This cluster randomized controlled trial (cRCT) aims to evaluate the effectiveness of a narrative therapy (NT) intervention in (i) reducing mental distress, depressive symptoms, and anxiety, as well as (ii) enhancing perceived control and fostering a stronger sense of self among at-risk youth in Hong Kong. Participants are youths with moderate mental health concerns, indicated by K6 scores ranging from 11 to 14. The study involves seven clusters, each based on community hubs, which will be randomly assigned to either the intervention group or a wait-list control group. Clusters assigned to the intervention group will receive six face-to-face sessions led by trained youth workers. Control clusters will receive the same intervention after the initial follow-up period. Participants will be evaluated at baseline, post-intervention, and one-month follow-up. An interim analysis is built for the sake of evaluation of the collected data from the ongoing trial, in which the primary research question is addressed, and which has the potential for modifying the conduct of the study. Furthermore, a qualitative follow-up will be conducted after the trial, involving both participants and the workers delivering the NT intervention. This qualitative component aims to gather feedback on participants' experiences, and inform potential revisions to enhance future implementation. It is hypothesized that youths receiving the NT intervention will show significantly greater improvements in perceived control and sense of self, along with reductions in mental distress, as well as depressive and anxiety symptoms, compared to those in the wait-list control group.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
770
In Hong Kong, deeply ingrained norms and expectations shape each stage of life. As young people navigate their growth, they are constantly influenced by mainstream narratives stemming from sociocultural traditions, family, educators, peers, or social media. These narratives often define socially approved notions of "good" versus "bad," "meaningful" versus "meaningless," and "successful" versus "failing." Many youths may not fully realize how these dominant discourses subtly influence their life choices, often leading them to unconsciously accept predetermined paths they believe they "should" follow. Whether they conform successfully or struggle with these expectations, young people frequently experience pressure and negative emotions. Even more concerning, some internalize these societal judgments, resulting in negative self-perceptions. Through this group program utilizing narrative intervention methods, we aim to provide a safe, supportive space for youth to re-examine and explore th
University of Hong Kong
Hong Kong, Hong Kong
RECRUITINGPsychological Distress
The 6-item Kessler Psychological Distress Scale (scores range from 0 to 24 where a higher score indicates a worse outcome)
Time frame: Baseline, 6-week, and 10-week
Depression and anxiety Symptoms
Depression Anxiety Stress Scales (scores range from 0 to 63 where a higher score indicates more severe symptoms)
Time frame: Baseline, 6-week, and 10-week
Perceived Control / Self-efficacy
Sense of Mastery Scale (scores range from 7 to 28 where a higher score indicates a a better outcome)
Time frame: Baseline, 6-week, and 10-week
Narrative Identity
Narrative Identity Self-Evaluation Scale (scores range from 0 to 200 where a higher score indicates a better outcome)
Time frame: Baseline, 6-week, and 10-week
Perceived Social Support
Multidimensional Scale of Perceived Social Support (scores range from 12 to 84 where a higher score indicates a better outcome)
Time frame: Baseline, 6-week, and 10-week
Loneliness
UCLA Loneliness Scale (scores range from 20 to 80 where a higher score indicates a worse outcome)
Time frame: Baseline, 6-week, and 10-week
Resilience
The 10-item Connor-Davidson Resilience Scale (scores range from 0 to 40 where a higher score indicates a better outcome)
Time frame: Baseline, 6-week, and 10-week
Rumination
The 22-item Rumination-Reflection Questionnaire (scores range from 22 to 88 where a higher score greater rumination)
Time frame: Baseline, 6-week, and 10-week
Self-stigma
The 9-item Internalized Stigma of Mental Illness Inventory (scores range from 1 to 4 where a higher score indicating high internalized stigma)
Time frame: Baseline, 6-week, and 10-week
Hopefulness / Hopelessness
Beck Hopelessness Scale (scores range from 0 to 20 where a higher score indicates greater levels of hopelessness)
Time frame: Baseline, 6-week, and 10-week
Service Utilization
Client Service Receipt Inventory
Time frame: Baseline, 6-week, and 10-week
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