
f bin
ge d
rinki
ng a
nd m
ariju
ana
use
wer
e fo
und .
Rou
tine
scre
enin
g an
d br
ief i
nter
vent
ion
proc
edur
es in
a m
enta
l hea
lth
setti
ng m
ay re
duce
pro
blem
atic
subs
tanc
e us
e am
ong
colle
ge
stud
ents
.
No
cont
rol g
roup
. Una
ble
to o
btai
n A
SSIS
T sc
ores
on
all s
tude
nts .
No
acce
ss to
clin
ical
reco
rds,
ther
efor
e it
coul
d be
that
stud
ents
who
re
ceiv
ed th
e A
SSIS
T re
duce
d th
eir
use
of a
lcoh
ol a
nd d
rugs
bec
ause
of
thei
r ong
oing
men
tal h
ealth
th
erap
y .
Bonthuys & Botha98
Ref
eren
ce
nC
onte
xt
Age
in Y
ears
Prog
ram
me
Obj
ectiv
es
Res
ults
L
imita
tions
Du
Toit,
Du
Ples
sis &
K
irste
n (2
011)
18 (E
G 9
, C
G 9
) Ed
ucat
iona
l In
terp
rete
rs a
t un
iver
sity
19 -
36
Det
erm
ine
the
impa
ct o
f the
To
mat
is M
etho
d on
edu
catio
nal
inte
rpre
ters
and
exp
lore
thei
r ex
perie
nce
of th
e To
mat
is
prog
ram
me .
Sign
ifica
nt im
prov
emen
t in
Inte
rpre
ting
Tech
niqu
e in
the
expe
rimen
tal g
roup
. Im
prov
ed in
terp
retin
g ef
ficie
ncy,
spee
ch
prod
uctio
n an
d lis
teni
ng sk
ills,
decr
ease
d Fa
tigue
-Ine
rtia;
in
crea
sed
Extra
vers
ion,
Act
ivity
and
Vig
our;
and
expe
rienc
es
of e
nhan
ced
rela
xatio
n . P
ositi
ve fe
edba
ck a
bout
the
enric
hing
ef
fect
of t
he T
omat
is p
rogr
amm
e on
per
sona
l liv
es st
reng
then
ed
the
valu
e of
the
TM fo
r ind
ivid
ual g
row
th a
nd P
WB
. Con
trol
grou
p sh
owed
som
e en
hanc
emen
t in
aspe
cts o
f int
erpr
etin
g an
d su
b-do
mai
ns o
f per
sona
lity,
and
out
perf
orm
the
expe
rimen
tal
grou
p on
the
Feel
ings
(Ope
nnes
s of t
he N
EO-P
I(R
)) . T
he
Tom
atis
pro
gram
me
had
a si
gnifi
cant
ly p
ositi
ve im
pact
on
inte
rpre
ters
’ per
form
ance
.
Smal
l sam
ple
size
due
to li
mite
d nu
mbe
r of E
lect
roni
c Ea
rs
avai
labl
e . C
ontro
l gro
up d
id n
ot
com
plet
e th
e PO
MS
asse
ssm
ent
due
to n
on-a
vaila
bilit
y of
pa
rtici
pant
s . N
o fo
llow
-up,
resu
lts
may
not
refle
ct th
e tru
e im
pact
of
the
TM .
Dya
lan,
Su
bram
ania
n &
El
ango
(201
0)
42 (E
G
21, C
G
21)
Hea
lthy
unde
rgra
d m
ed
stud
ents
from
M
ed C
ol a
nd U
ni
21 (m
ean)
A
sses
s the
eff
ect o
f Min
d So
und
Tech
nolo
gy (M
ST),
an
inte
llige
nce
enha
ncin
g pr
ogra
m,
on p
sych
olog
ical
wel
l-bei
ng o
f m
edic
al u
nder
grad
uate
s dur
ing
exam
stre
ss .
MST
pra
ctiti
oner
s wer
e ab
le to
man
age
thei
r stre
ss a
nd a
nxie
ty
leve
ls e
ven
durin
g ex
amin
atio
n . G
ener
al a
nd so
cial
hea
lth sc
ores
im
prov
ed a
fter p
ract
icin
g M
ST, m
ight
be
due
to in
crea
sed
self-
awar
enes
s, se
nse
of se
lfwor
th o
r est
eem
, and
redu
ctio
n in
m
ind
chat
ter d
urin
g M
ST p
ract
ice .
MST
Stu
dent
s per
form
ed
bette
r in
thei
r aca
dem
ic e
xam
inat
ions
. Ben
efits
such
as m
ore
cohe
rent
and
har
mon
ic b
rain
pat
tern
s, be
tter c
omm
unic
atio
n be
twee
n le
ft an
d rig
ht h
emis
pher
es o
f the
bra
in . I
mpr
oved
ac
adem
ic p
erfo
rman
ce a
nd e
nhan
ced
prob
lem
solv
ing
abili
ty is
al
so re
porte
d in
tran
scen
dent
al m
edita
tion .
Non
e re
porte
d
Ekm
an e
t al
(201
1)(I
G =
80
and
CG
=
78) .
Swed
ish
Uni
vers
ity
stud
ents
_C
ompa
re d
iffer
ence
s in
alco
hol
cons
umpt
ion
over
tim
e af
ter a
se
ries o
f e-S
BIs
was
con
duct
ed
stud
ents
who
wer
e co
nsid
ered
ris
ky d
rinke
rs .
