No Time to Wait: Single Session Intervention

August 24, 2026 updated by: Timmy Tsoi, United Christian Hospital

No Time to Wait: A Randomized Control Trial of Online Single-Session Intervention for Children and Adolescents on Psychotherapy Waitlists in Hong Kong

Mental health problems in youth are prevalent, but early intervention effectively reduces symptoms, substance abuse risk, suicide, and comorbidities. In Hong Kong, however, only 26% of people with common mental disorders seek services, and even then, they face long delays-e.g., 90 weeks (90th percentile) for stable cases in public psychiatry clinics (Hospital Authority, 2024). Barriers include high costs, transportation issues, stigma, and preference for self-help, creating a strong need for scalable, accessible digital solutions, especially for youth.

Single-Session Interventions (SSI) offer promise as brief, time-efficient tools that provide immediate support with minimal engagement burden. Online SSIs are often free, publicly available, and evidence-based. Research shows they reduce symptoms (moderate effect size Hedges' g = 0.32; 58% chance of better outcome vs. control), improve functioning, and boost satisfaction. They work well for specific phobias and acute stress. Yet, their real-world acceptability, effectiveness outside trials, and integration with public services remain understudied-particularly for children/adolescents on waitlists.

This pilot study evaluates an online single-session psychotherapy for youth (children/adolescents) on Hong Kong public psychotherapy waitlists, targeting depression and anxiety symptoms. It extends prior work by:

Targeting two key constructs prominent in Asian contexts:

Alexithymia - difficulty identifying/describing emotions; affects ~10% generally but 36% of Hong Kong adolescents (higher in females). It worsens depression, lowers well-being, complicates therapy, and reduces help-seeking.

Fixed mindset (vs. growth mindset) - Asian groups show lower growth mindset levels; growth mindset buffers mental health issues (meta-analysis r = -0.220 with anxiety/depression/stress) and promotes better emotional regulation and treatment engagement.

Examining how SSI influences acceptability and expectancy toward subsequent face-to-face psychotherapy.

Hypotheses:

SSI will reduce depression/anxiety symptoms more than treatment-as-usual. SSI will increase acceptability and positive expectancy for future in-person treatment.

Change mechanisms-perceived behavioral control and emotional control-will mediate and sustain post-intervention outcomes.

Overall, the study aims to test SSI as a bridge intervention to bridge service gaps, address culturally relevant barriers, and inform scalable mental health strategies in resource-constrained settings like Hong Kong's public system.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Early intervention has been shown to effectively reduce symptoms of mental disorder, and the subsequent risk of substance abuse, suicide, and other mental disorders. However, in Hong Kong, only 26% of individuals with common mental health disorders seek any mental health service. Even when help is sought, those in need often face lengthy waiting time before receiving treatment, which can have detrimental effects on their mental well-being. For individuals categorized as stable, the average 90th percentile waiting time for psychiatry specialist outpatient clinics amounted to 90 weeks. Numerous systemic and internal barriers further impede access to mental health services, particularly for youth. These barriers include high costs, transportation challenges, stigma, and a preference for self-help options. As the result, there is a pressing need for scalable and accessible digital interventions that can address the gap in service delivery.

Single-session intervention (SSI) has emerged as a time-efficient and accessible intervention that may provide immediate support and mitigate the negative impact of mental health issues. Online SSIs, in particular, hold substantial promise for addressing many challenges associated with traditional digital mental health tools. They can be completed in a single sitting, minimizing user engagement burdens, and many of them are cost-free, publicly accessible, and incorporate evidence-based intervention components. Despite these advantages, the acceptability and effectiveness of online SSIs outside of controlled clinical trials, as well as their synergy with public mental health services, remained underexplored. This study seeks to fill this gap by evaluating the effectiveness and acceptability of single-session psychotherapy for children and adolescents on psychotherapy waitlists in Hong Kong.

