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Expressed EmotionNCT06522243

Mindful Parenting for Parents With SEN Adolescents

A study testing 8-week mindful parenting program in people with Expressed Emotion and Stress, run by The University of Hong Kong at 1 site in Hong Kong.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of the study is to evaluate the effectiveness of an online eight-week mindful parenting program for parents of adolescents with special needs and its impact on parents' wellbeing and behaviors of their adolescents with SEN(s). Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
8-week mindful parenting program
Could I receive a placebo?
No, everyone receives an active treatment
How many people
120 participants
Where
1 siteHong Kong
Study dates
9 Aug 2024to 31 Aug 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

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

  • with one adolescent child with special educational need(s)
  • being the major caregiver for the adolescent for at least one year
  • Cantonese speaker

Who cannot join

  • schizophrenia-spectrum disorder
  • bipolar disorder
  • substance abuse
  • developmental disabilities
  • physical disabilities
  • with active psychotic symptoms
  • high suicidal risks
  • experiencing a recent personal crisis

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Jiaqi Xu, PhD contact

(852) 3917-5652

meloxu@hku.hk

Hong Kong1 site, 1 recruiting
  • Xu Jia-QI

    Hong Kong

    Melody XU, Ph.D., 0085239175652, meloxu@hku.hk

    Recruiting

Other trials in Hong Kong

About this study

Official title: Effectiveness of Mindfulness Program for Parents of Children With SEN

The goal of the study is to evaluate the effectiveness of an online eight-week mindful parenting program for parents of adolescents with special needs and its impact on parents' wellbeing and behaviors of their adolescents with SEN(s).

Researchers will randomize the participants into the immediate intervention group (to start the intervention soon after recruitment) and the waitlist control group (to start the intervention after the immediate intervention group) so as to compare the changes between the two groups.

The participants will join the 8-week mindful parenting intervention and one follow-up session. They will be asked to fill in the questionnaires at baseline, after the 8-week intervention, and at the follow-up sessions. Training sessions will be audio-taped and transcripted. The conversation during the zoom classes and participants' sharing on their subjective experience related to mindfulness practices will be analysed.

Read the detailed description

Being a parent is inherently a demanding and stressful job, and raising children with SEN may pose additional stressors to parents. Parents of SEN children have higher parenting stress compared to those of typically developed children in facing daily challenges with their children's learning and development, which may lead to a higher risk of child maltreatment. Adolescence and emerging adulthood are a transition period which may impose increased stress and challenges on both young people and their parents. As a result, parents of young people with SEN(s) require more support in both parenting skills and their own psychological wellbeing.

Parents not only provide care for their children but also create an everyday environment under which their children are raised. Improvements in parenting skills and parents' mental health could lead to positive outcomes for child and youth mental wellbeing (while malfunctioning parenting may also impose an aversive effect on children's development. For instance, a critical and over-involvement of parental-child interaction, i.e., high expressed emotion (high EE) in the family, was found to be a robust predictor of relapse in different psychiatric illnesses.

Parenting is by nature a highly challenging and complex job and raising a child with mental illness could be even more stressful and strain parents' experience. It was reported that the severity of children's emotional and behavioral disturbances was closely related to parents' stress levels. On the other hand, parenting stress is an essential factor contributing to parenting effectiveness. When parents experience a high level of stress, their parenting effectiveness may decrease. Hence, reducing parents' stress levels would not only benefit parents themselves but also enhance effective parenting so as to benefit the wellbeing of their children with mental illness.

Mindful parenting Mindful parenting has been defined as the ability to pay attention to your children and parenting in an intentional, non-judgmental, and moment-to-moment awareness. Mindful parenting intervention does not directly teach parenting skills like other parenting training programs. Being mindful in everyday parenting is to perceive their children with an unbiased and open attitude, providing more sensible and responsive reactions to the children instead of reacting automatically based on past experience of parenting or being parented. By decentering from the current thoughts or affects, it enables parents to observe their internal experiences objectively without overidentifying with them. This, in turn, strengthens their capacity to endure the intense emotions and allow them to be more fully present with their child. Mindful parenting was also found to be negatively correlated with parental stress, yet positively associated with the levels of adopting authoritative parenting style. Furthermore, one of the features of the mindful parenting program is to practice non-judgmental awareness when interacting with children instead of automatically reacting to children's behaviours. It is thus speculated that mindful parenting practice could also promote less high EE interactions between parents and adolescents, which has been sparsely studied in the existing literature. The current pilot study may thus provide a possible mechanism in explaining the effectiveness of mindful parenting in improving the wellbeing of both parents and their children with SEN(s).

