To Increase Psychological Well-being by the Implementation of Forgiveness Education

Implementation of Forgiveness Education to Increase Psychological Well-being in Three Culturally Distinct Areas: Northern Ireland, Israel/Palestine, and Taiwan

This project examines the development of psychological well-being in children and teachers through a 12- week forgiveness education program conducted in three conflict zones of the world, Northern Ireland, Israel/Palestine, and Taiwan.

A 12-week forgiveness education program will be investigated in elementary schools in three conflict zones of the world, Northern Ireland, Israel/Palestine, and Taiwan. The responsibilities of the sub-team in each of the three research sites will be:

• a. recruiting schools, assisting the teacher training before the forgiveness education program starts
• b. shepherding teachers, doing the fidelity checks, administering the instruments and collecting data during the forgiveness education program.

Once a school gives permission to be part of this study, the forgiveness curriculum will be implemented as a 12-week standard curriculum for the grade 5 (US equivalency) students. Teachers of the grade 5 classes will be trained to administer the program. Teachers, students and their parents must give the consent to take part in the measures of the study.

Study Overview

• Status: Completed
• Conditions: Anger; Anxiety; Depressive Symptoms
• Intervention / Treatment: Other: forgiveness education intervention

Detailed Description

Classrooms participating in this study will be randomly assigned to either an experimental or a control group. The experimental group will receive the 1st forgiveness intervention for 12 weeks and then the control group will turn into an experimental group to receive a 2nd forgiveness intervention for 12 weeks.

In order to assess if such education increases psychological well-being in students (children) and teachers (adults), teachers and students in both groups will receive the same measures for four times in the study: within one week before the 1st forgiveness intervention, within one week after the 1st forgiveness intervention, within one week after the 2nd forgiveness intervention, four weeks after the 2nd forgiveness intervention.

The instruments include: for teachers, the assessment data will consist of the Enright Forgiveness Inventory Short Form (EFI-30), the Patient-Reported Outcomes Measurement Information System (PROMIS): Anger, Anxiety, and Depression scales, the Ethnic Prejudice Scale, the Herth Hope Index, the Rosenberg Self-Esteem Scale, a Classroom Cooperation scale, and a Cross-Cultural Exit Interview (written questionnaire). For students, the assessment data will consist of the Enright Forgiveness Inventory for Children (EFI-C), the PROMIS measures for pediatric self-report (ages 8-17): Anger, Anxiety, and Depressive Symptoms scales, the Ethnic Prejudice Scale for children, the Children's Hope Scale, the Coopersmith Self-Esteem Inventory (School Form), and academic achievement (likely to be scores/grades of Math, writing and reading in their own language). After the 2nd forgiveness intervention, select participants (teachers and children) will take part in individual interviews.

• Study Type: Interventional
• Enrollment (Actual): 1300
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Wisconsin
    • Madison, Wisconsin, United States, 53706
      • University of Wisconsin-Madison

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 10 years to 65 years (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Students in 5th grade (US equivalency, aged 10-12)
• Teachers in 5th grade (US equivalency)

Exclusion Criteria:

• Students who are in grades other than 5th grade
• Teachers who are in grades other than 5th grade

