This study aims to evaluate the feasibility and preliminary effects of the MIND-SET Intervention Module, an integrated Motivational Interviewing and Rational Emotive Behavior Therapy (MI-REBT) intervention, among Malaysian primary school students involved in Non-Suicidal Self-Injury (NSSI) behaviour. The module is designed to reduce self-injurious behaviour, improve emotional regulation, and enhance readiness for change among 12-year-old students in school settings. This study will use a quasi-experimental design involving three groups: a MIND-SET intervention group, a PRISMA Mental Health Module group, and a treatment-as-usual group. Data will be collected at pre-intervention, post-intervention, and follow-up stages using validated psychological instruments. The findings are expected to support the development of culturally responsive, school-based mental health interventions for children involved in NSSI behaviour in Malaysia.
Non-Suicidal Self-Injury (NSSI) among children and adolescents is an increasingly important mental health concern worldwide, including in Malaysia. NSSI refers to deliberate self-injurious behaviour without suicidal intent and is often associated with emotional distress, maladaptive coping, emotional dysregulation, and interpersonal difficulties. These concerns highlight the need for early, structured, and school-based intervention, particularly among primary school students who may have limited emotional regulation and help-seeking skills. Despite increasing attention to NSSI, culturally appropriate intervention modules for Malaysian primary school students remain limited. Many existing interventions are developed within Western contexts and may not fully address the developmental, emotional, family, school, and sociocultural needs of Malaysian children. Therefore, this study introduces the MIND-SET Intervention Module, which integrates Motivational Interviewing (MI) and Rational Emotive Behavior Therapy (REBT) to support emotional regulation, cognitive restructuring, and readiness for behavioural change among students involved in NSSI behaviour. MI is incorporated to enhance readiness for change, reduce ambivalence, and strengthen intrinsic motivation toward healthier coping behaviours. REBT is used to help participants identify irrational beliefs, challenge maladaptive thinking patterns, and develop healthier emotional and behavioural responses. The integration of MI and REBT is expected to provide a structured, supportive, and developmentally appropriate intervention for school counselling settings. This study will employ a quasi-experimental pre-test, post-test, and follow-up design involving three groups. Approximately 105 primary school students aged 12 years from selected schools in Kedah, Malaysia, will participate in the study. Participants will be identified through school mental health screening and NSSI-related assessment procedures. The treatment group will receive the MIND-SET Intervention Module through structured group counselling sessions. The active comparator group will receive the PRISMA Mental Health Module developed by the Ministry of Education Malaysia. The treatment-as-usual group will continue receiving routine school support and normal school activities without participating in any structured intervention module during the study period. Data will be collected at three time points: pre-intervention, post-intervention, and follow-up assessment. The study will evaluate changes in NSSI frequency, emotional dysregulation, and readiness for change using validated psychological instruments. Quantitative data analysis will be conducted to examine the feasibility and preliminary effects of the intervention across the three groups. The findings are expected to contribute to the development of evidence-informed and culturally responsive school-based mental health interventions for Malaysian children. In addition, this study may provide practical guidance for school counsellors, educators, and policymakers in strengthening early intervention efforts related to emotional wellbeing and self-injurious behaviour among primary school students
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
105
A structured school-based intervention module integrating Motivational Interviewing (MI) and Rational Emotive Behavior Therapy (REBT) approaches to reduce Non-Suicidal Self-Injury behaviour, improve emotional regulation, and enhance readiness for change among Malaysian primary school students through group counselling sessions.
A structured school-based mental health intervention module developed by the Ministry of Education Malaysia (KPM) implemented as the standard care benchmark for students.
Selected Primary Schools in Kulim District
Kulim, Kedah, Malaysia
Change in Non-Suicidal Self-Injury Frequency
Measured using the translated version of the Six-Item Non-Suicidal Self-Injury Instrument (Prinstein et al., 2010). The instrument consists of the frequency of self-injury behavior using a 5-point scale: 0 (never), 1 (1-2 times), 2 (3-5 times), 3 (6-9 times), and 4 (10 times or more). Scores range from 0 to 4 per item. A higher score indicates a higher frequency of non-suicidal self-injury behavior (worse outcome).
Time frame: Baseline (Week 0), 4 weeks after baseline (Week 4), and 16 weeks after baseline (Week 16).
Change in Emotional Dysregulation
Measured using the Malay version of the Difficulties in Emotion Regulation Scale-18 (DERS-18), originally developed by Gratz and Roemer (2004). The instrument consists of 18 items, with each item rated on a 5-point scale ranging from 1 (almost never) to 5 (almost always). Total scores can range from a minimum of 18 to a maximum of 90. A higher total score indicates a greater level of emotional dysregulation, representing a worse outcome.
Time frame: Baseline (Week 0), 4 weeks after baseline (Week 4), and 16 weeks after baseline (Week 16).
Change in Readiness for Change
Measured using the translated short version of the University of Rhode Island Change Assessment (URICA-S), developed and validated by Mander et al. (2017). The instrument contains 12 items mapping across four distinct subscales representing the Stages of Change framework: Precontemplation, Contemplation, Action, and Maintenance. Each item is rated on a 5-point Likert scale ranging from 1 (Strongly Disagree) to 5 (Strongly Agree). Individual subscale scores range from 3 to 15. A composite Readiness to Change score is calculated by summing the Contemplation, Action, and Maintenance scores, and subtracting the Precontemplation score. Total composite scores range from a minimum of 4 to a maximum of 44, where higher scores indicate a greater readiness to change behavior (better outcome).
Time frame: Baseline (Week 0), 4 weeks after baseline (Week 4), and 16 weeks after baseline (Week 16).
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