Sign
ifica
nt d
ecre
ase
in th
e av
erag
e w
eekl
y co
nsum
ptio
n fo
r th
e IG
ove
r tim
e bu
t not
for t
he C
G, d
iffer
ence
s bet
wee
n th
e gr
oups
wer
e no
n-si
gnifi
cant
. Sig
nific
ant d
ecre
ases
in H
ED o
ver
time
with
in b
oth
grou
ps; e
qaul
diff
eren
ces i
n bo
th g
roup
s at t
he
6-m
onth
follo
w-u
p . T
he p
ropo
rtion
of r
isky
drin
kers
dec
reas
ed
by a
bout
a th
ird in
bot
h th
e C
G a
nd IG
at t
he 3
- and
6-m
onth
fo
llow
-ups
. The
shor
ter,
gene
ric b
rief i
nter
vent
ion
appe
ars t
o be
as
eff
ectiv
e as
the
long
er o
ne in
clud
ing
norm
ativ
e fe
edba
ck .
Smal
l sam
ple .
Ass
essm
ent
reac
tivity
mig
ht h
ave
been
un
dere
stim
ated
in d
esig
n of
th
e st
udy .
The
IG re
ceiv
ed a
lo
nger
, mor
e co
nven
tiona
l, br
ief
inte
rven
tion
in c
ontra
st to
the
cont
rol g
roup
who
rece
ived
a v
ery
shor
t sum
mar
y of
thei
r drin
king
w
ith n
o ad
vice
abo
ut re
duci
ng
cons
umpt
ion .
Has
sed
et a
l (2
009)
148
1st-y
ear
unde
rgra
d m
edic
al st
uden
ts
18 -
22
Des
crib
es th
e de
velo
pmen
t, im
plem
enta
tion
and
outc
omes
of
the
Hea
lth E
nhan
cem
ent P
rogr
am
(HEP
)
Self-
care
thro
ugh
min
dful
ness
-bas
ed st
ress
man
agem
ent a
nd
lifes
tyle
pro
gram
s can
impr
ove
stud
ent w
ellb
eing
, eve
n du
ring
high
stre
ss p
erio
ds . S
tude
nts g
radu
atin
g sh
ould
be
heal
thie
r and
m
ore
resi
lient
than
whe
n th
ey c
ame
into
stud
ying
.
No
cont
rol g
roup
. Thi
s stu
dy o
nly
follo
wed
stud
ents
for a
6-w
eek
perio
d an
d lo
nger
-term
follo
w-u
p is
pla
nned
. Con
clus
ions
abo
ut
long
-term
ben
efits
shou
ld b
e in
terp
rete
d w
ith c
autio
n .
Journal of Psychology in Africa 99
Ref
eren
ce
nC
onte
xt
Age
in Y
ears
Prog
ram
me
Obj
ectiv
es
Res
ults
L
imita
tions
Hija
zi e
t al
(201
1)
108
Inte
rnat
iona
l st
uden
ts a
t an
urba
n un
iver
sity
in
the
Mid
wes
t U
nite
d St
ates
18 -
49
Inve
stig
ated
whe
ther
indi
vidu
al
diff
eren
ces m
oder
ated
the
effe
cts
of E
xpre
ssiv
e W
ritin
g an
d A
sser
tiven
ess T
rain
ing .
Gre
ater
acc
ultu
rativ
e st
ress
at b
asel
ine
pred
icte
d gr
eate
r im
prov
emen
t fro
m b
oth
inte
rven
tions
. Wom
en b
enef
ited
mor
e fr
om A
T th
an E
W, e
xcep
t tha
t EW
impr
oved
wom
en’s
phy
sica
l sy
mpt
oms .
Men
ben
efite
d m
ore
from
EW
than
AT .
Stu
dent
s w
ith li
mite
d em
otio
nal a
war
enes
s and
exp
ress
ion
tend
ed to
be
nefit
from
bot
h . N
atio
n of
orig
in c
ultu
ral d
iffer
ence
s gen
eral
ly
did
not p
redi
ct o
utco
mes
.
Subs
ets o
f stu
dent
s als
o en
gage
d in
ano
ther
inte
rven
tion
(e .g
., th
e co
mbi
ned
grou
p) . L
imite
d ge
nera
lizat
ion
to st
uden
ts fr
om
othe
r nat
ions
and
cul
ture
s . In
divi
dual
diff
eren
ces i
nves
tigat
ed
are
only
ass
ocia
ted
with
out
com
es
and
do n
ot c
ause
them
.K
ang,
Cho
i &
Ryu
(200
9)
41 (E
G
21, C
G
20)
Juni
or a
nd se
nior
nu
rsin
g st
uden
ts
at u
nive
rsity
.
_Ex
amin
ed th
e ef
fect
iven
ess o
f a
stre
ss c
opin
g pr
ogra
m b
ased
on
min
dful
ness
med
itatio
n on
the
stre
ss, a
nxie
ty, a
nd d
epre
ssio
n ex
perie
nced
by
nurs
ing
stud
ents
in
Kor
ea .
Sign
ifica
ntly
redu
ced
stre
ss le
vels
, whi
le st
ress
leve
ls in
a
cont
rol g
roup
sign
ifica
ntly
incr
ease
d ov
er th
e sa
me
perio
d .
The
resu
lts su
gges
t tha
t a m
edita
tion-
base
d st
ress
man
agem
ent
prog
ram
is e
ffec
tive
in st
ress
man
agem
ent .
The
deve
lope
d pr
ogra
m si
gnifi
cant
ly re
duce
d th
e an
xiet
y sc
ore
in th
e ex
perim
enta
l gro
up .
Sam
ple
not c
ompl
etel
y re
pres
enta
tive .
Pre
-inte
rven
tion
valu
es w
ere
not e
qual
bet
wee
n th
e tw
o gr
oups
des
pite
rand
om
assi
gnm
ent .
Smal
l sam
ple
size
, so
me
subj
ects
wer
e ex
clud
ed .