Research on SSIs highlights its potential benefits in addressing mental health concerns in a time-limited manner. Single-session interventions, such as the "Walk-in Clinic" and online self-help model, have been implemented successfully in various settings, demonstrating positive outcomes for individuals with a range of psychological difficulties. Studies have shown that single-session interventions can lead to significant symptom reduction, improved functioning, and increased patient satisfaction. A meta-analysis has shown that the calculated effect size (ES) at the end of the intervention was found to be 0.32 according to Hedges' g, indicating a moderate positive impact. This suggests that there was a 58% likelihood of an adolescent who received the single-session intervention (SSI) experiencing better outcomes compared to a youth in the control group. Moreover, single-session psychotherapy has been found to be particularly effective for certain conditions, such as specific phobias and acute stress reactions.

However, limited research has specifically examined the application of single-session psychotherapy for children and adolescents on public mental health service waitlist. Understanding the potential benefits and limitations of single-session psychotherapy in this context can inform mental health service providers and policymakers in developing efficient and accessible interventions for children and adolescents. This study will examine the possibility of SSI in enhancing participants' acceptability toward future psychotherapy. Furthermore, it aims to address specify personality constructs - alexithymia and fixed mindset - that impede the recovery process and are particularly prominent within Asian culture context.

Alexithymia, a condition marked by difficulties in processing emotions and distinguishing them from physical sensations, affects approximately 10% of the general population. However, research indicates that 36% of adolescents in Hong Kong exhibit alexithymic traits, with 34.3% of males and 40% of females affected. First described by Sifneos, alexithymia has been linked in neurobiological studies to impairments in identifying emotions in others. This condition can worsen depressive symptoms and diminish overall well-being. Moreover, alexithymia complicates psychological treatments, often leading to poorer therapeutic outcomes in managing other psychiatric disorders and reducing the likelihood of seeking help.

In addition to alexithymia, Asian populations tend to exhibit lower levels of growth mindset compared to Western populations. A growth mindset, which reflects the belief in one's capacity for improvement and development, is recognized as a potential buffer against mental health challenges. Emerging research highlights the positive relationship between growth mindset and mental health. For example, a meta-analysis revealed a moderate negative association (r = -0.220, 95% CI = -0.257, -0.184, p < 0.001) between growth mindset and psychological issues such as anxiety, depression, stress, and low well- being. Individuals with a growth mindset are more likely to adopt healthier emotional regulation strategies, including seeking professional support.

Additionally, those with growth mindsets regarding substance addiction demonstrate more favorable attitudes toward treatment, while those with growth mindsets about personality are more likely to engage positively with counseling and show greater commitment to therapy.

This pilot study is the empirical study that aims at evaluating the efficacy of an online single session intervention for depression and anxiety symptoms. It will also extend the past research in the following ways: (1) the research will further explore the efficacy and effectiveness of targeting alexithymia and growth mindset in a single session intervention; (2) how single-session intervention affects the treatment expectancy and acceptability of subsequent face-to-face treatment. We hypothesize that (1) the single-session intervention will be more effective in reducing depression and anxiety symptoms compared to a treatment-as-usual group; (2) single-session psychotherapy will enhance the participants' acceptability and expectancy of subsequent face-to-face treatment; (3) mechanisms of change, including perceived primary behavioural control and perceive emotional control, will contribute to and maintain the post- treatment outcome.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
124

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Hong Kong
      • Hong Kong, Hong Kong
        • Recruiting
        • United Christian Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

(1) being Hong Kong residents aged 12 - 17; (2) having anxiety and/or depression symptoms, scoring 10 or above, in accordance with Patient Health Questionnaire (PHQ-9) or General Anxiety Disorder-7 (GAD-7); (3) having access to the internet and a valid email address for communication, (4) being able to understand and read Chinese and, (5) participants' parent or legal guardian will be willing to give informed consent.

Exclusion Criteria:

(1) they have received another psychological treatment for depression and/or anxiety in the past 3 months, (2) they report a diagnosis of other comorbid severe psychiatric disorder, including psychotic disorder, bipolar disorder, dissociative disorder, or other neurocognitive disorders that make participation infeasible or interfere with the adherence to the digital self-help intervention, (3) they would participate in another similar study concurrently, (4) any suicidal ideation is reported (score > 2 on Question 9 of the Beck Depression Inventory), (5) they report substance abuse history, (6) having changes in psychotropic medication within 2 weeks before baseline assessment; or (7) they report pregnancy.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Intervention Group
Participants who receive online single session intervention
Other: Online Single Session Intervention on Growth Mindset
Participants would receive an online single session intervention, which includes animation and exercises that enhance children and adolescents' growth mindset
No Intervention: Control Group
Waitlist Control

