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Attention-deficit/Hyperactivity DisorderMFNT-CADHDNCT06064942

Multiple Family Narrative Therapy for Chinese Families of Children With Attention Deficit Hyperactivity Disorder

A study testing Multiple Family Narrative Therapy (MFNT) and School services for families of children with ADHD in people with Attention-deficit/Hyperactivity Disorder and Special Education, run by Hong Kong Baptist University at 1 site in Hong Kong.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of this randomized controlled trial is to develop and to implement a multiple family narrative therapy intervention consisting of parent-child relationships training among Chinese families of children with attention deficit hyperactivity disorder (ADHD). Read more about this study

Who is it for?
Ages 7 to 13 years
What is being tested?
Multiple Family Narrative Therapy (MFNT) and School services for families of children with ADHD
Could I receive a placebo?
No, everyone receives an active treatment
How many people
140 participants
Where
1 siteHong Kong
Study dates
1 Sep 2022to 31 Aug 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 7 to 13 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Participants 7-13 years old and their parents
  • ADHD diagnosis (by psychiatrist or educational psychologist)
  • Diagnosis with comorbidity of other learning disabilities
  • Cantonese speaking participants (child and parents)
  • At least one of the parents, but not siblings nor grandparents, can commit to all four sessions
  • Participants able to comply with all testing and study requirements

Who cannot join

  • Formal current diagnosis of psychosis
  • Limitation in daily communication
  • Previous service recipients of Narrative Therapy or Multiple Family Group
  • Non-Cantonese speaking child or parent
  • Parents or children who refuse to give written consent for their participation in the study

Trial locations and contacts

1 site in 1 country.

Hong Kong1 site
  • Department of Social Work, Hong Kong Baptist University, Hong Kong, China

    Hong Kong

Other trials in Hong Kong

About this study

Official title: Multiple Family Narrative Therapy as Treatment for Chinese Families of Children With Attention-Deficit/Hyperactivity Disorder: A Randomised Controlled Trial

The goal of this randomized controlled trial is to develop and to implement a multiple family narrative therapy intervention consisting of parent-child relationships training among Chinese families of children with attention deficit hyperactivity disorder (ADHD). The intervention aims to reduce the psychological distress of parents and their child, thus improving parent-child relationships, and the trial aims to assess the effectiveness of MFNT among them. A RCT design supplemented by qualitative interviews will be used to evaluate the effectiveness of multiple family narrative therapy intervention on family welfare.

Read the detailed description

Attention deficit hyperactivity disorder (ADHD) affects 6.4% of children in Hong Kong while medicating children with ADHD in Hong Kong has increased 36-fold between 2001 and 2015. Global studies provide evidence that children with ADHD have experienced a substantial amount of stress due to the childrearing distress of their parents. The education system in Hong Kong is exceptionally competitive and academically focused. When parenting skills are measured against the academic achievement of children, parents may feel helpless and hopeless, which contribute to social isolation during stressful times that stem from caring for a child with ADHD or other developmental disabilities. Chinese parents who are heavily burdened by the pressure of preventing the academic failure of their children typically resort to outing their children in privately operated tutorial classes and giving them additional home-based assignments. These remedial actions often increase the stress levels of both parents and child. In the Chinese culture, academic failure shames the family, which leads to parent-child conflicts and mental health issues. These family problems can negatively affect Chinese children with ADHD.

Related support services in Hong Kong are also inadequate and insufficient. The management of ADHD in Hong Kong follows the international mainstream treatments that comprise prescribing stimulant medication and behavioural interventions. Few studies on psychoeducation models have focused on parent-child relationships, parental stress for families of children with learning disabilities in Hong Kong. The available psychological approaches mainly address the behavioural changes of children with special educational needs (SENs). However, the psychoeducation approach does not reduce the social isolation of parents and the stigmatisation of medication by parents who fear the side effects and long-term effects. To address this research gap, a psychotherapy model is used to evaluate the impact of its intervention on both parents and their child with SENs, especially ADHD, which has been recently seen an increase in demand. At the same time, it is crucial to examine the process of change in attitudes and interactions among family members who participate in Multiple Family Narrative Therapy (MFNT) so that helping professionals can learn from this qualitative part to refine the design and session plan of MFNT.

This study addresses a need in the Hong Kong Chinese community with four anticipated outcomes: 1) the effectiveness of MFNT as a brief-targeted intervention model with CFCAs is determined; 2) a participatory approach that engages both parents and children is realised; 3) a culturally applicable practice manual for the Chinese context is produced; and 4) the use of the practice manual by school and integrative family services is encouraged.

