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Therapeutic EngagementECTPNCT07902336

Empathy and Communication Training Program for Psychiatric Nurse Specialists in Saudi Arabia (ECTP)

A study testing Usual institutional training (Madinah) and ECTP (Dammam) in people with Therapeutic Engagement and Psychiatric Nursing, run by Lincoln University College at 2 sites in Saudi Arabia.

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

This study tests whether a five-day Empathy and Communication Training Program (ECTP) helps psychiatric nurse specialists in Saudi Arabia engage better with their patients. Good relationships between nurses and patients are central to mental health care, but structured training in empathy and communication is limited… Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
Usual institutional training (Madinah) and ECTP (Dammam)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
154 participants
Where
2 sitesSaudi Arabia
Study dates
1 Mar 2025to 30 Jul 2026
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 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Currently employed at one of the two study hospitals (Eradah Complex for Mental Health, Dammam, or Eradah Hospital for Mental Health, Madinah)
  • Psychiatric nurse specialist assigned to a psychiatric ward or an outpatient psychiatric or addiction clinic, with direct patient care responsibilities
  • At least six months of psychiatric nursing experience
  • Written informed consent

Who cannot join

  • Less than six months of psychiatric nursing experience
  • Currently on extended leave (for example maternity leave, sick leave or other long-term absence)

Trial locations and contacts

2 sites in 1 country.

Saudi Arabia2 sites
  • Eradah Complex for Mental Health

    Dammam, Eastern Province, 32253

  • Eradah Hospital for Mental Health

    Madinah, Al Madinah Province, 42363

Other trials in Saudi Arabia

About this study

Official title: Effectiveness of an Empathy and Communication Training Program on Nurse-Reported Therapeutic Engagement Among Psychiatric Nurse Specialists in Saudi Arabia: A Two-Site Quasi-Experimental Study With an Explanatory Sequential Mixed-Methods Design

This study tests whether a five-day Empathy and Communication Training Program (ECTP) helps psychiatric nurse specialists in Saudi Arabia engage better with their patients. Good relationships between nurses and patients are central to mental health care, but structured training in empathy and communication is limited in Saudi psychiatric hospitals.

The ECTP is a face-to-face program of five two-hour sessions (10 hours in total). It covers empathy and communication, the work environment, language and cultural barriers, and emotional preparedness. Sessions use short lectures, role-play, case discussions and group reflection.

Read more

The study took place at two psychiatric hospitals. Nurses at the Eradah Complex for Mental Health in Dammam took the ECTP. Nurses at the Eradah Hospital for Mental Health in Madinah attended their usual hospital training sessions instead. Participants were not randomly assigned. The hospital they worked in decided which group they joined.

Nurses at both hospitals completed a 15-item questionnaire about therapeutic engagement before and after the training period. After the program, 15 nurses from the Dammam group were interviewed about how the training affected their work and what barriers remained.

The study aims to find out whether nurses' self-reported therapeutic engagement improves after the ECTP compared with usual training, and to understand nurses' own experiences of the program.

Read the detailed description

BACKGROUND The relationship between nurse and patient is a core part of effective psychiatric care. Empathy, active listening, trust and clear communication are its main building blocks. In Saudi Arabia, language and cultural differences within a diverse nursing workforce, together with heavy workloads, can make these relationships harder to build. Structured empathy and communication training for psychiatric nurses is scarce in Saudi hospitals and has rarely been evaluated.

DESIGN This is an explanatory sequential mixed-methods study. The first phase is a quasi-experimental, pre-test/post-test, non-equivalent control-group study. The second phase is a descriptive qualitative study using semi-structured interviews. Participants were assigned to conditions by hospital site rather than individually, because individual randomisation was not feasible (different institutional protocols, geographical separation, the need to keep routine clinical operations running) and to limit contamination between groups.

SETTING AND PARTICIPANTS The intervention site was the Eradah Complex for Mental Health in Dammam (Eastern Region). The control site was the Eradah Hospital for Mental Health in Madinah (Western Region). Both are tertiary psychiatric hospitals providing inpatient, outpatient and addiction services. All eligible psychiatric nurse specialists providing direct patient care at each site were invited to take part. Written informed consent was obtained from all participants.

