Development of a College Student-Delivered Cognitive-Behavioral Therapy (CBT) Intervention for Rural High School Students

Inclusion Criteria: * High school students ages 13-18 years. * Attending a participating rural high school in Schuylkill County, Pennsylvania. * Presenting with self-reported symptoms of depression, anxiety, or stress. Must have a t-score ≥ 55 on one or more of the following three measures: i. PROMIS Emotional Distress Depression short-form questionnaire ii. PROMIS Emotional Distress Anxiety short-form questionnaire iii. PROMIS Psychological Stress Experiences short-form questionnaire * English-speaking (to ensure comprehension of CBT materials and assessments). Exclusion Criteria: * Diagnosis of a psychotic disorder, bipolar disorder, intellectual disability, or seizure disorder. * Assessed to be at high risk for suicide or requiring immediate crisis intervention. * Inability to participate in school-based sessions due to scheduling conflicts or behavioral concerns.