Kim
et a
l (2
012)
631
An
intro
duct
ion
man
agem
ent
clas
s at a
un
iver
sity
in th
e U
.S .A
_Ex
amin
ed w
heth
er c
ore
self-
eval
uatio
ns (C
SEs)
aff
ect
lear
ning
mot
ivat
ion
and
perf
orm
ance
bey
ond
indi
vidu
al-
leve
l est
ablis
hed
pred
icto
rs
of g
ener
al m
enta
l abi
lity
and
cons
cien
tious
ness
.
Supp
ort f
or th
e pr
opos
ed m
odel
, ind
icat
ing
the
usef
ulne
ss o
f C
SE a
s ano
ther
impo
rtant
, ind
irect
pre
dict
or o
f per
form
ance
in a
le
arni
ng se
tting
via
mul
tiple
dim
ensi
ons o
f lea
rnin
g m
otiv
atio
n:
self-
effic
acy,
goa
l set
ting,
and
goa
l com
mitm
ent .
Indi
cate
the
supe
riorit
y of
the
mul
tidim
ensi
onal
ove
r the
uni
dim
ensi
onal
m
odel
of l
earn
ing
mot
ivat
ion
as a
med
iato
r .
Dat
a co
llect
ed fr
om a
n ac
adem
ic
popu
latio
n . D
ata
colle
cted
onl
y po
stte
st .
Kw
an, F
aulk
ner
& B
ray
(201
3)65
to IG
an
d C
G
Pros
pect
ive
univ
ersi
ty
stud
ents
18 .5
1 (m
ean)
To te
st th
e fe
asib
ility
and
eff
icac
y of
a th
eore
tical
ly in
form
ed,
web
site
-del
iver
ed p
hysi
cal a
ctiv
ity
inte
rven
tion
aim
ed a
t stu
dent
s en
terin
g un
iver
sity
.
Sign
ifica
nt d
eclin
es in
bro
ader
stud
ents
’ phy
sica
l act
ivity
be
havi
ors,
attit
udes
, and
per
ceiv
ed b
ehav
iora
l con
trol .
Sign
ifica
nt in
tera
ctio
n ef
fect
for i
nter
vent
ion
usag
e an
d tim
e on
per
ceiv
ed b
ehav
iora
l con
trol b
etw
een
inte
rven
tion
user
s and
no
n-us
ers .
Posi
tive
resu
lts fo
und
75%
of t
he st
uden
ts li
ving
in
the
sele
cted
resi
denc
es h
ad in
itial
ly e
xpre
ssed
inte
rest
. Im
plem
enta
tion
of th
e w
ebsi
te-d
eliv
ered
phy
sica
l act
ivity
in
terv
entio
n on
cam
pus i
s fea
sibl
e an
d of
inte
rest
to st
uden
ts .
Stud
ents
may
be
gene
rally
am
biva
lent
abo
ut th
eir p
hysi
cal
activ
ity le
vels
.
Poor
inte
rven
tion
usag
e, th
eref
ore
poor
eng
agem
ent o
f the
stud
ent
popu
latio
n . S
trugl
ing
to m
aint
ain
stud
ent i
nter
est o
ver t
he d
urat
ion
of
the
inte
rven
tion .
Lim
ited
finan
cial
re
sour
ce . S
elf-
repo
rt m
easu
res a
re
susc
eptib
le to
reca
ll er
rors
and
so
cial
des
irabi
lity
bias
. A sm
all
sam
ple
size
. Exc
lusi
on o
f a tr
ue
cont
rol g
roup
. Sho
rt fo
llow
-up
perio
d .
LaB
rie e
t al
(200
7)11
01s
t off
ende
rs o
f ca
mpu
s alc
ohol
po
licie
s at a
un
iver
sity
18 .9
4 (m
ean)
Inte
rven
tion
focu
sed
on fe
mal
e-sp
ecifi
c re
ason
s for
drin
king
and
in
clud
ed d
ecis
iona
l bal
ance
, goa
l se
tting
and
oth
er e
xerc
ises
.
Find
ings
supp
ort t
he u
se o
f an
MI-
base
d in
terv
entio
n to
redu
ce
both
alc
ohol
con
sum
ptio
n an
d co
nseq
uenc
es a
mon
g ad
judi
cate
d fe
mal
es . A
lcoh
ol u
se w
as re
duce
d by
29 .
9% a
nd n
egat
ive
cons
eque
nces
redu
ced
by 3
5 .87
% fr
om p
re-in
terv
entio
n to
3-
mon
th fo
llow
up .
Inte
rven
tion
appe
ared
to su
cces
sful
ly in
itiat
e ch
ange
in th
e he
avie
st d
rinke
rs .
Not
repo
rted
Bonthuys & Botha100
Ref
eren
ce
nC
onte
xt
Age
in Y
ears
Prog
ram
me
Obj
ectiv
es
Res
ults
L
imita
tions
Lee,
Lim
&
Gra
bow
ski
(201
0)
261
Und
ergr
ad
stud
ents
at
univ
ersi
ty in
no
rthea
ster
n U
.S .A
.
_Ex
amin
e th
e ef
fect
s of t
wo
scaf
fold
ing
stra
tegi
es—
gene
rativ
e le
arni
ng st
rate
gy (G
LS)
prom
pts a
nd m
etac
ogni
tive
feed
back
(MC
F)—
on
lear
ners
’ com
preh
ensi
on a
nd
self-
regu
latio
n .
GLS
pro
mpt
ed w
ith M
CF
impr
oved
lear
ners
’ sel
f-re
gula
tion
and
use
of G
LS a
nd le
arni
ng p
erfo
rman
ce, b
ut G
LS p
rom
pts w
ithou
t M
CF
did
not .
