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Image Narrative Intervention with College Students

Principal Investigator (PI) / Project Lead:


Funding Organization:

University of Utah Research Foundation


Research Incentive Seed Grant Program – College of Social Work

Award Number:


Project Period:

3/1/2021 – 3/1/2022

Total Funding:


Project Status:



Project Description:

In the middle of a dark traumatic event, we often lose sight of what matters in life. We are experiencing utter uncertainty about how and when the pandemic will evolve and end and what the post-pandemic world will look like. In the context of such urgency and desperation, this study is proposed. It is urgent and significant to understand how emerging adult college students have been living through and responding to the pandemic, and help them reauthor their stories and thrive beyond the trauma.



The mental health problems of college students have emerged as an important topic, with increases in reported cases of anxiety and depression, as well as rising substance use and abuse. College students are mainly in their emerging adulthood, roughly between 18-25 years old, often characterized by feeling in between, identity exploration, instability, self-focus, and a sense of possibility. Their mental health, which inherently deals with uncertainty, ambiguity, and instability as part of their developmental stage, is further compromised by the current Covid-19 pandemic. How the pandemic will affect all aspects of life in the long term is yet to be known, but a few studies on its short-term effects are gloomy. Its direct threats on health and life, our exposure to anxiety-provoking social media and news, being a member of a higher risk group, magnified discrimination in resource distribution due to minority status, economic consequences, such as unemployment, and accompanying life changes, such as social isolation, have taken a significant toll, leading to distress, anxiety, depression, and inadequate functioning.

The current pandemic will be recorded in human history as a collectively traumatic event for the people living in this era. It is a traumatic and seismic event for the essential beliefs that make up the assumptive world. The pandemic, as a trauma, could lead to posttraumatic stress (PTS) and posttraumatic growth (PTG) due to its transformative nature. The traumatic experience needs to be adequately and properly processed and addressed for healthy post-trauma adjustment. Strength-based interventions that emphasize PTG can help people to not only recover psychologically from the effects of the trauma, but also to thrive in the face of the experience. It is urgent and significant to understand how emerging adult college students have been living through and responding to the pandemic, and help them reauthor their stories and thrive beyond the trauma.

The majority of the interventions for trauma and trauma survivorship are deficit-focused and aim to reduce PTS. With notable exceptions, many psychosocial interventions overlook PTG as a process by which survivors can make meaning of their trauma experiences. PTG is used to describe the transformative quality of a traumatic event, especially positive changes in self-perception, relationships with others, and life philosophy. PTG is likely to co-occur with PTS, yet PTG may help people who have faced adversity to maintain their life satisfaction by playing a moderating role in the relationship between PTS and quality of life. Although narratives—interpretive stories used to make sense of one’s experiences—are recommended as an intervention to help survivors make meaning of their experiences and thrive beyond the trauma, few studies of narrative approaches have been conducted.

The PI developed the Image Narrative Intervention (INI) based on her research using visual images in which she found that visual images and narratives support trauma survivors in narrating their experiences and in meaning making. The proposed study is the first study to test the therapeutic effect of the INI program. We propose to assess, both qualitatively and quantitatively, the feasibility and preliminary effect of the INI. The CSW Seed Grant to pilot test the INI will help us understand the unique experiences of emerging adult college students in the face of the pandemic; ensure that the INI is delivered in a consistent and reproducible fashion in future randomized controlled trials (RCTs); and explore the potential outcomes of the INI to examine in future studies. The results from this pilot study will be used to support manualization of the INI and a future R03 application to conduct an RCT of the intervention.

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Last Updated: 3/2/22