Impact of dialectic behaviour therapy and assertiveness training on the mental health of socially stressed senior secondary students

Abstract

Social stress resulting from substance abuse is a growing global concern. It is linked to mental health with psychosocial challenges faced by a large number of the populace in Nigeria. It is worrisome, especially among students in senior secondary schools in Port-Harcourt Metropolis. Thus, this research examined ‘Dialectic Behaviour Therapy and Assertiveness Training’ in managing psychosocial mental health problems of senior secondary school students who abuse substances in the Port-Harcourt metropolis. Tests before and after the study had a population of 9.650 students and employed quasi-experimental procedures. For the study, a 75-student sample from senior secondary school 2, comprised of 37 males and 38 females, was selected utilizing a multistage selection approach. Car, Relax, Alone, Forget, Family/Friends Trouble, Edinburg Mental well-being scale, and Social Phobia Inventory were the instruments utilized to collect the data. Findings revealed significant differences in the psychosocial problems of adolescents in senior secondary schools because of the interventions, however, dialectic behaviour therapy made more impact in the reduction of adolescents’ social stress though both treatments had a significant impact. Keywords: Assertiveness training, dialectic behaviour therapy, mental health, social stress, substance abuse

Full text

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Impact of dialecc behaviour therapy and asserveness training on
the mental health of socially stressed senior secondary students
Rita Okorite Kienka
*
, University of Lagos, University Road Lagos Mainland Akoka, Yaba, Lagos 100213, Nigeria
Ngozi Osarenren, University of Lagos, University Road Lagos Mainland Akoka, Yaba, Lagos 100213, Nigeria
P. Nwadinigwe, University of Lagos, University Road Lagos Mainland Akoka, Yaba, Lagos 100213, Nigeria
Suggested Citaon:
Kienka, R. O., Osarenren, N., & Nwadinigwe, P. (2023). Impact of dialecc behaviour therapy and asserveness
training on the mental health of socially stressed senior secondary students. Contemporary Educaonal
Researches Journal. 13(2), 60-70. hps://doi.org/10.18844/cerj.v13i2.7797
Received from January 02, 2023; revised from February 12, 2023; accepted from Apirl 03, 2023.
Selection and peer review under responsibility of Deniz Ozcan, Ondokuz Mayis University, Turkey.
©2023 by the authors. Licensee Birlesik Dunya Yenilik Arastirma ve Yayincilik Merkezi, North Nicosia, Cyprus.
This article is an open access article distributed under the terms and conditions of the Creative Commons
Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/ ).
Abstract
Social stress resulting from substance abuse is a growing global concern. It is linked to mental health with psychosocial
challenges faced by a large number of the populace in Nigeria. It is worrisome, especially among students in senior
secondary schools in Port-Harcourt Metropolis. Thus, this research examined ‘Dialectic Behaviour Therapy and
Assertiveness Training’ in managing psychosocial mental health problems of senior secondary school students who abuse
substances in the Port-Harcourt metropolis. Tests before and after the study had a population of 9.650 students and
employed quasi-experimental procedures. For the study, a 75-student sample from senior secondary school 2, comprised of
37 males and 38 females, was selected utilizing a multistage selection approach. Car, Relax, Alone, Forget, Family/Friends
Trouble, Edinburg Mental well-being scale, and Social Phobia Inventory were the instruments utilized to collect the data.
Findings revealed significant differences in the psychosocial problems of adolescents in senior secondary schools because of
the interventions, however, dialectic behaviour therapy made more impact in the reduction of adolescents’ social stress
though both treatments had a significant impact.
Keywords: Assertiveness training, dialectic behaviour therapy, mental health, social stress, substance abuse.
*
ADDRESS FOR CORRESPONDENCE: Rita Okorite Kienka, University of Lagos, University Road Lagos Mainland
Akoka, Yaba, Lagos 100213, Nigeria.
E-mail address: ritakienka@gmail.com
Contemporary Educaonal
Researches Journal
Volume 13, Issue 2, (2023) 60-70