GLS
& M
CF
equa
lly e
ffec
tive
in im
prov
ing
qual
ity o
f lea
rner
s’ G
LSk
use,
eve
n th
ough
the
GLS
pro
mpt
s al
one
wer
e no
t eff
ectiv
e in
impr
ovin
g le
arne
rs’ s
elf-
regu
latio
n .
Lear
ners
hav
e di
ffer
ent l
evel
s of s
elf-
regu
lato
ry sk
ills a
nd p
rior
dom
ain
know
ledg
e .
Non
e re
porte
d
Meh
rotra
(2
013)
17
1 (E
G
62, C
G
59)
3 C
olle
ges
17-2
5 Ex
amin
ing
the
effic
acy
of
a m
enta
l hea
lth p
rom
otiv
e in
terv
entio
n pr
ogra
m .
Sign
ifica
nt se
lf-re
port
chan
ges(
ffic
acy
to m
anag
e m
otiv
atio
n to
wor
k on
goa
ls, m
anag
e ob
stac
les i
n go
al p
ursu
it, a
nger
, an
xiet
y &
sadn
ess)
. Pos
sibl
e sl
eepe
r eff
ect a
nd p
ositi
ve e
ffec
ts
of th
e pr
ogra
m re
late
d pa
rtly
to e
nhan
ced
self
awar
enes
s &
oppo
rtuni
ties t
o ex
perie
nce
enha
nced
mot
ivat
ion
to a
ctiv
ely
wor
k on
thei
r goa
ls . S
elf r
egul
atio
n as
a p
ossi
ble
mec
hani
sm o
f im
pact
in p
ositi
ve in
terv
entio
ns w
ere
disc
usse
d .
Shor
t dur
atio
n of
pro
gram
. Sel
f re
ports
bas
ed o
n si
ngle
item
m
easu
res,
obta
ined
1 &
4 m
ths
follo
win
g in
terv
entio
n pr
ogra
m .
Diff
eren
t out
com
es (e
.g .,
acad
emic
/wor
k pe
rfor
man
ce) a
nd
psyc
holo
gica
l out
com
es to
be
furth
er re
sear
hed .
N
eal &
C
arey
(200
4)
92U
nive
rsity
st
uden
ts_
Det
erm
ine
whe
ther
tech
niqu
es
deve
lope
d fo
r dis
crep
ancy
are
va
lid a
nd to
com
pare
met
hods
of
dev
elop
ing
disc
repa
ncy
on
inte
ntio
n to
redu
ce a
lcoh
ol u
se
indi
ces .
PNF
grou
p sh
owed
sign
ifica
ntly
hig
her l
evel
s of s
elf–
othe
r di
scre
panc
y an
d in
tent
ion
to re
duce
alc
ohol
use
than
atte
ntio
n-co
ntro
l gro
up . S
igni
fican
tly h
ighe
r lev
els o
f beh
avio
ral
inte
ntio
ns d
id n
ot tr
ansl
ate
to si
gnifi
cant
ly lo
wer
leve
ls
of d
rinki
ng d
urin
g fo
llow
up .
Dis
crep
ancy
was
pos
itive
ly
corr
elat
ed w
ith in
tent
ion
and
drin
king
beh
avio
r, an
d ne
gativ
e af
fect
was
not
rela
ted
to a
ny o
utco
me .
SR
theo
ry a
ppea
rs le
ss
usef
ul fo
r ide
ntify
ing
actu
al m
echa
nism
s of c
hang
e .
Not
des
igne
d as
a tr
ue lo
ngitu
dina
l ex
perim
ent .
Bas
elin
e as
sess
men
t no
t the
sam
e as
pos
t tes
ting .
U
nmea
sure
d di
ffer
ence
s bet
wee
n th
e gr
oups
. Sm
all s
ampl
e si
ze . O
ne
wee
k of
self-
mon
itorin
g m
ay h
ave
been
too
shor
t to
obse
rve
chan
ge .
Podd
ar e
t al
(201
2)
211
(107
EG
, 104
C
G)
2 he
alth
-rel
ated
cl
asse
s at
univ
ersi
ty
20 .2
(mea
n)
Use
of S
elf-
regu
latio
n Th
eory
to
impr
ove
soci
al su
ppor
t, se
lf-ef
ficac
y, o
utco
me
expe
ctat
ions
, sel
f-re
gula
tion,
and
be
havi
or re
late
d to
dai
ry in
take
in
colle
ge st
uden
ts .
Parti
cipa
nts i
n th
e in
terv
entio
n gr
oup
repo
rted
high
er in
take
of
tota
l dai
ry fo
ods (
P 0 .
012)
and
impr
oved
use
of s
elf-
regu
latio
n st
rate
gies
for c
onsu
min
g th
ree
serv
ings
per
day
of t
otal
dai
ry
(P 0
.000
) and
low
-fat
dai
ry fo
ods (
P 0 .
002)
follo
win
g th
e in
terv
entio
n . N
utrit
ion
educ
atio
n vi
a el
ectro
nic
mai
l bas
ed o
n an
SC
T m
odel
impr
oved
tota
l dai
ry in
take
and
self-
regu
latio
n .
Parti
cipa
nts r
epor
ted
incr
ease
d da
iry in
take
and
bet
ter u
se o
f se
lf-re
gula
tion
stra
tegi
es .
Self-
repo
rted
diet
ary
inta
ke
may
not
hav
e re
flect
ed a
ctua
l in
take
and
may
hav
e le
d to
ov
eres
timat
ion
or u
nder
estim
atio
n .
Lim
ited
gene
raliz
abili
ty o
f the
re
sults
to ra
cial
ly/e
thni
cally
di
vers
e po
pula
tions
, and
lim
ited
gene
raliz
abili
ty o
f the
resu
lts
to y
oung
adu
lts n
ot e
nrol
led
in
colle
ge .
