ACT-Based Training for Parental Burnout and Child Well-being

Acceptance and Commitment Therapy-Based Training Programme for Reducing Parental Burnout and Improving Emotional and Behavioural Issues in Children: A Pilot Randomised Controlled Trial

The purpose of the proposed randomized controlled trial is to evaluate the feasibility, acceptability, and potential effectiveness of Acceptance and Commitment Therapy (ACT) in reducing parental burnout and improving children's emotional and behavioral adjustment in families in Hong Kong over 3 months after the intervention. The findings will provide valuable and scientific insights to inform better parenting interventions and child protection policies.

Study Overview

• Status: Recruiting
• Conditions: Child Abuse; Parental Burnout
• Intervention / Treatment: Behavioral: ACT Intervention Group; Other: control group

Detailed Description

Parental burnout is becoming more widely recognized as a serious social issue. It is particularly prevalent among high-stress families like those impacted by child maltreatment or domestic violence. According to prior research, psychological flexibility-a core component of Acceptance and Commitment Therapy (ACT)-is crucial for promoting healthy parent-child relationships and adaptive parenting practices. However, there is still a dearth of empirical evidence supporting ACT-based interventions for reducing parental burnout and improving child adjustment.

The purpose of this study is to investigate how ACT interventions differ in their impact on parents and children in Hong Kong. The specific aims are to evaluate the effectiveness of an ACT-based training program in lowering parental burnout and investigate its influence on children's emotional and behavioral adjustment.

Parents will participate in an ACT-based parenting training program designed to increase psychological flexibility in the ACT intervention group. Aiming at improving psychological flexibility and reducing parental burnout, the training program incorporates mindfulness, values-based parenting, and cognitive defusion strategies. It provides parents with the resources they require to manage stress, regulate emotions, and promote parent-child relationships, which benefits both themselves and their children.

To foster emotional regulation and resilience, children aged 6-11 will also participate in a group-based, child-focused ACT Program designed for their developmental needs. This program incorporates experiential learning exercises, mindfulness activities, and storytelling using picture books to facilitate participation and engagement. These child-focused components seek to reinforce the skills parents have learned while directly supporting child adjustment.

This study aims to examine the feasibility, acceptability, and potential efficacy of a group-based Acceptance and Commitment Therapy (ACT) intervention targeting. The intervention is designed to improve parental psychological flexibility and parenting behaviour, enhance parent- child relationships, and child-related outcomes within a separate sample of parents and children over the 3- month post-intervention. The study will be conducted in collaboration with Harmony Home Limited, leveraging the expertise of paraprofessionals trained in ACT.

• Study Type: Interventional
• Enrollment (Estimated): 120
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Yuen Yu Chong, PhD; Phone Number: (852) 3943 0665; Email: conniechong@cuhk.edu.hk
• Study Contact Backup: Name: Choi Hung TANG; Phone Number: (852) 3943 5016; Email: choihungchtang227@cuhk.edu.hk

Study Locations

• Hong Kong
  • Kwun Tong, Hong Kong
    • Recruiting
    • Harmony House Limited
    • Contact: Choi Hung TANG; Phone Number: (852) 3943 5016; Email: choihungchtang227@cuhk.edu.hk
  • Sha Tin, Hong Kong
    • Recruiting
    • Chinese University of Hong Kong
    • Contact: Choi Hung TANG; Phone Number: (852) 3943 5016; Email: choihungchtang227@cuhk.edu.hk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

For the Parent ACT Group:

1. Cantonese-speaking Hong Kong residents between the ages of 19 and 65 years.
2. Primary caregivers of a child aged 3 to 11 years.
3. Have been identified by school social workers as being at risk of domestic violence or experiencing emotional distress.

For the Child ACT Group:

1. Cantonese-speaking Hong Kong residents between the ages of 3 and 11 years.
2. Have been identified by school social workers as being at risk of domestic violence or experiencing emotional distress.

For both groups (Shared inclusion criteria):

1. Participants must have sufficient Cantonese language proficiency to understand and communicate during the intervention.
2. Both parents and children must provide informed consent to participate in the study and all related assessments.

Exclusion Criteria:

For the Parent ACT Group:

1. Parents diagnosed with severe mental illnesses.
2. Parents with a developmental disability that interferes with their ability to comprehend the program's content.
3. Parents with cognitive, language, communication, visual, or hearing impairments or disorders that could impede their understanding of the intervention content; or
4. Parents currently participate in other psychosocial, psychoeducational, or parenting interventions.
5. Parents with active substance abuse issues that may interfere with their ability to participate in or benefit from the program.
6. Parents whose children have been diagnosed with psychological or medical conditions.

For the Child ACT Group:

1. Children who have been diagnosed with psychological or medical conditions.

For both groups (Shared Exclusion criteria):