Kienka, R. O., Osarenren, N., & Nwadinigwe, P. (2023). Impact of dialecc behaviour therapy and asserveness training on the mental health
of socially stressed senior secondary students. Contemporary Educaonal Researches Journal. 13(2), 60-70.
hps://doi.org/10.18844/cerj.v13i2.7797
61
1. Introduction
We live in a society that is full of occurrences that could stress any individual (Uzunboylu &
Akçamete, 2020). It is so worrisome because the academic body of the entire nation is bedevilled
with incessant closures and problems the government has not been able to address. The senior
secondary school student who in time past would look forward to moving on to university may not
be so enthusiastic because of university strikes every year. Adebayo (2016) stated that in recent
times the scale of social ills in society has become so worrisome that people begin to question
whether anything left at all that Nigeria as a nation can be proud of. These social ills among
adolescent secondary school students manifest in diverse forms which can be seen in the increase of
cases of bullying, gangsterism, truancy, youth restiveness, substance abuse, and many other vices
which have taken their tolls on the academic and social pursuit of the children and youth. Thus,
making mostly secondary schools and tertiary institutions turn out youth who cannot hold their own
in society.
Social stress may have various causes and could have mental health effects on people differently
(Halladay et al., 2022; Zając et al., 2023). One such could be an abuse of substances and mental
health concerns which are often intertwined (Alalwan et al., 2023). It could negatively affect health-
enhancing behaviour and increase people’s risk of illness and injury. Stress is a response that occurs
in the body when a change is encountered. It is a feeling that threatens one’s relationships, affects
the individual’s sense of belonging, and can affect self-esteem. It can be related to physical and
psychological strain. Social stress is also a mental health problem that can be caused by substance
abuse because long-term use of substances can also lead to stressful situations and can aggravate
aggressive behaviour that could affect relationships with others in schools as well as the social
environment (Abate et al., 2021; Adesida et al., 2022; Drozdova et al., 2022).
Social stress is a burden that affects individuals as well as communities where people reside.
Senior secondary school students could begin to abuse substances because of stressors in life, but
the abuse of substances could also enhance social stress among them which could make them
display various forms of negative behaviour. Stress could be harmful, making people vulnerable and
very resilient. Wood and Bhatnagar (2015) showed that various causes enable the capacity to
withstand or to recover quickly from difficulties or vulnerability and being able to resist is just not the
opposite of the possibility of being attacked physically or emotionally since some processes are
separate withstanding difficulties among vulnerable individuals. The effect of substance abuse could
also adversely impact the stress level of other family members’ health and may result in
psychological or physical disarray. Studies have also proved that when individuals share homes with
people who abuse substances, there could be an increase in the cases of mental and physical disarray
(Ólafsdóttir et al., 2018; Rabie et al., 2020; Spoth et al., 2022).
United Nations International Drug Control Programme (1995) posited that the result of taking
drugs may not necessarily be to boost friendship or self-acknowledgment, the effect of taking drugs
could make an individual behave indifferently and psychologically removed. Such persons could have
problems establishing friendships and become increasingly isolated socially, physically, and
emotionally. They also concluded that the mental health burden of social stress on the individual,
school, and society is enormous which could lead to various forms of criminal activities. Socially
stressed individuals often do not want to communicate with others. Newcomb and Locke (2005)
observed that violent, erratic, or paranoid behaviour may arise from substance abuse. It has resulted
in mental health problems that have led to drowning, car crashes, falls, burns, sex abuse, and many
other problems which have become a burden of social stress on society. The consumption of alcohol
to reduce social stress often leads to alcoholism in individuals (Thomas et al., 2003).
The consumption of substances may attract social acceptance from peers, but in the long run,
could lead to social stress and other vices. Other social predictors for the abuse of substances could
be the environment the adolescents grow from. Some may include communities that are not stable