Pool
& Q
ualte
r (2
012)
13
4 (E
G
66, C
G
68)
Und
ergr
ad
stud
ents
from
a
univ
ersi
ty
22-2
4 (m
ean)
In
vest
igat
es w
heth
er it
is p
ossi
ble
to im
prov
e le
vels
of e
mot
iona
l in
telli
genc
e an
d em
otio
nal
self-
effic
acy
in u
nive
rsity
stud
ents
th
roug
h a
teac
hing
inte
rven
tion .
Posi
tive
chan
ges i
n EI
and
ESE
wer
e se
en a
cros
s the
in
terv
entio
n gr
oup
in b
oth
mal
e an
d fe
mal
e pa
rtici
pant
s . It
appe
ars p
ossi
ble
to im
prov
e ab
ility
EI p
artic
ular
ly in
rela
tion
to
unde
rsta
ndin
g an
d m
anag
ing
emot
ion .
Sig
nific
ant i
mpr
ovem
ents
in
‘und
erst
andi
ng e
mot
ion’
and
‘man
agin
g em
otio
n’, b
ut n
o si
gnifi
cant
impr
ovem
ents
in ‘p
erce
ivin
g’ a
nd ‘u
sing
’ . R
esul
ts
show
that
it is
pos
sibl
e to
incr
ease
a p
erso
n’s s
elf-
effic
acy
in re
latio
n to
thei
r em
otio
nal f
unct
ioni
ng b
y in
crea
sing
thei
r kn
owle
dge
and
unde
rsta
ndin
g in
this
are
a .
Rel
ianc
e on
dat
a ga
ther
ed fr
om a
si
ngle
sour
ce . F
urth
er re
sear
ch to
co
mpa
re st
uden
ts fr
om sc
ienc
e an
d ar
ts su
bjec
ts .
Journal of Psychology in Africa 101
Ref
eren
ce
nC
onte
xt
Age
in Y
ears
Prog
ram
me
Obj
ectiv
es
Res
ults
L
imita
tions
Prin
sloo
(200
8)20
Uni
vers
ity
stud
ents
_
To a
sses
s the
impa
ct o
f a G
o M
AD
® tr
aini
ng p
rogr
amm
e on
th
e se
lf-re
gula
tion
of a
gro
up o
f st
uden
ts .
Expe
rimen
tal g
roup
’s (E
G) L
ong
Ran
ge C
aree
r Orie
nted
Ex
pect
ancy
, Per
sona
l Gro
wth
, App
roac
h-A
void
ance
Sty
le a
nd
gene
ral P
robl
em S
olvi
ng sk
ills p
ract
ical
ly im
prov
ed . T
he E
G
also
had
pra
ctic
ally
bet
ter A
ppro
ach-
Avo
idan
ce S
tyle
com
pare
d to
the
cont
rol g
roup
(CG
) afte
r exp
osur
e to
Go
MA
D®
. Mos
t pa
rtici
pant
s per
ceiv
ed th
emse
lves
as h
avin
g be
en a
ble
to
succ
essf
ully
ach
ieve
spec
ific
sele
cted
goa
ls th
roug
h ap
plyi
ng G
o M
AD
® p
rinci
ples
, and
rega
rded
Go
MA
D®
as e
asy
to fo
llow
as
wel
l as u
sefu
l in
esta
blis
hing
and
dev
elop
ing
new
skill
s . Th
ose
who
cho
se u
nrea
listic
, non
-fea
sibl
e go
als a
nd w
ho h
ad to
dea
l w
ith u
nres
olve
d em
otio
nal i
ssue
s fou
nd it
har
d to
atta
in th
eir
goal
s . Po
tent
ial a
s a v
alid
tool
to fo
ster
self-
regu
latio
n an
d as
sist
in
ach
ievi
ng g
oals
.
The
timef
ram
e an
d ty
pe o
f goa
ls
Sust
aina
bilit
y co
uld
not b
e m
easu
red,
tim
e an
d st
ruct
ural
lim
itatio
ns m
ade
it im
poss
ible
to
do fu
rther
pos
t-tes
t ass
essm
ents
.
Ros
ário
et a
l (2
010)
Spai
n (4
4 EG
, 40
CG
) Po
rtuga
l (4
8 EG
, 44
CG
)
Uni
vers
ity
(Spa
in) a
nd
Uni
vers
ity
(Por
tuga
l) .
17 -
27
A p
rogr
amm
e to
enh
ance
fir
st-y
ear c
olle
ge st
uden
ts’
self-
regu
late
d le
arni
ng st
rate
gies
.
Com
firm
pro
gram
me
effic
acy
to te
ach
effic
ient
lear
ning
st
rate
gies
and
to p
rom
ote
self-
regu
latio
n . Im
prov
ed d
ecla
rativ
e kn
owle
dge
of le
arni
ng st
rate
gie,
& se
lfreg
ulat
ion
com
pete
nces
, &
redu
ced
use
of su
rfac
e ap
proa
ches
to le
arni
ng . N
o si
gnifi
cant
ch
ange
s rel
ated
to u
se o
f dee
p ap
proa
ches
in a
ny o
f the
ex
perim
enta
l gro
ups .
The
prog
ram
me
cont
ents
pro
ved
to m
eet
stud
ents
’ exp
ecta
tions
and
imm
edia
te a
cade
mic
cha
lleng
es’
(tim
e m
gnt,
proc
rast
inat
ion,
not
e ta
king
, aca
dem
ic d
istra
cter
s, go
als s
ettin
g an
d vo
litio
n) .
Self-
regu
latio
n an
d ap
proa
ches
to
lear
ning
wer
e as
sess
ed a
s apt
itude
s, m
easu
ring
gene
ral d
ispo
sitio
ns
and
mis
sing
a re
al a
ppro
ach
to
the
proc
ess .
