The effectiveness of a stress management intervention designed to reduce affective distress in 79 student nurses who previously reported significant distress, was evaluated by comparing stress management with wait-list control. The intervention had reliable, positive effects on affective outcomes including General Health Questionnaire-30, State and Trait Anxiety Inventory, Beck Depression Inventory, and a measure of domestic satisfaction. The intervention also led to an increase in Direct Coping use. State Anxiety immediately preceding two important examinations, i.e. at 3 and 18 month follow-up, was lower for students receiving stress management. However, no effect was detected on sickness, absence and examination performance following this intervention. Stress management delivered in groups reduces affective distress and increases adaptive coping use in both clinical and academic settings.