ACT-Based Training for Parental Burnout and Child Well-being: A Pilot RCT

Not Applicable

Recruiting

• Conditions: Child Abuse; Parental Burnout

• Registration Number: NCT07047378
• Lead Sponsor: Chinese University of Hong Kong

Brief Summary

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.

Detailed Description

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.

Study Timeline

• Study Start: 2025-04-22
• Status Verified: 2025-06
• Study First Submitted: 2025-06-24
• Study First Submitted QC: 2025-06-24
• Last Update Submitted: 2025-06-24
• Study First Posted: 2025-07-02
• Last Update Posted: 2025-07-02
• Primary Completion: 2027-04-30
• Study Completion: 2028-04-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 120

Inclusion Criteria

For the Parent ACT Group:

1. Cantonese-speaking Hong Kong residents between the ages of 19 and 65 years.
2. Primary caregivers of a child aged 3 to 11 years.
3. Have been identified by school social workers as being at risk of domestic violence or experiencing emotional distress.

For the Child ACT Group:

1. Cantonese-speaking Hong Kong residents between the ages of 3 and 11 years.
2. Have been identified by school social workers as being at risk of domestic violence or experiencing emotional distress.

For both groups (Shared inclusion criteria):

1. Participants must have sufficient Cantonese language proficiency to understand and communicate during the intervention.
2. Both parents and children must provide informed consent to participate in the study and all related assessments.

Exclusion Criteria

For the Parent ACT Group:

1. Parents diagnosed with severe mental illnesses.
2. Parents with a developmental disability that interferes with their ability to comprehend the program's content.
3. Parents with cognitive, language, communication, visual, or hearing impairments or disorders that could impede their understanding of the intervention content; or
4. Parents currently participate in other psychosocial, psychoeducational, or parenting interventions.
5. Parents with active substance abuse issues that may interfere with their ability to participate in or benefit from the program.
6. Parents whose children have been diagnosed with psychological or medical conditions.

For the Child ACT Group:

1. Children who have been diagnosed with psychological or medical conditions.

For both groups (Shared Exclusion criteria):

1. Families who are unable or unwilling to commit to attending the six-week sessions or completing follow-up assessments.
2. Families who lack access to transportation or other necessary resources to attend the intervention sessions
3. Parents and children who cannot understand or communicate in the language used in the intervention and assessments (i.e., Cantonese and Chinese).

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Parental Burnout	Change from baseline assessment to immediate and 3 months post-intervention	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.
Children's emotional and behavioral adjustment	Change from baseline assessment to immediate and 3 months post-intervention	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).

Secondary Outcome Measures

Name	Time	Method
Children's psychological flexibility	Change from baseline assessment to immediate and 3 months post-intervention	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.
Parental Psychological flexibility	Change from baseline assessment to immediate and 3 months post-intervention	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.
Parent-Child Relationship Quality	Change from baseline assessment to immediate and 3 months post-intervention	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.
Adaptive parenting behaviors	Change from baseline assessment to immediate and 3 months post-intervention	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.

Trial Locations

Locations (2)

Harmony House Limited; 🇭🇰 Kwun Tong, Hong Kong

Chinese University of Hong Kong; 🇭🇰 Sha Tin, Hong Kong