Follo
w u
p to
o sh
ort
to a
sses
s lon
g-te
rm im
pact
of t
he
prog
ram
me .
Shor
t, K
inm
an
& B
aker
(201
0)
65 (
EG
32, C
G
33)
Fina
l yea
r ps
ycho
logy
st
uden
ts a
t un
iver
sity
25 (m
ean)
Ex
amin
e th
e ef
fect
iven
ess o
f a
peer
coa
chin
g in
terv
entio
n on
as
pect
s of w
ell-b
eing
in st
uden
ts .
Hel
ping
stud
ents
man
age
wel
lbei
ng d
urin
g a
pote
ntia
lly st
ress
ful
perio
d . O
ngoi
ng fo
llow
-up
rese
arch
to e
xten
d th
is te
chni
que
in u
nive
rsity
setti
ngs .
Mos
t com
mon
topi
cs c
over
ed w
ere
rela
tions
hips
, hea
lth a
nd c
aree
r iss
ues a
nd 6
7 pe
r cen
t of t
he
sam
ple
foun
d th
e in
terv
entio
n to
be
at le
ast m
oder
atel
y ef
fect
ive .
A
shor
t pro
gram
me
may
be
bene
ficia
l for
stud
ents
at a
stre
ssfu
l tim
es . S
ome
prot
ectio
n fr
om in
crea
se in
psy
chol
ogic
al d
istre
ss
& e
nhan
ced
pers
onal
pro
blem
s dur
ing
a st
ress
ful p
erio
d .
Smal
l sam
ple
size
, a c
ohor
t fro
m
1 ye
ar g
roup
self-
repo
rt da
ta o
nly
. D
ata
refle
cts a
subj
ectiv
e es
timat
e of
the
com
pete
nce
of th
e pe
er c
oach
rath
er th
an a
n ob
ject
ive
mea
sure
of t
he b
enef
its p
rovi
ded .
Skar
et a
l (2
011)
1273
Uni
vers
ity
cam
pus
22 .8
(mea
n)Ex
amin
ed th
e ef
ficac
y of
two
type
s of p
lann
ing
inte
rven
tions
(a
ctio
n pl
ans a
nd c
opin
g pl
ans)
in
incr
easi
ng p
hysi
cal a
ctiv
ity le
vels
w
hen
they
are
del
iver
ed v
ia th
e in
tern
et .
Did
not
cha
nge
self-
repo
rted
phys
ical
act
ivity
, atte
ndan
ce a
t ca
mpu
s spo
rts fa
cilit
ies o
r TPB
mea
sure
s . Pl
anni
ng in
terv
entio
ns
unde
r inv
estig
atio
n ar
e in
effe
ctiv
e in
cha
ngin
g be
havi
our
whe
n de
liver
ed o
nlin
e to
a sa
mpl
e of
par
ticip
ants
una
war
e of
th
e al
loca
tion
to d
iffer
ent c
ondi
tions
. Pos
sibl
e m
oder
ator
s of
the
effe
ctiv
enes
s of p
lann
ing
inte
rven
tions
in c
hang
ing
heal
th
beha
viou
rs a
re d
iscu
ssed
.
Low
-res
pons
e ra
tes t
o th
e in
vita
tion
to
parti
cipa
te w
ith d
ropo
ut ra
tes
betw
een
40 a
nd 5
2% li
mit
the
gene
ralis
abili
ty o
f thi
s stu
dy .
Bonthuys & Botha102
Ref
eren
ce
nC
onte
xt
Age
in Y
ears
Prog
ram
me
Obj
ectiv
es
Res
ults
L
imita
tions
Váz
quez
et a
l (2
012)
133
Uni
vers
ity
stud
ents
23
.3 (m
ean)
Com
pare
resu
lts o
f rel
axat
ion
train
ing
(RT)
with
that
of a
co
gniti
ve-b
ehav
iour
al p
rogr
amm
e (C
BT)
for p
reve
ntio
n of
de
pres
sion
in u
nive
rsity
stud
ents
w
ith e
leva
ted
depr
essi
ve
sym
ptom
s .
By
itsel
f, in
terv
entio
n ha
d no
sign
ifica
nt e
ffec
t on
eith
er
depr
essi
on o
r anx
iety
scor
es . T
he sc
ores
wer
e lo
wer
at t
he
follo
w-u
p tim
e po
ints
with
resp
ect t
o pr
e-in
terv
entio
n sc
ores
. Ef
fect
size
was
gre
ates
t bet
wee
n pr
e- a
nd im
med
iate
ly
post
-inte
rven
tion
scor
es fo
r CB
T, a
nd b
etw
een
pre-
and
6-m
onth
po
st-in
terv
entio
n sc
ores
for R
T . A
nxie
ty sy
mpt
oms s
igni
fican
tly
impr
oved
by
both
inte
rven
tions
at 3
-mon
th fo
llow
-up,
and
by
CB
T at
6-m
onth
follo
w-u
p al
so . I
n th
e m
ediu
m te
rm (3
-6
mon
ths)
, rel
axat
ion
train
ing
prod
uced
sim
ilar r
educ
tions
in
depr
essi
ve a
nd a
nxie
ty sy
mpt
oms a
s a m
ore
com
plex
cog
nitiv
e-be
havi
oura
l pro
gram
me .
The
resu
lts n
ot a
pplic
able
to
othe
r pop
ulat
ions
of y
oung
peo
ple .
Sh
ort f
ollo
w-u
p pe
riod .
Fem
ale,
m
ale
ratio
.
Ven
ter (
2011
) 24
21U
nive
rsity
st
uden
ts18
.5 (m
ean)
Dev
elop
stra
tegi
es fo
r Se
lf-re
gula
ted
lear
ning
skill
s of
first
yea
r uni
vers
ity st
uden
ts .
