Mental health and well-being are increasingly recognized as a serious, worldwide public health concern. It includes our psychological, emotional, and social well-being that affects how we think, behave, and feel. The National Health and Morbidity Survey 2017 reported 29 percent of Malaysians had depression and anxiety disorders compared to 12 percent in 2011 due to environmental and individual-related stress [1]. According to the National Health Morbidity Survey 2015, there has been an increase in mental health problems from 10.6 percent in 1996 to 29.2 percent in 2015. Sports as a regular physical activity is vital in preserving a healthy lifestyle. Physical inactivity is presumed to be the foremost cause of hypertensive illness and disorders which are estimated to cause two million deaths per year [2]. Physical activity showed signi-ficant effects on the prevention and treatment of physical diseases and psychological disorders [3-5]. Nevertheless, in Malaysia, more than half of the adult population does not assume good physical activities to increase their health benefits [6]. Hence, it is imperative to develop complementary modules and interventions regarding psycho-physical aspects to improve university-athlete students' well-being as well as physical activities in their daily life.

Three indicators of health are used worldwide: life expectancy, infant mortality, and well-being. In contrast to life expectancy and infant mortality, well-being (SWB) focuses on one’s perceptions and self-judgments of health. Well-being, which encompasses a person’s feelings of happiness and life satisfaction, has a significant effect on health [7]. The main applied goal of researchers who study well-being is the improvement of people’s lives beyond the elimination of misery. Well-being is a key component of quality of life, its measurement is crucial to understanding how to improve people’s lives. In addition, a growing body of research shows that high levels of well-being are beneficial to the effective functioning of societies beyond the advantages they bestow on individuals.

Additionally, mental health issue is an important concern among adults and closely correlates with well-being. Even though there is increasing recognition of the importance of maintaining and promoting the mental wellbeing of individuals globally (Naci & Ioannidis, 2015 cited in [8], mental health concern among Malaysian population has yet to be established [8]. Nowadays, the issue of mental health has started to gain importance because there is an alarming increase of prevalence in individuals aged 16 years old and above experiencing problems related in mental health, which increased to 29.2 percent in 2015 from 10.6 percent in 1996 [9], and data from the National Health and Morbidity Survey (NHMS) in 2015 showed that the prevalence of mental health problems among children in Malaysia was 11.1 percent [10]. Thus, well-planned strategies for maintaining and improving well-being are needed as primary prevention [11]. An inactive lifestyle, anxiety, stress, and depression have been proven to have a negative impact on mental health, especially on the quality of life, mood, and self-esteem, and can cause moodiness and lack of enthusiasm in activities that an individual used to find enjoyable [12]. In Malaysia, previous studies have reported widely on fitness and mental health among the specific population with focused on aerobic exercise interventions such as dance exercise, walking, jogging, aqua Zumba, or soccer [13-16]. This conceptual paper is based on Malaysian university-athlete students and offers a unique opportunity to promote, maintain and improve wellbeing. Investigation of psycho-physical intervention effects on mental health conditions could be relatively important.

The term psycho-physical training refers to training learners on the basis of two psychological and physical domains. It is notable that each athlete's mental training is directly related to their physical training, based on sports training, physical endurance, physical exercise, and more. Sports training can be considered a system involving the following physical, tactical, technical, and psychological components. These aspects of preparation are associated in unity - the psycho-physical of the athlete and the results of sports show the effect of these two components on athletes’ performance [17]. Mental training is a pedagogical process for improving mental processes, qualities, and personality traits in order to increase efficiency and improve health. That is, mental training is a pedagogical process to form mental readiness. The goal of psychic training is to form a mental preparedness for actions in extreme situations [18]. The expression of individuality, creativity, and uniqueness of using high cognitive skills is essential for high sporting skills to achieve top sporting achievements.

In order to regulate mental activity, it is necessary to optimize the situational psychological readiness and the adaptation of the person because it is the situational psychological readiness to judge the reliability of the person in extreme situations [19]. Emotional problems such as anxiety and stress in sports have negative impacts on athletes’ performance and sporting achievement. It includes various methods to measure anxiety in athletes, such as physiological, biochemical, or psychometric investigations. Despite, various anxiety measurements, there are different kinds of interventions to assist athletes in coping adequately with their anxiety levels [20]. According to individual anxiety levels, different kinds of interventions should be required to assist athletes adequately [20, 21] stated physical readiness includes physical (motor) qualities such as strength, coordination, endurance, balance, speed, and flexibility. Moreover, Fisher and his colleagues indicated different vital factors of physical and mental for psycho-physical training, such as responsibility, confidence, control, and concentration (Fig. 1) [22].

Fig. (1). The components of physical and mental training.

All these psycho-physical qualities for the athletes’ training further construct positive self-esteem, confidence, expectations, and good performance and also enhance monitoring and control over the internal and external environment, which lead to a beneficial influence on anxiety, stress or tension that may experience in an extreme situation such as a sports competition.

Cognitive processes are significant for human development, the thinking process has a special role in creating, directing and persistence of human moods and behaviors. On the basis of the cognitive approach, Rational-Emotive and Cognitive Behavior Therapy (RE & CBT) educate clients to disprove cognitive distortions, or fundamental faulty thinking to replace one’s irrational, counter-factual beliefs with more accurate and beneficial ones by cognitive restructuring techniques. Furthermore, RE & CBT emphasizes the clients’ responsibility for creating their behaviors and dysfunctional emotions, such as depression, anxiety, and stress, that affect their well-being. Consequently, RE & CBT advises changing such irrational beliefs and substituting more rational ones [23]. Thus, the investigation of this intervention as a crucial subject for Malaysian experts to train Malaysian university-athlete students to distinguish, challenge, and replace their irrational thoughts with rational and productive thoughts on the basis of Rational-Emotive and Cognitive Behavior Therapy (RE & CBT) is necessary and valuable research [24].

It is notable that when athletes encounter some problems with a high rate of difficulties, their cognitive process will focus on task-irrelevant thoughts instead of task-relevant ones. Attention to task-irrelevant thoughts makes to process irrelevant issues and the results will be unrelated to the actual task. In addition, when athletes create unrelated consequences that cannot produce the desired results, it creates negative emotions such as fear, anxiety, anger, hate, sadness, etc. More adequate task-relevant thoughts, positive automatic thoughts, rational beliefs, and interpreting rationally directly enable athletes to substitute the task-irrelevant thoughts with task-relevant thoughts in order to impact negative and maladjustment emotions. Completing the Athletes Cognitive Restructuring Module can assist athletes to understand how their cognitive process can influence positively or negatively their behavior and emotions related to physical training. Similarly, athletes will educate to disprove cognitive distortions or fundamental faulty thinking to replace irrational beliefs with rational ones. This module is a combination of the most famous cognitive therapeutic methods, such as Rational Emotive Behavior Therapy [23, 25], Cognitive Behavior Therapy, and Systematic Rational Restructuring [26]. All forms of cognitive therapy are based on the premise that negative emotional disturbances are a result of distorted cognition, automatic negative thoughts, and illogical or irrational beliefs. Although rational-emotive and cognitive behavior therapy give the rationale for cognitive restructuring, also systematic, rational restructuring organizes this rationale into a series of more systematic steps and procedures [27]. Athlete cognitive restructuring module consists of eight psycho-educational counseling sessions that focus on training athletes to cope properly with psycho-physical problems, negative emotions, and maladaptive behaviors in sports performance (Fig. 2).

Fig. (2). Framework of Athletes' Psycho-physical and Cognitive Restructuring module (APPCR) training module.