Kienka, R. O., Osarenren, N., & Nwadinigwe, P. (2023). Impact of dialecc behaviour therapy and asserveness training on the mental health
of socially stressed senior secondary students. Contemporary Educaonal Researches Journal. 13(2), 60-70.
hps://doi.org/10.18844/cerj.v13i2.7797
62
with lower levels of unemployment. In their study, Whitesell et al. (2013) concluded that abuse of
substances among adolescents could bring about social stress to the individual and the community in
the adolescent resides because they are often related to individuals or groups involved in
perpetrating deviant behaviour which may be associated with abnormal friendship related problems
which may include, bullying and popularity in gangs within the environment they live. Ayodele et al.
(2018), agreed that it has personal and social consequences for society.
Their view supports other research into epidemiological studies as revealed in the reports that
despite the drug laws and plans to reduce it, the weight that drug abuse carries is growing more
among the younger population, secondary school students included. Substance abuse is exposing
these senior secondary school students to various forms of social stress and debilitating conditions.
Therefore, Jatau et al. (2021) concluded tight measures of keeping interventions should be hurriedly
put in place to reduce the increasing weight of the burden of substance abuse in Nigeria.
United Nations Reports (2013) the research on substance abuse puts enormous social stress on
the health of the masses in countries around the globe such that it is hampering effective progress
and smooth functioning. The global cost is immeasurable because many countries have not been
able to measure the cost of substance abuse on health, public safety, crime, productivity, and
governance in their nations. The drugs that are most commonly reported and for which individuals
receive much of the treatment in societies are Heroin, cannabis, and cocaine. The cost of these
treatments alone for about 4.5 million people is estimated to be a global cost of $35 billion annually.
Social stress no doubt is a mental health concern and could be aggravated by the abuse of
substances by the senior secondary school student whose mental development is undergoing a rapid
developmental process.
Dialectic behaviour therapy can bring people’s acceptable balance with social and other changes
in focus. It could enable individuals to build lives that are worth living through ‘bio-social dialectical
paradigm and strategies of validation, radical genuineness, skills training and group work’. Dialectic
behaviour therapy treatment can bring out the client’s strength and network support that naturally
occurs to create change. Cooper and Parson (2009) opined that dialectic behaviour therapy
treatment could model character, provide reassurance, give advice, provide protection, support, and
care, use persuasion, assertiveness skills, use negotiation skills, deal with hostility, aggression, and
violence, empower and teach individuals how to relate in their environment. Dialectic behaviour
therapy, therefore, teaches people to co-exist peacefully and productively.
Nnadi et al. (2020), in their work, reported that assertiveness training could reduce social
withdrawal behaviour among adolescents. Manesh et al. (2015) agreed that social stress could cause
social avoidance, negative feelings of social interactions, and distress but assertiveness training skills
aid the reduction of social anxiety, changes expectations, beliefs, and attitude, and build positive
evaluation among individuals. Adolescents who are not socially assertive could be prone to substance
abuse but assertive skills could also deter others from taking advantage of another person.
The degree to which substance abuse is influencing the mental health of adolescent secondary
school students in Port Harcourt Metropolis and the social stress accompanying it is becoming
overwhelming. It has become a regular subject of discussion in various households and a vital
problem confronting students. This behaviour has the potential to cause massive negative impacts
like bullying, stealing and fighting, and many other delinquent characteristics on the lives and future
of the youths if they are not managed. The direct and indirect burden of treatment, management,
and prevention of consequences of substance abuse on the economic development of the state if
properly valued could be alarming.
1.1. Purpose of study
Various studies have been carried out by researchers on the prevalence of challenges of
substance abuse and its social effects on society. However, there are no widely known empirical

Kienka, R. O., Osarenren, N., & Nwadinigwe, P. (2023). Impact of dialecc behaviour therapy and asserveness training on the mental health
of socially stressed senior secondary students. Contemporary Educaonal Researches Journal. 13(2), 60-70.
hps://doi.org/10.18844/cerj.v13i2.7797
63
studies about the mental health of adolescent secondary school students and how stressed they are
in Rivers State. The research, therefore, was conducted to discover the impact of mental health
challenges in adolescent senior secondary school students who abuse substances and are socially
stressed using dialectical behaviour therapy and assertiveness training. The following questions
served as the study's guide.
i. How much will the post-test mean scores differ from the pre-test mean scores of
students in senior secondary school students who have mental health challenges and
abuse substances as a result of the application of dialectic behaviour therapy,
assertiveness training, and the control group?
ii. What will be the extent of difference in the post-test mean scores of social stresses in
students in senior secondary schools who have mental health challenges and abuse
substances due to gender as a result of the experimental conditions?
1.2. Research hypotheses
H1- Social stress and mental health problems do not signicantly dier among students in senior
secondary schools exposed to dialecc behaviour therapy and asserveness training and the control
group.
H2- Social stress on mental health challenges may not significantly differ among students in senior
secondary schools exposed to dialectic behaviour therapy and assertiveness training and the control
group due to gender.
2. Materials and methods
The research design used in this study was a pre-test, post-test quasi-experimental design. The
groups were three; dialectic behaviour therapy, assertiveness training, and a control group.
2.1. Participants
The research was made up of a population was 9,600 students from 17 public schools in 13 zones
of the metropolis. The research process was broken into various stages. A multi-stage sampling
procedure was used to choose 3 schools from the 17 in the metropolis using simple random
sampling. The population from the selected schools was 1,680 where instruments were
administered.
The first baseline instrument, Car, Relax, Alone, Forget, Family/Friends Trouble (CRAFFT) was
administered. Students identified as having abused substances were 205 and Warwick. A second
baseline test, Edinburg Mental well-being scale (WEMWBS) was administered to the 205 students to
ascertain their mental health status. Students who scored above average were 75. Simple random
sampling was applied. 25 students were assigned to dialectic behaviour therapy treatment for 6
weeks, 24 students to assertiveness training treatment, and 26 students to the control group for 6
weeks. All groups received a post-test after the treatment.
2.2. Data collection instruments
Instruments used in the study for the collecon of data:
• CRAFFT
• WEMWBS
• Social Phobia Inventory (SPIN).
2.2.1. Car, Relax, Alone, Forget, Family/Friends Trouble
Knight et al. (2016) developed the CRAFFT instrument in Boston Massachuses, USA. It is relevant
in the screening of substance abuse among adolescents. It is permied to be self-administered and
can be used as a tool for interviews. It has an internal consistency Cronbach’s a = 0.65–0.85 and 12
items which are answered in ‘Yes’ or ‘No’.
2.2.2. Warwick Edinburg Mental Well-being Scale