Mot
ivat
ion,
Tim
e m
anag
emen
t and
Info
rmat
ion
proc
essi
ng w
ere
the
best
LA
SSI p
redi
ctor
s of a
cade
mic
succ
ess .
Uns
ucce
sful
l st
uden
ts d
id n
ot m
anag
e tim
e w
ell a
nd w
ere
not m
otiv
ated
. G
rade
12
mar
ks, a
ge a
nd g
ende
r cor
rela
ted
bette
r with
the
first
ye
ar st
uden
ts’ a
cade
mic
ach
ieve
men
t tha
n th
e LA
SSI s
ubsc
ales
. Su
cces
sful
stud
ents
real
ised
at t
he o
nset
of s
tudi
es th
at th
ey h
ad
to a
nd d
id a
dapt
thei
r stu
dy m
etho
ds to
mee
t the
cha
lleng
es, t
hey
. had
kno
wle
dge
of th
emse
lves
and
diff
eren
t stu
dy in
this
con
text
(U
se d
iffer
ent s
tudy
met
hods
and
des
crib
e le
arni
ng st
yles
and
pr
efer
ence
s cle
arly
, set
real
istic
aca
dem
ic g
oals
) . U
nsuc
cess
ful
stud
ents
did
not
con
side
r the
ir ow
n st
udy
pref
eren
ces o
r the
ac
adem
ic re
quire
men
tsof
the
univ
ersi
ty .
Not
repo
rted
Ver
cuei
l, Ta
ljaar
d, &
Du
Ples
sis (
2011
)
13 (E
G 7
, C
G 6
) So
phom
ore-
to-
post
grad
uate
st
uden
t pia
nist
s fr
om u
nive
rsity
_Th
e ef
fect
of t
he T
omat
is M
etho
d on
psy
chol
ogic
al w
ell-b
eing
(P
WB
) and
pia
no p
erfo
rman
ce o
f st
uden
t pia
nist
s was
stud
ied
from
di
ffer
ent p
ersp
ectiv
es, t
o de
velo
p a
mor
e co
mpr
ehen
sive
pic
ture
of
this
new
fiel
d of
stud
y .
Stud
ent p
iani
sts’
PW
B w
as n
ot st
atis
tical
ly si
gnifi
cant
ly
enha
nced
. Qua
litat
ivel
y m
ost o
f the
exp
erim
enta
l par
ticip
ants
re
flect
ed in
crea
sed
auto
nom
y, im
prov
ed in
terp
erso
nal
rela
tions
hips
and
incr
ease
d se
lf-co
nfid
ence
, ind
icat
ing
enha
nced
PW
B . S
igns
of e
nhan
cem
ent i
n re
latio
n to
oth
er d
imen
sion
s of
psy
chol
ogic
al w
ell-b
eing
(sel
f-ac
cept
ance
, env
ironm
enta
l m
aste
ry, c
opin
g ab
ility
and
sens
e of
dire
ctio
n) w
ere
also
not
ed
in a
min
ority
of e
xper
imen
tal p
artic
ipan
ts . P
ositi
ve c
hang
e w
as n
otic
ed in
onl
y on
e co
ntro
l par
ticip
ant .
Qua
litat
ive
resu
lts
sugg
est t
hat t
he T
omat
is L
iste
ning
Pro
gram
faci
litat
ed e
nhan
ced
PWB
in th
ese
stud
ents
, eve
n th
ough
eff
ects
wer
e no
t sta
tistic
ally
si
gnifi
cant
.
Smal
l sam
ple
size
, as e
xplo
rato
ry
stud
y, it
was
not
des
igne
d to
ev
alua
te th
e im
pact
of t
he T
omat
is
Met
hod
on sp
ecifi
c as
pect
s of
psyc
holo
gica
l wel
l-bei
ng o
r pia
no
perf
orm
ance
. Reg
ardi
ng th
ese
aspe
cts,
parti
cipa
nts’
pro
files
th
eref
ore
diff
ered
, whi
ch li
mite
d co
ntro
l ove
r dep
ende
nt v
aria
bles
, an
d th
ereb
y th
e po
ssib
ility
of
stat
istic
ally
sign
ifica
nt fi
ndin
gs
Vita
sari
et a
l (2
010)
12H
ealth
y st
uden
ts fr
om
5 en
gine
erin
g fa
culti
es a
t U
nive
rsity
_A
stud
y an
xiet
y in
terv
entio
n pr
ogra
m is
des
igne
d to
man
age
stud
ents
stud
y an
xiet
y in
ord
er to
im
prov
e ac
adem
ic p
erfo
rman
ce
amon
g st
uden
ts is
pro
pose
d .
Expe
rimen
t gro
ups p
erfo
rmed
bet
ter i
n co
ping
anx
iety
leve
ls
as w
ell a
s inc
reas
ing
acad
emic
per
form
ance
com
pare
d to
the
cont
rol g
roup
s . B
ased
on
thes
e re
sults
, stu
dy a
nxie
ty in
terv
entio
n ca
n be
con
clud
ed a
s an
effe
ctiv
e pr
ogra
m to
impr
ove
acad
emic
pe
rfor
man
ce a
mon
g un
iver
sity
stud
ents
. Par
ticip
ants
shou
ld
prac
tice
thes
e te
chni
ques
eff
ectiv
ely
to c
ope
with
stud
y an
xiet
y .
Not
repo
rted
Journal of Psychology in Africa 103
this 21-item tool is valid and reliable for the quality assessment of any quantitative study design, whether it might be randomised or non-randomised . Articles were scored as strong (1), moderate (2), or weak (3) on six different components, namely selection bias, study design, confounders, blinding, data collection methods, withdrawals and drop-outs . A global rating was then calculated for each article and a final score obtained.