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
TAS- 20-C
Time Frame: From enrolment to 1 month after the end of treatment
Alexithymia will be measured using the Toronto Alexithymia Scale (TAS-20), a validated self-report questionnaire assessing difficulty in identifying and describing feelings. The TAS- 20-C is a 20-item self-report scale rated on a five-point Likert scale. It includes three subscales: Difficulty Identifying Feelings (DIF) with items like "When I am upset I don't know if I am sad, frightened, or angry"; Difficulty Describing Feelings (DDF) with statements such as "I find it hard to describe how I feel about people"; and Externally Oriented Thinking (EOT), exemplified by "I prefer to just let things happen rather than to understand why they turned out that way." Scores can range from 20 to 100, where higher scores denote higher alexithymia. The TAS-20-C is validated for Chinese populations (Zhu et al., 2007). In this research, the scale achieved a Cronbach's alpha of 0.80.
From enrolment to 1 month after the end of treatment
Patient Health Questionnaire-9
Time Frame: From enrolment to 1 month after the end of treatment
The Patient Health Questionnaire 9-Item (PHQ-9) is a self-report measure that assesses the severity of depressive symptoms. Each question is a 4-point Likert-scale that generates a total score ranging from 0 to 27, while the score ≥ 10 was widely used as a clinical cut-off, indicating that the diagnosis of Major Depressive Disorder on Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).
From enrolment to 1 month after the end of treatment
General Anxiety Disorder-7
Time Frame: From enrolment to 1 month after the end of treatment
The Generalized Anxiety Disorder 7-item (GAD-7) is a self-report measure to evaluate the severity of anxiety symptoms. These measures reflect the DSM-IV diagnostic criteria of depression and anxiety respectively. Both measures show good convergent validity with other measures and are widely used in mental health research. These two measures also have a well-established sensitivity to changes after intervention.
From enrolment to 1 month after the end of treatment

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Perceived primary (behavioral) control
Time Frame: From Enrolment to 1 month after the end of treatment
The level of perceived primary control will be evaluated at the beginning, immediately after the intervention, and during the subsequent follow-up using the Perceived Control Scale for Children (PCSC; Weisz, Southam-Gerow, & McCarty, 2001). This scale consists of 24 items that measure the perceived ability to exert primary control, which refers to influencing objective events or conditions through personal effort. Participants will indicate their level of agreement with statements regarding their perceived primary control in the face of social and academic challenges.
From Enrolment to 1 month after the end of treatment
Perceived secondary (emotional) control
Time Frame: From enrolment to 1 month after the end of treatment
Similar to perceived primary control, perceived secondary control will be assessed at baseline, post-intervention, and the follow-up using the Mindset of Depression Anxiety and Stress Scale (MDASS; Zhu et al., 2022). The MDASS is a 12-item scale that measures the perceived capacity for secondary control, which involves influencing the personal psychological impact of objective conditions by adjusting oneself to fit those conditions. Respondents will rate their level of agreement with items reflecting perceived secondary control of various types, such as finding a positive aspect in distressing situations.
From enrolment to 1 month after the end of treatment
Attitudes Toward Seeking Professional Psychological Help (ATSPPH) Short Form
Time Frame: From enrolment to 1-month after the end of treatment
Acceptability towards professional help is a 10-item questionnaire assessing attitudes towards seeking psychological support. It evaluates participants' recognition of the need for help, stigma tolerance, interpersonal openness, and confidence in mental health practitioners. Items are scored on a four-point Likert scale from 0 to 3, with mean scores calculated for each subscale. This scale has been validated in both Western and Eastern samples (e.g., Hatchett, 2006; Masuda et al., 2005). Previous research has shown it to have strong reliability (α = .86), as supported by this study (α = .79).
From enrolment to 1-month after the end of treatment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
United Christian Hospital

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Hong Kong University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
January 10, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 12, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 1, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
January 26, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 26, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
February 3, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
August 26, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 24, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • PAED-2025-077

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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