Nonviolent Communication for Parents

Effectiveness of Group-based Nonviolent Communication Interventions for Improving Mental Well-being in Parents: a Randomised Controlled Trial

This randomised controlled trial (RCT) aims to evaluate the effectiveness of face-to-face Nonviolent Communication (NVC) intervention in improving parents' mental well-being and NVC skills, reducing parenting stress, depression and anxiety symptoms, and child emotional and behavioural problems.

A total of 172 parents with primary-school-age children will be recruited and randomly assigned to an intervention group or a waitlist control group. The intervention group will receive six weekly 1.5-hour face-to-face NVC training sessions delivered by trained social workers.

Five to ten social workers will be trained by professional NVC trainers through a train-the-trainer workshop, including three sessions. Each social worker will be assessed before (TTT1), after (TTT2) the workshops and 10 months (TTT3).

Assessments for participants will be conducted at baseline (T1), immediately post-intervention (T2), and at three-month follow-up (T3). After completing the assessments, the waitlist control group will receive the same sessions. Qualitative interviews will be conducted to explore participants' experiences and perceptions of NVC.

Study Overview

• Status: Recruiting
• Conditions: Anxiety; Well-being; Depression Symptom
• Intervention / Treatment: Behavioral: Nonviolent Communication Intervention

• Study Type: Interventional
• Enrollment (Estimated): 172
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Grace Yuying Sun, PhD; Phone Number: 852 39702916; Email: gsun@hkmu.edu.hk

Study Locations

• Hong Kong
  • Hong Kong, Hong Kong
    • Recruiting
    • The Jockey Club Institute of Healthcare of Hong Kong Metropolitan University
    • Contact: Grace Yuying Sun, PhD; Phone Number: 852 39702916; Email: gsun@hkmu.edu.hk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• 1) parents aged 24-59 years with children of primary school age;
• 2) with mild to severe depressive symptoms (score >5 on the Patient Health Questionnaire (PHQ)-9) (Kroenke et al., 2001) and/or mild to severe anxiety symptoms (score >5 on the General Anxiety Disorder (GAD)-7) (Spitzer et al., 2006); and
• 3) Hong Kong residents who can understand Cantonese.

Exclusion Criteria:

• 1) under psychiatric treatment, psychotherapy groups and are classified as unstable cases based on the judgment of the recruiting social workers;
• 2) participating in other related parenting programmes.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Receiving NVC Interventions; Participants in the intervention group will receive six weekly 1.5-hour face-to-face NVC training sessions delivered by trained social workers.	Behavioral: Nonviolent Communication Intervention; The intervention will be conducted by social workers who will be trained by professional NVC trainers through a train-the-trainer workshop, including six sessions. The interventions include an introduction to four fundamental principles of NVC, distinguishing observations from evaluations, identifying and expressing feelings, taking responsibility for feelings and needs, and using positive action language to make requests. Each session will feature a review of the previous session, a warm-up game and an exercise to consolidate the learning of the concepts. The intervention sessions will also include group discussions and debriefing sessions on parents' experiences of practising NVC.
No Intervention: Wailist Control Group; The waitlist control group will not receive any training before all the assessments have been done by both groups. The wailist control group will receive NVC training sessions after all assessments. During the whole study period, these participants can access usual medical services, whether related or unrelated to mental health needs.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Well-being	The Short Warwick-Edinburgh Mental Well-being Scale (SWEMWS) is a 7-item scale for assessing mental health in non-clinical populations. Using a 5-point Likert scale (1 = none of the time, 5 = all the time), the total score is calculated by summing all seven items. The Chinese version showed good validity and reliability in the investigators' previous study. The congeneric reliability was 0.85 and the test-retest reliability was 0.70.	T1: Baseline; T2: Immediate post-intervention; T3: 3 months post-T2
NVC skills	The measure of NVC skills was developed based on a 16-item scale that represents the four principles of NVC skills. Each item is rated on a 5-point scale ranging from 0 = never to 5 = always. The average score is calculated, with higher scores indicating better NVC skills. Cronbach's alpha was 0.82 in the investigators' pilot study.	T1: Baseline; T2: Immediate post-intervention; T3: 3 months post-T2

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Depressive symptoms	The Patient Health Questionnaire (PHQ)-9 is a 9-item instrument that is commonly used to measure depressive symptoms in the past two weeks. Each item is rated on a 4-point scale ranging from 0 = not at all to 3 = nearly every day. The Chinese version showed good validity and reliability (Cronbach's alphas: 0.82-0.92).	T1: Baseline; T2: Immediate post-intervention; T3: 3 months post-T2
Anxiety	The Generalized Anxiety Disorder (GAD)-7 scale is a 7-item instrument to assess generalised anxiety disorder in the past two weeks. The response options for the seven symptoms are the same as PHQ-9. The Chinese version showed good validity and reliability (Cronbach's alphas: 0.89-0.95).	T1: Baseline; T2: Immediate post-intervention; T3: 3 months post-T2
Parenting stress	The Parental Stress Scale (PSS) is an 18-item questionnaire that assesses feelings about parents' parenting role. A 16-item version of the PSS was developed by Leung et al. for Hong Kong parents. Responses are given on a 5-point scale. The Chinese version showed good internal consistency (Cronbach's alpha: 0.86).	T1: Baseline; T2: Immediate post-intervention; T3: 3 months post-T2
Child emotional and behavioural problems	The Strengths and Difficulties Questionnaire (SDQ) is a 25-item emotional and behavioural screening questionnaire for children and young people. The version for the parents of 4-17-year-olds will be used. Each item is rated on a 3-point scale ('not true', 'somewhat true', 'certainly true'). The Chinese parent version showed good validity and reliability (Cronbach's alpha: 0.81).	T1: Baseline; T2: Immediate post-intervention; T3: 3 months post-T2

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Train-the-trainer outcome	Social workers' understanding of NVC will be assessed at TTT1-TTT3. Overall satisfaction with the workshops will be assessed during TTT2. Items are rated on a 5-point Likert scale (0 = strongly disagree to 5 = strongly agree).	T1: Baseline, before the workshop; T2: Immediate after the workshop; T3: 10 months after baseline.

Collaborators and Investigators

• Sponsor: Hong Kong Metropolitan University
• Investigators: Principal Investigator: Grace Yuying Sun, Hong Kong Metropolitan University

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2025
• Primary Completion (Estimated): May 31, 2026
• Study Completion (Estimated): June 30, 2026

Study Registration Dates

• First Submitted: April 17, 2025
• First Submitted That Met QC Criteria: April 17, 2025
• First Posted (Actual): April 24, 2025

Study Record Updates

• Last Update Posted (Estimated): September 17, 2025
• Last Update Submitted That Met QC Criteria: September 11, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: Anxiety; parents; Depressive Symptoms; Nonviolent Communication
• Additional Relevant MeSH Terms: Mental Disorders; Behavioral Symptoms; Behavior; Anxiety Disorders; Depression
• Other Study ID Numbers: HE-RGC2024/NHS02

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: We are not sharing individual participant data (IPD) due to privacy concerns and limitations in participant consent. Although the data is de-identified, there remains a risk of re-identification, and participants were not explicitly consented for public data sharing. Aggregate results will be made available through publications and presentations to ensure transparency.

Drug and device information, study documents

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