1. Families who are unable or unwilling to commit to attending the six-week sessions or completing follow-up assessments.
2. Families who lack access to transportation or other necessary resources to attend the intervention sessions
3. Parents and children who cannot understand or communicate in the language used in the intervention and assessments (i.e., Cantonese and Chinese).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: ACT Intervention Group; Both ACT Intervention and the Control Group will receive standard services originally provided by Harmony House. For parents allocated to this experimental group, 6 sessions of the ACT-based parenting program, one weekly session, 90 minutes per session. For children allocated to this experimental group, 6 sessions of the child-focused ACT programme, one weekly session, 90 minutes per session.	Behavioral: ACT Intervention Group; For Parent ACT Group, parents will participate in a six-week, group-based ACT program integrated with behavioral parenting training based on positive parenting principles. Each session lasts two hours and includes 65 minutes of ACT-based activities (e.g., experiential exercises, guided imagery, mindfulness, values clarification, metaphors) and 25 minutes of parenting education and/or behavioral skills training. For Children ACT Group, children (aged 6-11) will also receive a child-focused ACT intervention to help them manage emotional challenges. Each session lasts two hours and includes 65 minutes of ACT-based activities (e.g., experiential exercises, guided imagery, mindfulness, values clarification, metaphors) and 25 minutes of behavioral skills training.
Other: Control Group; Participants allocated to the Control Group will not receive the ACT intervention during the initial 3-month study period but will be offered the intervention afterward as part of a waitlist control design.	Other: control group; Participants allocated to the Control Group will not receive the ACT intervention but will continue to receive the standard services originally provided by Harmony House. These services constitute usual care and include initial assessments, individual counselling, group counselling, the provision of community resource information, and referrals. Control group participants will receive these supports as usual. This study will not alter their existing service arrangements in any way, nor will it add to or reduce the support they receive. Aside from not participating in the ACT program, the control group's experience will be identical to that of clients receiving regular services. After the intervention group completes the program, the control group will be offered the same course content (i.e., a waitlist intervention arrangement).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Parental Burnout	The Parental Burnout Assessment (PBA, 23-item, 7-point Likert scale) will be employed to evaluate the level of parental burnout. The Chinese version of PBA has reported good internal consistency (Cronbach's α = >.8), adequate construct validity (.66~.79), and strong convergent validity in Chinese parents.	Change from baseline assessment to immediate and 3 months post-intervention
Children's emotional and behavioral adjustment	The Strengths and Difficulties Questionnaire (SDQ, 25-item, 3-point Likert scale) will be used to assess children's emotional and behavioral adjustment. The Chinese version of SDQ demonstrates satisfactory internal consistency (Cronbach's α = .45-.90) and good test-retest reliability (coefficients = 0.8 to 0.85).	Change from baseline assessment to immediate and 3 months post-intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Parental Psychological flexibility	Parental Psychological Flexibility Questionnaire (PPFQ, 16-item, 7-point Likert scale) will be employed to measure parents' psychological flexibility. The PPFQ measures psychological flexibility using three subscales: cognitive defusion, committed action, and acceptance. The total and each subscale scores of the Chinese version of PPFQ have demonstrated substantial discriminant and criterion validity and internal consistency (Cronbach's α = .77-.86), and test-retest reliability coefficients ranging from 0.55 to 0.75.	Change from baseline assessment to immediate and 3 months post-intervention
Children's psychological flexibility	Child and Adolescent Mindfulness Measure (CAMM, 10-item, 5-point Likert scale) will be used to assess children's psychological flexibility through children's self-reports. Grounded in Acceptance and Commitment Therapy (ACT), it measures present-moment awareness and non-judgmental acceptance of thoughts and feelings. The Chinese version of CAMM demonstrates good internal consistency (Cronbach's α = .826) and strong construct validity and acceptable criterion-related validity among Chinese primary school students.	Change from baseline assessment to immediate and 3 months post-intervention
Adaptive parenting behaviors	Interpersonal Mindfulness in Parenting Scale (IM-P, 31-item, 5-point Likert scale), a parent self-report measure, will be employed to measure adaptive parenting behaviors. The IM-P assesses five dimensions: Listening with Full Attention, Emotional Awareness of Self and Child, Self-Regulation in Parenting, Non-Judgmental Acceptance of Self and Child, and Compassion for Self and Child. The Chinese version of the IM-P was found to have adequate internal consistency (Cronbach's α = 0.85) and has been demonstrated to be a valid measure among Chinese populations.	Change from baseline assessment to immediate and 3 months post-intervention
Parent-Child Relationship Quality	Child-Parent Relationship Scale-Short Form (CPRS-SF, 15-item, 5-point Likert scale), a parent self-report measure, will be used to assess the quality of the parent- child relationship. The Chinese version of CPRS-SF assesses child-parent relationships across two subscales: conflict and closeness. The internal consistency of the subscales is typically reported as being in the range of 0.70 to 0.90, indicating good reliability.	Change from baseline assessment to immediate and 3 months post-intervention

Collaborators and Investigators

• Sponsor: Chinese University of Hong Kong
• Collaborators: Harmony House; Hong Kong Jockey Club

Study record dates

Study Major Dates

• Study Start (Actual): April 22, 2025
• Primary Completion (Estimated): April 30, 2027
• Study Completion (Estimated): April 30, 2028

Study Registration Dates

• First Submitted: June 24, 2025
• First Submitted That Met QC Criteria: June 24, 2025
• First Posted (Actual): July 2, 2025

Study Record Updates

• Last Update Posted (Actual): July 10, 2025
• Last Update Submitted That Met QC Criteria: July 7, 2025
• Last Verified: July 1, 2025

More Information

Terms related to this study

• Keywords: Feasibility; Acceptability; Acceptance and Commitment Therapy (ACT); Psychological flexibility; Hong Kong; Emotional development; Child maltreatment; Parental burnout; Child adjustment; Child emotion
• Additional Relevant MeSH Terms: Behavioral Symptoms; Stress, Psychological; Burnout, Psychological
• Other Study ID Numbers: NTEC-2025-184

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: As participants were not asked to provide consent for sharing their individual data with external researchers, IPD cannot be made available.

Drug and device information, study documents

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