INTERVENTION The ECTP was developed by the principal investigator with a panel of three experts in psychiatric nursing and nursing education. It was delivered 2 to 6 August 2026 by nurse educators and psychiatric nurse trainers with at least five years of experience in mental health education. Day 1 covered orientation and baseline assessment. Day 2 covered empathy and communication, Day 3 the work environment and training, Day 4 language and cultural barriers, and Day 5 emotional preparedness. Methods included short lectures, role-play, case-based discussion and reflective group activities.

COMPARATOR Control-group nurses attended usual institutional training sessions of their own choosing, lasting 5 to 8 hours, and submitted certificates of attendance. Because this content varied and could include material related to communication or de-escalation, the comparator is usual institutional training and not a no-training control.

DATA COLLECTION Participants completed a paper-based questionnaire in hospital classrooms during working hours, under researcher supervision. The 15-item questionnaire was adapted from the Therapeutic Engagement Questionnaire (used with permission from the developers at Kingston University London) and has four domains: empathy and communication, work environment and training, language and cultural barriers, and emotional preparedness. Items are rated 1 to 5. Three barrier-worded items are reverse-scored so that higher scores always mean more favourable engagement. The questionnaire was given at baseline and immediately after Day 5 for the intervention group, and at an equivalent interval for the control group. Participants created anonymous codes so that their before and after responses could be matched.

After the program, a purposive sample of intervention-group nurses took part in face-to-face interviews of 35 to 55 minutes, audio-recorded with separate written consent. Interviews continued until thematic saturation (15 participants).

SAMPLE SIZE A power analysis (independent-samples t-test, two-tailed, alpha 0.05, power 0.80, Cohen's d 0.50) gave a minimum of 64 participants per group. After finite population correction and a 15% allowance for attrition, the target samples were 66 (Dammam) and 61 (Madinah).

ANALYSIS Quantitative data are analysed with paired and independent-samples t-tests, with non-parametric tests as robustness checks, and with analysis of covariance using baseline score as the covariate. Effect sizes are reported as Cohen's d and partial eta squared. Interview transcripts are analysed with thematic analysis (Braun and Clarke) in NVivo. Quantitative and qualitative findings are integrated using a joint display.

REGISTRATION This study was registered retrospectively, after data collection had finished.

Being tested
Usual institutional training (Madinah), ECTP (Dammam)
Keywords
empathy training, communication training, therapeutic engagement, psychiatric nursing, mental health nursing, nurse education, quasi-experimental, Saudi Arabia
Medical subject headings
Communication

What participants receive

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

  • Usual institutional training (Madinah)Other

    Training sessions of the nurse's own choosing, offered as part of routine hospital education (for example on substance use, personality disorders or trauma-informed care), lasting 5-8 hours. Nurses submitted certificates of attendance.

  • ECTP (Dammam)Behavioural

    Structured five-day, face-to-face training program, two hours per day (10 hours in total), delivered 2-6 August 2026 by nurse educators and psychiatric nurse trainers. Day 1: orientation and baseline assessment. Day 2: empathy and communication. Day 3: work environment and training. Day 4: language and cultural barriers. Day 5: emotional preparedness. Methods: short lectures, role-play, case-based discussion and reflective group activities.

Study groups in NCT07902336
Study groupRoleWhat they receive
ECTP (Dammam)ExperimentalPsychiatric nurse specialists at the Eradah Complex for Mental Health, Dammam, who took part in the five-day ECTP. They completed the therapeutic engagement questionnaire at baseline (Day 1) and immediately after Day 5. Fifteen of these nurses were interviewed afterwards.
Receives: Behavioral: ECTP (Dammam)
Usual institutional training (Madinah)Active comparatorPsychiatric nurse specialists at the Eradah Hospital for Mental Health, Madinah, who did not receive the ECTP and attended usual institutional training sessions of their choice (5-8 hours). They completed the same questionnaire at baseline and at an equivalent interval later.
Receives: Other: Usual institutional training (Madinah)

