Abstract Background The rising incidence of severe anxiety among college students calls for the development of more effective and integrated intervention strategies. While traditional psychological counseling remains a fundamental treatment, its limitations in addressing non-verbal emotional processing and fostering positive psychological resources are increasingly recognized. Aesthetic education, involving structured artistic engagement, offers a unique pathway for emotional expression, self-exploration, and stress reduction. This study proposes that a synergistic model combining evidence-based counseling with systematic aesthetic education can produce superior outcomes by concurrently targeting cognitive restructuring and emotional-somatic regulation. This study aims to empirically evaluate the effect and sustainability of aesthetic education and psychological counseling on the alleviation of anxiety symptoms, comorbid depression symptoms and psychological resilience in college students with severe anxiety. Methods The study enrolled 96 undergraduate students who met the criteria for severe anxiety (Generalized Anxiety Disorder 7-item scale GAD-7 score ≥ 15) and were randomly assigned to either the experimental group (n = 48) or the active control group (n = 48). The experimental group received an 8-week combined intervention, including weekly individual cognitive behavioral therapy (CBT) and a structured group aesthetic education course (covering visual arts, music, and expressive writing). The control group received weekly individual CBT alone. The primary outcome measure (anxiety) was assessed using the GAD-7. Secondary outcome measures included depressive symptoms (Self-rating Depression Scale SDS) and psychological resilience (Connor-Davidson Resilience Scale CD-RISC). Data were analyzed using independent samples t-tests. Results The comparison of symptom index between the two groups is shown in Table 1. As shown in Table 1, no significant differences existed between the two groups at baseline (p.05). After the intervention, the experimental group (combined intervention) showed significantly lower anxiety (GAD-7: t = 4.52, p.001) and depression (SDS: t = 3.15, p=.002) scores, alongside significantly higher psychological resilience (CD-RISC: t = 4.33, p.001) compared to the control group (counseling only). These advantages remained stable at the 3-month follow-up. The results indicate that the combined intervention is superior to counseling alone in rapidly alleviating emotional symptoms and enhancing positive psychological resources. Discussion The findings robustly support the superior efficacy of the combined intervention model. The integration of aesthetic education appears to deepen therapeutic gains by providing an experiential modality for processing distress and building strengths, complementing traditional talk therapy. This synergy aligns with a holistic biopsychosocial approach to anxiety treatment. The sustained effects suggest that skills acquired through artistic engagement may enhance long-term self-management. This study provides an empirical framework for implementing integrated mental health support in university settings. Future research should investigate the specific mechanisms of change within the aesthetic component and explore strategies for broader dissemination. Funding No. 202401001069.
Mao Chen (Sun,) studied this question.