A study was considered to be of good quality if no weak or at least four strong ratings were scored, those with less than four strong and not more than two weak scores were considered as moderate in quality and those with more than two weak scores were considered as a weak overall study . The two additional reviewers completed this process separately and disputes were discussed and settled by consensus to obtain a final score. Only strong and moderate articles were included in this review, while weak articles were excluded .
Data analysisNarrative empirical synthesis (Popay et al ., 2006) was used to combine the results from the individual studies . This method of analysis was found to be most appropriate in synthesising different types of empirical and experimental evaluative research (EPPI, 2010) . The four main elements of a narrative synthesis were followed, namely: 1) Information of programme objectives and theories of behaviour change were gathered during data extraction, 2) a preliminary synthesis of findings were developed through tabulation and grouping of similarities between studies, 3) findings of the studies were qualitatively synthesised, and 4) the quality assessment tool for quantitative studies (Thomas, 2003) was used to assess the validity and quality of reviewed studies . Methodological triangulation was used to integrate evidence from the different studies to better understand and gain insight about the ‘mechanisms underlying’ the reported findings (Popay et al ., 2006, p . 21) . A summary table (Table 1) provides a combination of extracted data after critical evaluation and quality assessment of each included study (EPPI, 2010) . This review specifically focused on the content and limitations of interventions, designed and implemented for the improvement of tertiary students’ overall functioning and in particular their self-regulation and psychological well-being .
Results and discussion Summary of articles retrieved A total of 35 manuscripts met the inclusion criteria for this study . These include 33 published articles, 1 master’s dissertation and 1 doctoral thesis . A PRISMA flow diagram (Moher et al ., 2009) illustrates the search, exclusion and inclusion of relevant research (Figure 1) .
The majority (n = 27) of included articles were published between 2010 and 2013, representing various contexts, with most studies conducted in the United States (n = 14), South Africa (n = 4), and England (n = 4) . Study population samples mainly included undergraduate students (n = 24), of which three studies specified participants as first-year or freshman students. Ages ranged between 18 and 27 years, with the exception
of four studies (Caldwell, Emery, Harrison, & Greeson, 2011; Caldwell, Harrison, Adams, Quin, & Greeson, 2010; Hijazi, Tavakoli, Slavin-Spenny, & Lumley, 2011; Du Toit et al ., 2011) which included student participants up to the age of 49 years . Study designs ranged from randomised control trials, quasi-experimental, and surveys . Pre-post measures were reported in all retrieved studies for narrative empirical synthesis to be conducted for all designs .
Content and theoretical assumptions of interventionsCognitive Behaviour Therapy (CBT) (Collard, Avny, & Boniwell, 2008; Poddar, Hosig, Anderson-Bill, Nickols-Richardson, & Duncan, 2012) and Mindfulness training (Caldwell, et al ., 2010, 2011; Hassed, de Lisle, Sullivan, & Pier, 2009; Kang, Choi, & Ryu, 2009) were the most prevalent approaches to training students in self-regulation .
Only four studies, three of which included either Mozart Music or the Tomatis® Method, made use of sound stimulation (Bowman, Punyanunt-Carter, Cheah, Watson, & Rubin, 2007; Dayalan, Subramanian, & Elango, 2010; Du Toit et al ., 2011; Vercueil et al ., 2011) .
Tomatis® Method efficacy vs Cognitive Behaviour Education Compared to the multi-level behavioural changes found after completing the Tomatis® Method (Du Toit et al ., 2011), Cognitive Behaviour Education mostly focused on reducing negative mood and affect symptoms of students (Collard et al ., 2008; Vázquez et al ., 2012) . Vázquez et al . (2012) suggested that relaxation therapy be used in conjunction with Cognitive-behavioural programmes for behavioural change to be more effective and enhance student well-being . The Tomatis® Method, on the other hand, not only reduced the impact of psychosocial and emotional stressors, but also enhanced well-being of students (Du Toit et al ., 2011) .
Tomatis® Method vs Mindfulness training Similarities were found between results of Mindfulness training and the Tomatis® Method (Caldwell et al ., 2011; Vercueil et al ., 2011): increased self-regulation, psychological well-being, and self-awareness . Mindfulness training resulted in more active awareness of perceptions, thoughts and feelings and was therefore associated with increased well-being, self-regulation, self-efficacy, mood and perception of stress (Caldwell et al ., 2011) . Tomatis® Method also contributed to growth and well-being, specifically psychological well-being, with positive changes also noticed in associated dimensions of self-acceptance, environmental mastery, coping and sense of direction (Vercueil et al ., 2011) .
Limitations of the interventions Studies evaluated in this systematic review reported various limitations . These included the lack of a true longitudinal experimental design (Neal & Carey, 2004), lack of true control groups (Adams et al ., 2006; Collard et al ., 2008; Denering & Spear, 2012; Hassed et al ., 2009; Kwan et al ., 2013), and often relying only on self-reporting measures to obtain data (Acee & Weinstein, 2010; Bresó et al ., 2011; Kwan et al ., 2013; Poddar et al ., 2012; Short
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et al ., 2010) . The concern with self-reporting measures is that participants may be prone to provide socially desirable responses, leading to biased results (Kimberlin & Winterstein, 2008) . Further research is recommended to investigate the positive relationship found between the Tomatis® Method and self-regulation .
Conclusion The Tomatis® Method compared well with Cognitive-behavioural and Mindfulness training approaches in promoting self-regulation among tertiary students . Specific areas in which the method was as effective as these alternative approaches include self-awareness and self-monitoring . Compared to alternative approaches, The Tomatis® Method was the more effective approach to decrease psychosocial and emotional stressors, as well as enhance well-being of students . Other approaches were more focused on, and effective in the promotion of critical thinking skills .
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