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Forgiveness curriculum for 5th grade; Classrooms randomly assigned to the experimental group will receive the forgiveness intervention. The forgiveness intervention will follow the curriculum - "The Journey Toward Forgiveness -A Guided Curriculum for Children Ages 10-12 (Grade 5 in the US)". The Forgiveness Curriculum Guide consists 14 lessons over 12 weeks. Each class meets weekly for 40 to 60 minutes to complete one lesson (in two of the weeks, there will be two lessons).	Other: forgiveness education intervention; The forgiveness education intervention primarily teaches the concept of forgiveness through stories. We chose the kind of stories that should appeal to children ages 10 through 12. Each lesson is planned according to the following procedure: story-telling/movie-watching, discussion, and in-class activities.
No Intervention: Regular school instruction; Classrooms randomly assigned to the control group will have instruction as usual.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in forgiveness in adult (teachers) after forgiveness intervention assessed by EFI-30.	Enright Forgiveness Inventory Short Form (EFI-30), scores range from 30 to 180 with higher scores representing higher levels of forgiveness, which is a better outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Change in forgiveness in child (students) after forgiveness intervention assessed by EFI-C.	Enright Forgiveness Inventory for Children (EFI-C): scores range from 30 to 120 with higher scores representing higher levels of forgiveness, which is a better outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Change in anger in adult (teachers) after forgiveness intervention assessed by PROMIS Measures.	The Patient Reported Outcome Measurement Information System (PROMIS) Anger Short Form: scores range from 5 to 25 with higher scores representing higher levels of anger, which is a worse outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Change in anger in child (students) after forgiveness intervention assessed by PROMIS Measures.	The Patient Reported Outcome Measurement Information System (PROMIS) Measures for Pediatric (ages 8-17) Anger Short Form: scores range from 5 to 25 with higher scores representing higher levels of anger, which is a worse outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Change in anxiety in adult (teachers) after forgiveness intervention assessed by PROMIS Measures.	The Patient Reported Outcome Measurement Information System (PROMIS) Anxiety Short Form: scores range from 5 to 40 with higher scores representing higher levels of anxiety, which is a worse outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Change in anxiety in child (students) after forgiveness intervention assessed by PROMIS Measures.	The Patient Reported Outcome Measurement Information System (PROMIS) Measures for Pediatric (ages 8-17) Anxiety Short Form: scores range from 5 to 40 with higher scores representing higher levels of anxiety, which is a worse outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Change in depression in adult (teachers) after forgiveness intervention assessed by PROMIS Measures.	The Patient Reported Outcome Measurement Information System (PROMIS) Depression Short Form, scores range from 5 to 40 with higher scores representing higher levels of depression, which is a worse outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Change in depression in child (students) after forgiveness intervention assessed by PROMIS Measures.	The Patient Reported Outcome Measurement Information System (PROMIS) Measures for Pediatric (ages 8-17) Depressive Symptoms Short Form: scores range from 5 to 40 with higher scores representing higher levels of depression, which is a worse outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Change in prejudice in adult (teachers) after forgiveness intervention assessed by the Ethnic Prejudice Scales.	The Ethnic Prejudice Scale: scores range from 20 to 100 with higher scores representing higher levels of prejudice, which is a worse outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Change in prejudice in child (students) after forgiveness intervention assessed by the Ethnic Prejudice Scales.	Ethnic Prejudice Scales: wording changes in the adult form of the Ethnic Prejudice Scale will be made to bring it to the level of 5th grade students (aged 10-12). Scores range from 20 to 100 with higher scores representing higher levels of prejudice, which is a worse outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Change in hope in adult (teachers) after forgiveness intervention assessed by Herth Hope Index.	Herth Hope Index: scores range from 12 to 48 with higher scores representing more hopefulness, which is a better outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Change in hope in child (students) after forgiveness intervention assessed by Children's Hope Scale.	The Children's Hope Scale: scores range from 6 to 36with higher scores representing more hopefulness, which is a better outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Change in self-esteem in adult (teachers) after forgiveness intervention assessed by the Rosenberg Self-Esteem Scale.	The Rosenberg Self-Esteem Scale: scores range from 10 to 40 with higher scores representing higher self-esteem, which is a better outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Change in self-esteem in child (students) after forgiveness intervention assessed by the Coopersmith Self-Esteem Inventory.	Coopersmith Self-Esteem Inventory Short Form: scores range from 0 to 25 with higher scores representing higher self-esteem, which is a better outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Change in classroom cooperation in students after forgiveness intervention assessed by the Classroom Cooperation Scale.	The Classroom Cooperation Scale is teachers' measure of student cooperation, scores range from 10 to 40 with higher scores representing higher level of cooperation, which is a better outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.

