The purpose of the proposed randomized controlled trial is to evaluate the feasibility, acceptability, and potential effectiveness of Acceptance and Commitment Therapy (ACT) in reducing parental burnout and improving children's emotional and behavioral adjustment in families in Hong Kong over 3 months after the intervention. The findings will provide valuable and scientific insights to inform better parenting interventions and child protection policies.
Parental burnout is becoming more widely recognized as a serious social issue. It is particularly prevalent among high-stress families like those impacted by child maltreatment or domestic violence. According to prior research, psychological flexibility-a core component of Acceptance and Commitment Therapy (ACT)-is crucial for promoting healthy parent-child relationships and adaptive parenting practices. However, there is still a dearth of empirical evidence supporting ACT-based interventions for reducing parental burnout and improving child adjustment. The purpose of this study is to investigate how ACT interventions differ in their impact on parents and children in Hong Kong. The specific aims are to evaluate the effectiveness of an ACT-based training program in lowering parental burnout and investigate its influence on children's emotional and behavioral adjustment. Parents will participate in an ACT-based parenting training program designed to increase psychological flexibility in the ACT intervention group. Aiming at improving psychological flexibility and reducing parental burnout, the training program incorporates mindfulness, values-based parenting, and cognitive defusion strategies. It provides parents with the resources they require to manage stress, regulate emotions, and promote parent-child relationships, which benefits both themselves and their children. To foster emotional regulation and resilience, children aged 6-11 will also participate in a group-based, child-focused ACT Program designed for their developmental needs. This program incorporates experiential learning exercises, mindfulness activities, and storytelling using picture books to facilitate participation and engagement. These child-focused components seek to reinforce the skills parents have learned while directly supporting child adjustment. This study aims to examine the feasibility, acceptability, and potential efficacy of a group-based Acceptance and Commitment Therapy (ACT) intervention targeting. The intervention is designed to improve parental psychological flexibility and parenting behaviour, enhance parent- child relationships, and child-related outcomes within a separate sample of parents and children over the 3- month post-intervention. The study will be conducted in collaboration with Harmony Home Limited, leveraging the expertise of paraprofessionals trained in ACT.
For Parent ACT Group, parents will participate in a six-week, group-based ACT program integrated with behavioral parenting training based on positive parenting principles. Each session lasts two hours and includes 65 minutes of ACT-based activities (e.g., experiential exercises, guided imagery, mindfulness, values clarification, metaphors) and 25 minutes of parenting education and/or behavioral skills training. For Children ACT Group, children (aged 6-11) will also receive a child-focused ACT intervention to help them manage emotional challenges. Each session lasts two hours and includes 65 minutes of ACT-based activities (e.g., experiential exercises, guided imagery, mindfulness, values clarification, metaphors) and 25 minutes of behavioral skills training.
Participants allocated to the Control Group will not receive the ACT intervention but will continue to receive the standard services originally provided by Harmony House. These services constitute usual care and include initial assessments, individual counselling, group counselling, the provision of community resource information, and referrals. Control group participants will receive these supports as usual. This study will not alter their existing service arrangements in any way, nor will it add to or reduce the support they receive. Aside from not participating in the ACT program, the control group's experience will be identical to that of clients receiving regular services. After the intervention group completes the program, the control group will be offered the same course content (i.e., a waitlist intervention arrangement).
Harmony House Limited
Kwun Tong, Hong Kong
RECRUITINGChinese University of Hong Kong
Shatin, Hong Kong
RECRUITINGParental Burnout
The Parental Burnout Assessment (PBA, 23-item, 7-point Likert scale) will be employed to evaluate the level of parental burnout. The Chinese version of PBA has reported good internal consistency (Cronbach's α = \>.8), adequate construct validity (.66\~.79), and strong convergent validity in Chinese parents.
Time frame: Change from baseline assessment to immediate and 3 months post-intervention
Children's emotional and behavioral adjustment
The Strengths and Difficulties Questionnaire (SDQ, 25-item, 3-point Likert scale) will be used to assess children's emotional and behavioral adjustment. The Chinese version of SDQ demonstrates satisfactory internal consistency (Cronbach's α = .45-.90) and good test-retest reliability (coefficients = 0.8 to 0.85).
Time frame: Change from baseline assessment to immediate and 3 months post-intervention
Parental Psychological flexibility
Parental Psychological Flexibility Questionnaire (PPFQ, 16-item, 7-point Likert scale) will be employed to measure parents' psychological flexibility. The PPFQ measures psychological flexibility using three subscales: cognitive defusion, committed action, and acceptance. The total and each subscale scores of the Chinese version of PPFQ have demonstrated substantial discriminant and criterion validity and internal consistency (Cronbach's α = .77-.86), and test-retest reliability coefficients ranging from 0.55 to 0.75.
Time frame: Change from baseline assessment to immediate and 3 months post-intervention
Children's psychological flexibility
Child and Adolescent Mindfulness Measure (CAMM, 10-item, 5-point Likert scale) will be used to assess children's psychological flexibility through children's self-reports. Grounded in Acceptance and Commitment Therapy (ACT), it measures present-moment awareness and non-judgmental acceptance of thoughts and feelings. The Chinese version of CAMM demonstrates good internal consistency (Cronbach's α = .826) and strong construct validity and acceptable criterion-related validity among Chinese primary school students.
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Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
120
Time frame: Change from baseline assessment to immediate and 3 months post-intervention
Adaptive parenting behaviors
Interpersonal Mindfulness in Parenting Scale (IM-P, 31-item, 5-point Likert scale), a parent self-report measure, will be employed to measure adaptive parenting behaviors. The IM-P assesses five dimensions: Listening with Full Attention, Emotional Awareness of Self and Child, Self-Regulation in Parenting, Non-Judgmental Acceptance of Self and Child, and Compassion for Self and Child. The Chinese version of the IM-P was found to have adequate internal consistency (Cronbach's α = 0.85) and has been demonstrated to be a valid measure among Chinese populations.
Time frame: Change from baseline assessment to immediate and 3 months post-intervention
Parent-Child Relationship Quality
Child-Parent Relationship Scale-Short Form (CPRS-SF, 15-item, 5-point Likert scale), a parent self-report measure, will be used to assess the quality of the parent- child relationship. The Chinese version of CPRS-SF assesses child-parent relationships across two subscales: conflict and closeness. The internal consistency of the subscales is typically reported as being in the range of 0.70 to 0.90, indicating good reliability.
Time frame: Change from baseline assessment to immediate and 3 months post-intervention