ACT-Based Training for Parental Burnout and Child Well-being

Official title

Acceptance and Commitment Therapy-Based Training Programme for Reducing Parental Burnout and Improving Emotional and Behavioural Issues in Children: A Pilot Randomised Controlled Trial

Overview

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.

Interventions

• Behavioral ACT Intervention Group
  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 i
• Other control group
  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 a

Primary outcome measures

• Parental Burnout [Time frame: Change from baseline assessment to immediate and 3 months post-intervention]
• Children's emotional and behavioral adjustment [Time frame: Change from baseline assessment to immediate and 3 months post-intervention]

Secondary outcome measures (4)

• Parental Psychological flexibility [Time frame: Change from baseline assessment to immediate and 3 months post-intervention]
• Children's psychological flexibility [Time frame: Change from baseline assessment to immediate and 3 months post-intervention]
• Adaptive parenting behaviors [Time frame: Change from baseline assessment to immediate and 3 months post-intervention]
• Parent-Child Relationship Quality [Time frame: Change from baseline assessment to immediate and 3 months post-intervention]

Eligibility criteria

Inclusion criteria

For the Parent ACT Group:

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

For the Child ACT Group:

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

For both groups (Shared inclusion criteria):

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

Exclusion criteria

For the Parent ACT Group:

• Parents diagnosed with severe mental illnesses.
• Parents with a developmental disability that interferes with their ability to comprehend the program's content.
• Parents with cognitive, language, communication, visual, or hearing impairments or disorders that could impede their understanding of the intervention content; or
• Parents currently participate in other psychosocial, psychoeducational, or parenting interventions.
• Parents with active substance abuse issues that may interfere with their ability to participate in or benefit from the program.
• 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):

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

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Hong Kong · 2 centers

• Harmony House Limited — Kwun Tong
• Chinese University of Hong Kong — Shatin

Identifiers

NCT: NCT07047378 · NTEC-2025-184

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