Kienka, R. O., Osarenren, N., & Nwadinigwe, P. (2023). Impact of dialecc behaviour therapy and asserveness training on the mental health
of socially stressed senior secondary students. Contemporary Educaonal Researches Journal. 13(2), 60-70.
hps://doi.org/10.18844/cerj.v13i2.7797
64
Warwick Medical School developed the WEMWBS. The instrument consists of 14 items that a
posively worded to assess people’s mental well-being. It is an acceptable instrument to be used for
teenagers over 13 years and has Cronbach’s alpha of 0.87.
2.2.3. Social Phobia Inventory
The Psychiatry and Behavioural Sciences at Duke University in the USA created the SPIN. It
consists of 17 items that address social phobia-related physiological symptoms as well as dread and
avoidance. Each response is given a numerical value ranging from least intense to most intense, with
the responses being ‘Not at all to extremely’. It has been examined and found to have strong internal
consistency and test-retest reliability. It is a reliable screening measurement, with an internal
consistency range of 0.87–0.94. Table 1 displays the test–retest reliability coecient of the research
instrument (N = 30).
Table 1
Test-Retest Reliability Coecient of the Research Instrument (N = 30)
Instrument
N
No. of
statement
Reliability
coecient
4
SPIN
30
17
0.78
3. Results
3.1. Hypothesis 1
Social stress and mental health problems do not signicantly dier among students in senior
secondary schools exposed to dialecc behaviour therapy and asserveness training and the control
group.
Table 2
Description of Mean, Standard Deviation (SD), and Mean Difference in Social Stress Due to Experimental
Conditions
Experimental groups
N
Pre-test
Post-test
Mean
difference
Mean
SD
Mean
SD
Dialectic behaviour therapy
25
56.32
2.85
39.52
3.84
−16.80
Assertiveness training
26
57.92
3.20
43.35
5.31
−14.58
Control group
24
57.71
3.14
59.54
2.11
1.83
Total
75
57.32
3.11
47.25
9.50
−10.07
The social stress means for participants in the DBT, AST, and control groups at pre-test was 56.32,
57.92, and 57.71, respectively, according to the analysis of Table 2. The social stress means for DBT,
AST, and control group decreased to 39.52, 43.35, and 59.54, respectively, at the post-test. The DBT
group experienced a greater decline (−16.8) than the AST group (−14.58). The control group,
however, experienced a minuscule 1.83 gain. To determine the significant difference in the mean, an
analysis of covariance was done. Table 3 in the section below shows the analysis of the outcome.
Table 3
ANCOVA for Social Stress Due to Treatment Conditions
Source
Sum of squares
Df
Mean square
F
Sig.
Corrected model
5,549.421
3
1,849.807
116.560
0.000
Intercept
248.842
1
248.842
15.680
0.000
Covariate
33.317
1
33.317
2.099
0.152
Group
5,329.484
2
2,664.742
167.911
0.000
Error
1,126.766
71
15.870
Total
174,142.000
75
Corrected total
6,676.187
74

