Self-regulation strategies in anxiety and stress management interventions for severe mental disorders: a scoping review

Abstract Stress and anxiety are pervasive and disabling challenges for individuals with severe mental disorders (SMDs), exacerbating illness trajectories and diminishing quality of life. Yet the specific strategies used in self-management interventions remain underexplored and conceptually unclear. This scoping review aimed to identify and categorize self-regulation strategies embedded in interventions for stress and anxiety in individuals with SMDs, using Pintrich’s self-regulated learning (SRL) model as a guiding framework. A secondary aim was to examine reported outcomes and intervention formats. We systematically reviewed 42 studies across multiple databases, mapping strategies by SRL phase (Forethought, Monitoring, Control, Reflection) and regulatory domain (cognitive, motivational/affective, behavioral/physiological, contextual). The Control and Reflection phases were most frequently represented, while Forethought and Monitoring were less emphasized. Cognitive strategies spanned all phases, whereas motivational and contextual domains appeared least often. Despite this imbalance, interventions commonly improved symptoms, emotional regulation, and self-efficacy. Findings highlight the need for more balanced, phase-inclusive interventions that intentionally integrate motivational and contextual strategies to promote sustained self-regulation, recovery, and autonomy in real-world settings. The SRL model provides a dynamic, developmental framework that conceptualizes stress and anxiety regulation as an active learning process, elucidating underlying self-regulation mechanisms and informing intervention design.