Collaborators and Investigators

• Sponsor: University of Wisconsin, Madison
• Collaborators: Hebrew University of Jerusalem; Stranmillis University College, Northern Ireland; National Chung Cheng University, Taiwan
• Investigators: Principal Investigator: Robert W Enright, PhD, University of Wisconsin, Madison

Publications and helpful links

General Publications

• Herth K. Abbreviated instrument to measure hope: development and psychometric evaluation. J Adv Nurs. 1992 Oct;17(10):1251-9. doi: 10.1111/j.1365-2648.1992.tb01843.x.
• Akhtar S, Barlow J. Forgiveness Therapy for the Promotion of Mental Well-Being: A Systematic Review and Meta-Analysis. Trauma Violence Abuse. 2018 Jan;19(1):107-122. doi: 10.1177/1524838016637079. Epub 2016 Mar 23.
• Wade NG, Hoyt WT, Kidwell JE, Worthington EL. Efficacy of psychotherapeutic interventions to promote forgiveness: a meta-analysis. J Consult Clin Psychol. 2014 Feb;82(1):154-70. doi: 10.1037/a0035268. Epub 2013 Dec 23.
• Reed GL, Enright RD. The effects of forgiveness therapy on depression, anxiety, and posttraumatic stress for women after spousal emotional abuse. J Consult Clin Psychol. 2006 Oct;74(5):920-9. doi: 10.1037/0022-006X.74.5.920.
• Baxter SD, Smith AF, Litaker MS, Baglio ML, Guinn CH, Shaffer NM. Children's Social Desirability and Dietary Reports. J Nutr Educ Behav. 2004 Mar-Apr;36(2):84-9. doi: 10.1016/s1499-4046(06)60138-3.
• Snyder CR, Hoza B, Pelham WE, Rapoff M, Ware L, Danovsky M, Highberger L, Rubinstein H, Stahl KJ. The development and validation of the Children's Hope Scale. J Pediatr Psychol. 1997 Jun;22(3):399-421. doi: 10.1093/jpepsy/22.3.399.
• Freedman SR, Enright RD. Forgiveness as an intervention goal with incest survivors. J Consult Clin Psychol. 1996 Oct;64(5):983-92. doi: 10.1037//0022-006x.64.5.983.
• Enright RD, Santos MJ, Al-Mabuk R. The adolescent as forgiver. J Adolesc. 1989 Mar;12(1):95-110. doi: 10.1016/0140-1971(89)90092-4.
• Cattell RB. The Scree Test For The Number Of Factors. Multivariate Behav Res. 1966 Apr 1;1(2):245-76. doi: 10.1207/s15327906mbr0102_10. No abstract available.
• CRANDALL VC, CRANDALL VJ, KATKOVSKY W. A CHILDREN'S SOCIAL DESIRABILITY QUESTIONNAIRE. J Consult Psychol. 1965 Feb;29:27-36. doi: 10.1037/h0020966. No abstract available.
• CROWNE DP, MARLOWE D. A new scale of social desirability independent of psychopathology. J Consult Psychol. 1960 Aug;24:349-54. doi: 10.1037/h0047358. No abstract available.
• HORN JL. A RATIONALE AND TEST FOR THE NUMBER OF FACTORS IN FACTOR ANALYSIS. Psychometrika. 1965 Jun;30:179-85. doi: 10.1007/BF02289447. No abstract available.

Study record dates

Study Major Dates

• Study Start (Actual): September 3, 2021
• Primary Completion (Actual): July 31, 2022
• Study Completion (Actual): July 31, 2022

Study Registration Dates

• First Submitted: May 21, 2020
• First Submitted That Met QC Criteria: May 21, 2020
• First Posted (Actual): May 27, 2020

Study Record Updates

• Last Update Posted (Actual): August 4, 2022
• Last Update Submitted That Met QC Criteria: August 3, 2022
• Last Verified: August 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Depression
• Other Study ID Numbers: 2020-0432; A173000 (Other Identifier: UW Madison); EDUC/EDUC PSYCH (OTHER: University of Wisconsin, Madison)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Yes
• IPD Plan Description: The individual participant data (IPD) that underlie the results reported in this article, after de-identification (text, tables, figures, and appendices).
• IPD Sharing Time Frame: The IPD will be shared beginning 1 year and ending 5 years following the first article publication, with anyone who wished to access the data for any purpose.
• IPD Sharing Access Criteria: Data requestors will need to contact renright@wisc.edu to gain access to the data. Data are available for 5 years at a third party website (Link to be included).
• IPD Sharing Supporting Information Type: Study Protocol; Statistical Analysis Plan (SAP); Informed Consent Form (ICF); Clinical Study Report (CSR); Analytic Code

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No