International university students often experience acculturative stress, and culturally appropriate techniques to manage stress are needed. This randomized trial tested the effects of group assertiveness training, private expressive writing, their combination, and a wait-list control on the acculturative stress, affect, and health of 118 international students at an urban North American university. Interventions were conducted at the start of a semester, and assessments were conducted at baseline and at the end of the semester. Group assertiveness training was rated positively by students and led to lower negative affect, whereas expressive writing was less well received and led to higher homesickness and fear, but also to higher positive affect. The combined intervention had no effects, perhaps because the 2 components negated each other. It is concluded that group assertiveness training improves emotional adjustment of international students but that expressive writing has mixed effects and needs further development and study. (Contains 1 table.)