Kienka, R. O., Osarenren, N., & Nwadinigwe, P. (2023). Impact of dialecc behaviour therapy and asserveness training on the mental health
of socially stressed senior secondary students. Contemporary Educaonal Researches Journal. 13(2), 60-70.
hps://doi.org/10.18844/cerj.v13i2.7797
65
As a result of the experimental settings, a significant difference of 167.911 F-calculated values
was found, according to the ANCOVA results. Given 2 and 71 degrees of freedom and a 0.05 level of
significance, it was noted that the F-calculated value was higher than the 3.13 critical value. The
results and conclusion showed that there is a significant difference in social stress among senior
secondary school students with mental health issues and substance addiction when exposed to DBT,
AST, and the control group, rejecting the null hypothesis. To demonstrate the important pair, a
second analysis was conducted; the results are shown in Table 4.
Table 4
Pair-Wise Analysis of Social Stress Based on Treatment Groups
(I) Experimental group
(J) Experimental group
Mean difference (I–J)
Sig.
Dialectic behaviour therapy
Assertiveness training
−3.471a
0.003
Control group
−19.714a
0.000
Assertiveness training
Dialectic behaviour therapy
3.471a
0.003
Control group
−16.243a
0.000
Control group
Dialectic behaviour therapy
19.714a
0.000
Assertiveness training
16.243a
0.000
Based on estimated marginal means.
a The mean difference is significant at the 0.05 level.
Figures from Table 3 show that DBT when paired with AST (t = −3.471, p < 0.05) as well as control
group (t = −19.714, p < 0.05) was significant. Also, the pair of assertiveness training and control group
(t = −16.243, p < 0.05) was also significant.
3.2. Hypothesis 2
Social stress on mental health challenges may not significantly differ among students in senior
secondary schools exposed to dialectic behaviour therapy and assertiveness training and the control
group due to gender.
Table 5
Descriptive Analysis of Social Stress Based on Experimental Groups and Gender
Experimental group
Gender
N
Pre-test
Post-test
Mean
difference
Mean
Std.
deviation
Mean
Std.
deviation
Dialectic behaviour
therapy
Female
14
56.79
2.15
39.50
3.88
−17.29
Male
11
55.73
3.58
39.55
3.98
−16.18
Total
25
56.32
2.85
39.52
3.84
−16.80
Assertiveness training
Female
12
58.00
3.41
43.33
4.68
−14.67
Male
14
57.86
3.13
43.36
5.97
−14.50
Total
26
57.92
3.20
43.35
5.31
−14.58
Control group
Female
12
58.08
3.32
60.58
1.98
2.50
Male
12
57.33
3.06
58.50
1.73
1.17
Total
24
57.71
3.14
59.54
2.11
1.83
Total
Female
38
57.58
2.96
47.37
9.91
−10.21
Male
37
57.05
3.28
47.14
9.19
−9.92
Total
75
57.32
3.11
47.25
9.50
−10.07
Table 5 analysis reveals that at pre-test, female participants had social stress mean values of
56.79, 58, and 58.08 for dialectic behaviour therapy, assertiveness training, and the control group
respectively. Their male counterpart had mean values of 55.73, 57.86, and 57.33 47.08 for DBT, AT,
and control group, respectively.

Kienka, R. O., Osarenren, N., & Nwadinigwe, P. (2023). Impact of dialecc behaviour therapy and asserveness training on the mental health
of socially stressed senior secondary students. Contemporary Educaonal Researches Journal. 13(2), 60-70.
hps://doi.org/10.18844/cerj.v13i2.7797
66
The female participants’ mean value for DBT dropped to 39.5 at the post-test, AT to 43.33 and
the control group rose to 60.58. Similarly, the male counterpart violent behaviour mean value
dropped to 39.55, 46.36, and 58.5 for DBT, AT, and control group.
The DBT group's female and male participants saw the greatest decreases in social stress
compared to the other groups, as evidenced by the mean differences. In addition, an analysis of
covariance was calculated to identify any significant mean differences. The analysis's findings are
presented in Table 6.
Table 6
ANCOVA for Social Stress Due to Treatment Conditions and Gender
Source
Sum of squares
Df
Mean square
F
Sig.
Corrected model
5,572.044
6
928.674
57.194
0.000
Intercept
253.501
1
253.501
15.612
0.000
Covariate
29.882
1
29.882
1.840
0.179
Group
5,298.810
2
2,649.405
163.167
0.000
Gender
5.239
1
5.239
0.323
0.572
Group * gender
17.804
2
8.902
0.548
0.580
Error
1,104.143
68
16.237
Total
174,142.000
75
Corrected total
6,676.187
74
The study in Table 6 reveals that the difference in the effects of social stress on mental health
issues among adolescents who abuse substances in the three experimental groups was estimated as
an F-calculated value of 0.548. Given the degrees of freedom 2 and 68 at the 0.05 level of
significance, the calculated F was less than the tabulated value of 3.15, supporting the null
hypothesis. It was determined that there are no appreciable gender-related differences in the effects
of social stress on mental health issues among teenagers abusing substances in the experimental
groups.
4. Discussion
Social stress of senior secondary school students who have challenges with mental health as a
result of substance abuse was found to significantly differ as a result of the experimental conditions.
Participants were exposed to emotion regulation and distress tolerance treatment sessions which
could emotionally manage social stress. The dialectic behaviour therapy group was with the highest
reduction followed by the assertiveness training. The findings are in line with the findings of
Karbalaee et al. (2012) where a significant decrease was observed with the training in distress
tolerance and emotion regulation.
Reese et al. (2019) findings are consistent with this study because they agreed that distress
tolerance in dialectic behaviour therapy skills could change an individual’s mood and increase
emotional stability and teach reality acceptance which could help in making decisions to stay away
from substance abuse. The findings are also consistent with the conclusions of Cooper and Parson
(2009) who observed that dialectic behaviour therapy could be used to model character, provide
reassurance, and teach individuals how to support and care for themselves. The finding is also
supported by Manesh et al. (2015) who showed that assertiveness training decreases social stress,
and changes expectations, attitudes, beliefs, and positive evaluations. Manesh et al. (2015), and
Adegoke (2018) agree that assertiveness training skills could aid in the reduction of social anxiety,
and change expectations, and attitude.