This study evidence-informed and knowledge-building results will support a brief-targeted MFNT approach in Hong Kong to supplement the "treatment as usual" school-focused process in working with Chinese families of children with ADHD (CFCAs) towards a collaborative model where family members can reassess their identity and adopt alternative interaction behaviours. Excessive school-based work increases the pressure of students in an academic achievement-driven culture, which intensifies conflicts in parent-child relationships.

A randomized controlled trial (RCT) design and qualitative interviews will be used to evaluate the effectiveness of MFNT on family welfare. The first objective is to examine the effectiveness of a brief-targeted MFNT for CFCAs in Hong Kong. The aim is to reduce their psychological distress to enhance parent-child relationships. The second objective is to assess and document the course of change in attitudes and interactions among the MFNT participants.

Being tested
Multiple Family Narrative Therapy (MFNT), School services for families of children with ADHD
Keywords
Attention deficit, Hyperactivity disorder, Multiple family group, Narrative therapy, Efficacy, Special educational needs, Intervention, Parent-child
Medical subject headings
Attention Deficit Disorder with Hyperactivity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Multiple Family Narrative Therapy (MFNT)Behavioural

    MFNT consist of 4 weekly group sessions with selected themes from both multiple family therapy (MFT) and narrative therapy (NT) offered in a group format. Parents participates in four mentored sessions, while their children attend the second and fourth sessions. The family is treated as a system through both psychodynamic practices and attachment theories to manage symptoms, to achieve family resilience, and to empower both parents and child to share their unique and lived value-driven experiences. MFNT provides families with therapeutic environments that are conducive to learning and modelling in order to facilitate the process of building healthier parent-child dyads.

  • School services for families of children with ADHDBehavioural

    Selected school social personnel will deliver services as usual for the control group.

Study groups in NCT06064942
Study groupRoleWhat they receive
MFNT Intervention (Treatment Group)ExperimentalParents of children with ADHD who are randomized in Treatment Group will first take part in a pre-tested 4-session MFNT intervention programme. The parents will participate in lectures, group discussions, video demonstrations, and in-group exercises offered in these four mentored sessions, while their children will attend the second and fourth sessions.
Receives: Behavioral: Multiple Family Narrative Therapy (MFNT)
MFNT Intervention (Wait Listing Control Group)ExperimentalFamilies of children with ADHD who are randomized in Wait Listing Control Group receive services as usual by the school social personnel during the intervention period. The 4-session MFNT intervention program will be delivered to them after the intervention period.
Receives: Behavioral: School services for families of children with ADHD

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Kessler Psychological Distress Scale (KPDS)

    Kessler Psychological Distress Scale is a 10-item scale completed by the child and the child's parent. It assesses the frequency of distress-related feelings in the past month on a 5-point Likert Scale (1=None of the time; 2=A little of the time; 3=Some of the time; 4=Most of the time; 5=All of the time). The scale is reliable and valid for the local context, given it will be delivered in Chinese. Changes in scores of Kessler Psychological Distress Scale will be evaluated before, after the intervention as well as at a follow-up assessment (3 months after the end of the intervention).

    Measured: 1-week prior intervention, Intervention week 4, and 3 months post-intervention

  2. Parental Stress Scale (PSS)

    Parental Stress Scale (PSS) consists of 17 items on a 6-point scale (1 = strongly disagree; 2 = disagree; 3= somewhat disagree; 4 = somewhat agree; 5 = agree; 6 = strongly agree) measuring parents' perception of parental stress. Seven items require reverse scoring. A total score is calculated, with higher scores indicating higher levels of parental stress. The Chinese version of the scale has been translated and validated. Changes in its total score will be evaluated before, after the intervention as well as at a follow-up assessment (3 months after the end of the intervention).

    Measured: 1-week prior intervention, Intervention week 4, and 3 months post-intervention

  3. Parent-Child Relationship Scale

    Parent-Child Relationship Scale is a scale that assesses subjects' perceptions of their current relationship with their children. It consists of 17 items based on 5-point scale, ranging from 1 = never to 5 = always. The scale uses mean score, and a higher score indicates a more positive parent-child relationship. Changes in its mean score will be evaluated before, after the intervention as well as at a follow-up assessment (3 months after the end of the intervention).