What is being measured

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

  1. Change in overall nurse-reported patient therapeutic engagement (PTE) score

    Overall score on the 15-item nurse-reported PTE questionnaire, adapted from the Therapeutic Engagement Questionnaire. Each item is rated from 1 (strongly disagree) to 5 (strongly agree). Items 5, 9 and 10 describe barriers and are reverse-scored (6 minus the original value). The overall score is the mean of all 15 items (range 1 to 5). Higher scores mean more favourable therapeutic engagement. The outcome is the change from baseline to post-test, compared between the intervention group (Dammam) and the control group (Madinah).

    Measured: Baseline (Day 1) and immediately after Day 5 of the program (August 2026)

Secondary outcomes (4)
  1. Change in Empathy and Communication domain score

    Mean of items 1 to 3 of the PTE questionnaire (range 1 to 5). Higher scores mean more favourable engagement.

    Measured: Baseline (Day 1) and immediately after Day 5 of the program (August 2026).

  2. Change in Work Environment and Training domain score

    Mean of items 4 to 8 of the PTE questionnaire (range 1 to 5), with item 5 reverse-scored. Higher scores mean more favourable engagement.

    Measured: Baseline (Day 1) and immediately after Day 5 of the program (August 2026).

  3. Change in Language and Cultural Barriers domain score

    Mean of items 9 and 10 of the PTE questionnaire (range 1 to 5), both reverse-scored. Higher scores mean fewer perceived barriers.

    Measured: Baseline (Day 1) and immediately after Day 5 of the program (August 2026).

  4. Change in Emotional Preparedness domain score

    Mean of items 11 to 15 of the PTE questionnaire (range 1 to 5). Higher scores mean more favourable engagement.

    Measured: Baseline (Day 1) and immediately after Day 5 of the program (August 2026).

Timeline

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

  1. First posted28 Oct 2026
  2. Study start1 Mar 2025
  3. Primary completion30 Jul 2026
  4. Study completion30 Jul 2026

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
Health services research
Allocation
Non-randomised
Intervention model
Parallel groups
Model description
Quasi-experimental, pre-test/post-test, non-equivalent control-group design followed by an explanatory sequential qualitative phase. Participants were assigned to the intervention or the control condition by hospital site (Dammam: ECTP; Madinah: usual institutional training), not individually. Fifteen intervention-group nurses were interviewed after the program.
Masking
None (open label)
Enrolment
154 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07902336
Sponsor's protocol ID
ECTP-DMM-2026
Acronym
ECTP
Status last verified
Oct 2026
First submitted
21 Oct 2026
Last updated
28 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: De-identified questionnaire data (anonymous participant codes, demographic variables and item-level responses) will be shared with qualified researchers on reasonable request to the corresponding author. Interview transcripts and audio recordings will not be shared, to protect participant confidentiality.

Publications

  • Hartley S, Raphael J, Lovell K, Berry K. Effective nurse-patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance. Int J Nurs Stud. 2020 Feb;102:103490. doi: 10.1016/j.ijnurstu.2019.103490. Epub 2019 Nov 23.

    PubMed 31862531
  • Chambers M, McAndrew S, Nolan F, Thomas B, Watts P, Grant R, Kantaris X. The Therapeutic Engagement Questionnaire (TEQ): a service user-focused mental health nursing outcome metric. BMC Psychiatry. 2019 Dec 3;19(1):384. doi: 10.1186/s12888-019-2326-x.

    PubMed 31796008

Questions about this trial

What is this clinical trial studying?

A study testing Usual institutional training (Madinah) and ECTP (Dammam) in people with Therapeutic Engagement and Psychiatric Nursing, run by Lincoln University College at 2 sites in Saudi Arabia.

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 4 inclusion and 2 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 28 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Saudi Arabia. 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?

Change in overall nurse-reported patient therapeutic engagement (PTE) score (time frame: Baseline (Day 1) and immediately after Day 5 of the program (August 2026)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07902336, which also lists 2 linked publications.

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 28 Oct 2026.

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