Mindful parenting had been applied in parenting for children with special needs, childbirth and parenting, and parenting for children with mental illness. The results of various mindful parenting programs (with a minimum of 6-8 weekly group sessions) showed some evidence of improvements for parenting stress, parents' psychopathology, and their children's mental health symptoms. However, the study sample had mainly focused on parents whose children were in their early or middle childhood.

The current study thus aims to recruit a more diverse sample of adolescents with different types of SENs. The data and experience gained from the current pilot study would also shed light on a clearer picture of whether a nine-session mindful parenting program would benefit both parents and their adolescent children with SENs.

A mixed methods design with qualitative journaling and quantitative experimental design could leverage the benefits of both methods. The data collected from participants' journal writing would elucidate the benefits, challenges, and personal growth through mindfulness practices from a subjective experiential perspective. It will also provide valuable insights for designing a larger-scale study to understand the underlying mechanism of mindful parenting on wellbeing of both parents and their children with SEN.

Aims and Hypotheses to be Tested:

The current study aims to (i) to evaluate the effectiveness of mindfulness training in enhancing the wellbeing of both parents and behaviors of their adolescents with SEN(s); (ii) to assess the feasibility and acceptability of adopting a nine-session Mindful Parenting program among parents of adolescents with SEN(s); (iii) to formulate useful suggestions and guidelines on mindfulness training for parents of adolescents with SEN(s).

Being tested
8-week mindful parenting program
Medical subject headings
Psychological Well-Being

What participants receive

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

  • 8-week mindful parenting programBehavioural

    The current study adopts the Mindful Parenting program developed by Prof Susan Bögels (Bögels \& Restifo, 2013), which is an application of mindfulness-based intervention which aims to improve parenting by reducing parents' own stress levels, decreasing parental automatic reactivity, increasing open and unbiased attitudes towards children, and decreasing inter-generational dysfunctional parenting (Bögels et al., 2014). The program consists of eight consecutive weeks of parent groups and one follow-up session two months after the last session. Each parent group will include 15-20 participants. The original Mindful Parenting Program will last for around 3 hours for each session, with the longest practice of 40 minutes. Considering parents recruited in the study may have a higher risk of psychiatric conditions than the general population, each session of mindful parenting group will be reduced to 2 to 2.5 hours with the longest mindfulness practice of 30 minutes (Baer et al., 2019).

Study groups in NCT06522243
Study groupRoleWhat they receive
immediate interventionExperimentalStart with the 8-week intervention immediately/soon after recruitment
Receives: Behavioral: 8-week mindful parenting program
waitlist controlNo interventionNo intervention while being assessed but will receive the intervention after the assessments

What is being measured

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

  1. Parental Stress

    Parental Stress Scale is an 18-item self-report measure in which parents respond to statements about their typical relationship with their child. For each statement, respondents rate their level of agreement on a 5-point Likert scale (1- strongly disagree, 2 - disagree, 3- undecided, 4 - agree, and 5 -strongly agree).Higher scores reflect more parental stress. The possible range of the PSS is 18 (low stress) to 90 (high stress).

    Measured: 16 weeks

  2. Mindfulness in Parenting

    The 31-item Chinese version of the Interpersonal Mindfulness in Parenting Scale (IM-P) will be used to evaluate parents' mindfulness on four aspects, including compassion for the child, nonjudgmental acceptance in parenting, emotional awareness, and listening with full attention. A total sum will be calculated to indicate mindfulness in parenting with a higher score implying better outcome (minimum value=31; maximum value=155).

    Measured: 16 weeks

  3. Parents' Expressed Emotion

    Family Questionnaire (FQ) is used to evaluate the parents' level of expressed emotion, including criticism and over-involvement. FQ is a 20-item parent self-rated questionnaire with four possible answers ranging from "never/very rarely" to "very often." A total score will be calculated with a higher score indicating a a higher level of expressed emotion (minimum value=20; maximum value=80).

    Measured: 16 weeks

  4. Children's behaviors

    The 25-item Chinese version of the Strength and Difficulties Questionnaire (SDQ) will be used to assess the externalising and internalising problems of adolescents. It comprises five subscales, ranging from emotional problems, conduct problems, hyperactivity, peer problems and prosocial behaviours in adolescents. Each item is rated on a Likert scale from 0 (not true) to 2 (certainly true). A total difficulties score will be calculated with a higher score implying more difficult behaviors by summing scores from all the items except the prosocial scale (minimum value=0; maximum value=40).