    Measured: 1-week prior intervention, Intervention week 4, and 3 months post-intervention

  4. Parental Acceptance-Rejection Questionnaire (PARQ)

    The Parental Acceptance-Rejection Questionnaire (PARQ) is a self-report instrument designed to measure individuals' perceptions of parental acceptance-rejection. It consisted of four scales: (1) warmth/affection, (2) hostility/aggression, (3) indifference/neglect, and (4) undifferentiated rejection. The child version assesses children's current perceptions of the degree to which they experienced parental (maternal and paternal) acceptance or rejection in childhood, and it is suitable for children older than 7 years. The parent version asks parents to assess the way they now treat their children. Both scales are rated on 4-point Likert scale (Almost Never True = 1, Rarely True = 2, Sometimes True = 3, Almost Always True = 4) Changes in the scores of subscales namely (1) warmth/affection, (2) hostility/aggression, (3) indifference/neglect, and (4) undifferentiated rejection in both father and mother will be evaluated before, after the intervention.

    Measured: 1-week prior intervention, Intervention week 4, and 3 months post-intervention

  5. Parental Bonding Inventory (PBI)

    Parental Bonding Inventory (PBI) is a 25-item instrument assessing levels of parental care and overprotection perceived by the child. It consisted of two subscales termed 'care' and 'overprotection/control'. The measure is to be completed for both mothers and fathers separately, with each parent being scored on a 4-point Likert scale (Very unlike = 0, Moderately unlike = 1, Moderately like = 2, Very like = 3). Changes in the scores in "care" and "overprotection/control" subscales in both father and mother will be evaluated before, after the intervention as well as at a follow-up assessment (3 months after the end of the intervention).

    Measured: 1-week prior intervention, Intervention week 4, and 3 months post-intervention

Secondary outcomes (3)
  1. Satisfaction With Family Life Scale (SWFL)

    Satisfaction With Family Life Scale (SWFL) is a 5-item scale that assesses an individual's global judgment of family satisfaction. Parents and children were required to agree or disagree with global statements about family life on a 7-point Likert-type scale ranging from 1 = strongly disagree to 7 = strongly agree. This instrument has been successfully used in a variety of family samples and offers a brief, widely applicable tool to measure satisfaction with family life. Changes in its total score will be evaluated before, after the intervention as well as at a follow-up assessment (3 months after the end of the intervention).

    Measured: 1-week prior intervention, Intervention week 4, and 3 months post-intervention

  2. Guilt and Shame Questionnaire (GSQ)

    Guilt and Shame Questionnaire (GSQ) is a 10-item scale to assess one's feelings of guilt and shame associated with disabilities including but not limited to mental illness. It consisted of two subscale - shame and guilt, both are rated on a 5-point Likert scale ranging from 1 (never) to 5 (always). The scale was completed by parents and children. The evaluation of guilt and shame is calculated based on the sum scores of each subscale. Changes in scores of total scale, guilt and shame subscales will be evaluated before, after the intervention as well as at a follow-up assessment (3 months after the end of the intervention).

    Measured: 1-week prior intervention, Intervention week 4, and 3 months post-intervention

  3. Walsh Family Resilience Questionnaire (WFRQ)

    Walsh Family Resilience Questionnaire (WFRQ) is a scale that assesses to what extent individual statements are truthful about how their family is coping with crises and ongoing challenges. The WFRQ consists of three main scales: belief systems (10 items), organisation, communication and problem-solving (13 items), and utilizing external resources (3 items). The scale asked the parents to complete on a 5-point scale (Rarely/Never= 1, Not Often= 2, Sometimes= 3, Often= 4, Almost Always= 5) Changes in the scores of subscales of (1) belief systems and (2) organisation, communication and problem-solving will be evaluated before, after the intervention as well as at a follow-up assessment (3 months after the end of the intervention). The subscale namely "utilizing external resources" was not included in the study as this dimension is conceptually irrelevant to the intervention process.

    Measured: 1-week prior intervention, Intervention week 4, and 3 months post-intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Oct 2023
  2. Study start1 Sep 2022
  3. Primary completion31 Aug 2023
  4. Study completion31 Aug 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
140 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06064942
Sponsor's protocol ID
RGC Ref No. 12615322
Other IDs
General Research Fund (GRF)
Acronym
MFNT-CADHD
Status last verified
Apr 2022
First submitted
26 Sep 2023
Last updated
3 Oct 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A study testing Multiple Family Narrative Therapy (MFNT) and School services for families of children with ADHD in people with Attention-deficit/Hyperactivity Disorder and Special Education, run by Hong Kong Baptist University at 1 site in Hong Kong.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 3 Oct 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Kessler Psychological Distress Scale (KPDS) (time frame: 1-week prior intervention, Intervention week 4, and 3 months post-intervention). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Oct 2023.

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