Kienka, R. O., Osarenren, N., & Nwadinigwe, P. (2023). Impact of dialecc behaviour therapy and asserveness training on the mental health
of socially stressed senior secondary students. Contemporary Educaonal Researches Journal. 13(2), 60-70.
hps://doi.org/10.18844/cerj.v13i2.7797
67
5. Conclusion
As a result of the proceeding discussion, the conclusion was drawn as follows. The research
demonstrated that dialectic behaviour therapy and assertiveness training are effective in reducing
social stress in the mental health challenges of adolescents. The research also showed that there is
no gender difference in social stress of senior secondary school students with mental health
challenges who abuse substances.
It further revealed that dialectic behaviour therapy is a more effective treatment for mental
health challenges of senior secondary school students who abuse substances than assertiveness
training. Finally, the study demonstrated that a lack of assertiveness skills and poor interpersonal
relationship contributes to mental health challenges of senior secondary school students who abuse
substances.
6. Recommendations
Recommendations made based on the findings of the research were as follows:
1. Mental health problems are becoming a subject of great concern especially as it relates to
senior secondary school students. Secondary school counsellors need to receive specialized
retraining in detecting and creating detection and treatment for mental health issues in adolescents.
2. Social stress is a burden that affects individuals as well as communities. The mental health
concerns and the global cost is immeasurable; therefore, assertiveness training should be added to
the secondary school curriculum to reduce rising cases of substance abuse among students.
3. Rehabilitation centres that enhance healthy social activities should be built and equipped
with professionals for the management of various forms of stress levels rather than allow them to
cohabit with other secondary school students and become subjects of social stress in the schools and
society.
4. Gender discrimination must end, and male and female adolescents should be treated
equally. Preferences of sexes should be avoided when managing social stress levels of students in
senior secondary schools’ students.
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Appendix
How many days did you spend in the past 6 months?
None
# of days
1
Have you ever used any tobacco or nicotine products, such as cigarettes, e-
cigarettes, hookahs, or smokeless tobacco? If none, type ‘0’
2
Use any other substances to get high (such as illicit drugs, prescription and
over-the-counter drugs, and drugs that you sniff, inhale, or vape). When
none, enter ‘0’
Yes
No
3
When you're alone (Alone), do you ever try using any kind of booze or
drugs?
WEMWBS
S/N
Items
None of the
time
Rarely
Some of
the time
Often
All of the
time
1
I am capable of coming to my own
decisions.
2
I've been having clear thoughts.

Kienka, R. O., Osarenren, N., & Nwadinigwe, P. (2023). Impact of dialecc behaviour therapy and asserveness training on the mental health
of socially stressed senior secondary students. Contemporary Educaonal Researches Journal. 13(2), 60-70.
hps://doi.org/10.18844/cerj.v13i2.7797
70
SPIN
S/N
ITEMS
Not at
all
A little
bit
Somehow
Very
much
Extremely
1
I'm uncomfortable talking to strangers because I'm
worried about what they might think of me.
2
When people are around, I am hesitant to act.