    Measured: 16 weeks

Secondary outcomes (3)
  1. General Mindfulness Awareness

    To assess the general mindfulness awareness in parents, the short 15-item version of the Five Facet Mindfulness Questionnaire (FFMQ-15) will be used. A total sum will be calculated to indicate trait mindfulness with a higher score implying better outcome (minimum value=15; maximum value=75).

    Measured: 16 weeks

  2. Decentering

    Decentering is measured using the Experiences Questionnaire, an 11-item self-report scale that assesses the construct of decentering or disidentification with content of negative thinking. A total sum will be calculated to indicate level of decentering with a higher score implying better outcome (minimum value=5; maximum value=55).

    Measured: 16 weeks

  3. Parenting Skills

    Alabama Parenting Questionnaire-short version is a 9-item self-rated questionnaire used to measures three factors in parenting: positive parenting, inconsistent discipline and poor supervision. Items are scored from 1 (never) to 5 (always). A higher score in subscale of positive parenting (minimum value=3; maximum value=15) indicates a better outcome while a higher score in subscales of inconsistent discipline and poor supervision (minimum value=3; maximum value=15) indicate worse outcomes.

    Measured: 16 weeks

Timeline

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

  1. First posted26 Jul 2024
  2. Study start9 Aug 2024
  3. Primary completion31 Aug 2026 (estimated)
  4. Study completion31 Aug 2027 (estimated)

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
Model description
waitlist randomized controlled trial
Masking
None (open label)
Enrolment
120 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06522243
Sponsor's protocol ID
EA240327
Status last verified
Jun 2025
First submitted
15 Jul 2024
Last updated
27 Jun 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Bogels SM, Lehtonen A, Restifo K. Mindful Parenting in Mental Health Care. Mindfulness (N Y). 2010 Jun;1(2):107-120. doi: 10.1007/s12671-010-0014-5. Epub 2010 May 25.

    PubMed 21125026
  • Baer R, Crane C, Miller E, Kuyken W. Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings. Clin Psychol Rev. 2019 Jul;71:101-114. doi: 10.1016/j.cpr.2019.01.001. Epub 2019 Jan 7.

    PubMed 30638824
  • Butzlaff RL, Hooley JM. Expressed emotion and psychiatric relapse: a meta-analysis. Arch Gen Psychiatry. 1998 Jun;55(6):547-52. doi: 10.1001/archpsyc.55.6.547.

    PubMed 9633674
  • Crijnen AA, Achenbach TM, Verhulst FC. Problems reported by parents of children in multiple cultures: the Child Behavior Checklist syndrome constructs. Am J Psychiatry. 1999 Apr;156(4):569-74. doi: 10.1176/ajp.156.4.569.

    PubMed 10200736
  • Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995 Mar;33(3):335-43. doi: 10.1016/0005-7967(94)00075-u.

    PubMed 7726811
  • van der Oord S, Bogels SM, Peijnenburg D. The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents. J Child Fam Stud. 2012 Feb;21(1):139-147. doi: 10.1007/s10826-011-9457-0. Epub 2011 Feb 2.

    PubMed 22347788
  • Wiedemann G, Rayki O, Feinstein E, Hahlweg K. The Family Questionnaire: development and validation of a new self-report scale for assessing expressed emotion. Psychiatry Res. 2002 Apr 15;109(3):265-79. doi: 10.1016/s0165-1781(02)00023-9.

    PubMed 11959363
  • Xu JQ, Poon K, Ho MSH. Brief Report: The Impact of COVID-19 on Parental Stress and Learning Challenges for Chinese Children with SpLD. J Autism Dev Disord. 2025 Jun;55(6):2186-2193. doi: 10.1007/s10803-023-05983-y. Epub 2023 Apr 20.

    PubMed 37079179

Questions about this trial

What is this clinical trial studying?

A study testing 8-week mindful parenting program in people with Expressed Emotion and Stress, run by The University of Hong Kong 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 3 inclusion and 8 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: looking for participants now, as of the sponsor's last update on 27 Jun 2025. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Jiaqi Xu, PhD ((852) 3917-5652, meloxu@hku.hk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Parental Stress (time frame: 16 weeks). The study lists 4 primary outcomes in all. 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 NCT06522243, which also lists 8 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 27 Jun 2025.

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