Digital Self-Compassion Writing Intervention to Support Mental Health of Parents of Autistic Individuals

A Digital Self-Compassion Writing Intervention to Improve the Mental Health of Parents of Autistic Individuals

This randomized controlled trial aims to evaluate the feasibility, acceptability, and preliminary efficacy of a digital self-compassion writing intervention for parents of autistic individuals. Participants will engage in a 14-day self-compassion writing program delivered via a WeChat mini-program. The study seeks to answer the following questions:

• Is the study design and digital self-compassion writing intervention feasible and acceptable for parents of autistic individuals?
• Does the intervention lead to greater improvements in self-compassion and mental health outcomes compared to the control group?
• Do baseline characteristics moderate the intervention effect compared to the control group?
• Among intervention participants, do satisfaction and usage patterns predict greater improvements in outcomes?
• Does improvement in self-compassion mediate changes in mental health outcomes?

Study Overview

• Status: Active, not recruiting
• Conditions: Mental Health
• Intervention / Treatment: Behavioral: Self-compassion writing group; Behavioral: Control group (placebo)

• Study Type: Interventional
• Enrollment (Actual): 240
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Macau
  • Taipa, Macau
    • University of Macau

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• are parents of individuals with either a formal autism diagnosis or a provisional diagnosis from a medical institution
• are living with the autistic individual
• are aged 18 years or older
• regularly use WeChat
• are willing to commit to the study procedure

Exclusion Criteria:

• current experience of acute mental health issues (e.g., severe depression, anxiety, suicidal tendencies)
• undergoing serious health crises (e.g., undergoing major surgery or diagnosed with a life-threatening illness)
• pregnancy

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Self-compassion writing group; This digital intervention is a 14-day writing program delivered via a WeChat mini-program. Each day, participants complete a two-step writing task: (1) mindfully describe an event and their feelings, and (2) support themselves with self-kindness. Daily reminders are sent to encourage engagement. Each session takes approximately 5 minutes. The program is tailored for parents of autistic individuals to provide a brief, low-cost mental health support option for chronically stressed caregivers.	Behavioral: Self-compassion writing group; This digital intervention is a 14-day writing program delivered via a WeChat mini-program. Each day, participants complete a two-step writing task: (1) mindfully describe an event and their feelings, and (2) support themselves with self-kindness. Daily reminders are sent to encourage engagement. Each session takes approximately 5 minutes. The program is tailored for parents of autistic individuals to provide a brief, low-cost mental health support option for chronically stressed caregivers.
Active Comparator: Control group; Participants in the control group use the same mini-program for 14 days but complete factual writing tasks. They are instructed to recall their day and describe events objectively, without emotional content or cognitive reframing. This controls for time, attention, and writing activity.	Behavioral: Control group (placebo); Participants in the control group use the same mini-program for 14 days but complete factual writing tasks. They are instructed to recall their day and describe events objectively, without emotional content or cognitive reframing. This controls for time, attention, and writing activity.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Eligibility rate	Proportion of registrants who met all inclusion criteria (n_eligible / n_registered). This metric evaluates the effectiveness of the registration form in screening for eligibility.	From date of initial registration until eligibility determination, typically within 2 days of registration (up to 10 days maximum)
Baseline questionnaire completion rate	Proportion of eligible registrants who completed the baseline assessment (n_baseline / n_eligible)	From date of eligibility confirmation until completion of baseline assessment, up to 10 days maximum
Post-intervention questionnaire completion rate	Proportion of baseline completers who complete the post-intervention questionnaire (n_post / n_baseline)	From date of completion of baseline assessment until completion of post-intervention assessment, typically within 1 day after intervention (up to 2 days maximum)
Follow-up questionnaire completion rate	Proportion of post-intervention assessment completers who provided follow-up data (n_follow / n_post).	From date of completion of the post-intervention assessment until 14 days after completion of the follow-up assessment (up to 15 days maximum).
Intervention satisfaction	A 4-item measure assessing satisfaction with the intervention. Items are rated on a 5-point Likert scale. Total scores are obtained by averaging item scores. Higher scores indicate higher satisfaction with the intervention.	Measured at the post-intervention assessment, conducted within two days after the end of the intervention
Intervention adherence	Measured by the average number of entries submitted during the intervention period.	During the 14-day intervention period.
Intervention fidelity	Measured by the proportion of entries that meet the criteria for intervention and control groups, respectively. Evaluated after intervention completion by reviewing all entries submitted during the 14-day intervention period.	During the 14-day intervention period.
Self-compassion	A 13-item measure (positive subscale of the Self-Compassion Scale) assessing self-compassion across three components: mindfulness, common humanity, and self-kindness. Items are rated on a 5-point Likert scale (1 = almost never, 5 = almost always). Total and subscale scores are calculated by averaging item responses. Higher scores indicate greater self-compassion.	Measured at three time points: baseline (prior to intervention), immediately post-intervention (within 2 days after intervention ends), and at two-week follow-up (15-16 days after intervention completion).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Emotion regulation	A six-item scale (Emotion Regulation Questionnaire-Short Form, ERQ-S) measuring two emotion regulation strategies: cognitive reappraisal and expression suppression. Items are rated on a 7-point Likert scale. Subscale scores are calculated by summing item scores within each strategy. Higher scores indicate more frequent use of that emotion regulation strategy.	Measured at three time points: baseline (prior to intervention), immediately post-intervention (within 2 days after intervention ends), and at two-week follow-up (15-16 days after intervention completion).
Psychological flexibility	A six-item scale (Psy-Flex) measuring psychological flexibility. Items are rated on a 7-point Likert scale. Total scores are calculated by summing item scores. Higher scores indicate higher levels of psychological flexibility.	Measured at three time points: baseline (prior to intervention), immediately post-intervention (within 2 days after intervention ends), and at two-week follow-up (15-16 days after intervention completion).
Well-being	5 items (WHO Well-Being Index, WHO-5). Total scores are calculated by summing item scores, ranging from 0 to 25. Higher scores indicate higher levels of well-being.	Measured at three time points: baseline (prior to intervention), immediately post-intervention (within 2 days after intervention ends), and at two-week follow-up (15-16 days after intervention completion).
Flourishing	8 items (Flourishing Scale). Total scores are calculated by averaging item scores, ranging from 1 to 7. Higher scores indicate higher levels of flourishing.	Measured at three time points: baseline (prior to intervention), immediately post-intervention (within 2 days after intervention ends), and at two-week follow-up (15-16 days after intervention completion).
Life satisfaction	A single-item measuring life satisfaction rated on a 0-10 reponse scale (0 = not at all, 10 = completely).	Measured at three time points: baseline (prior to intervention), immediately post-intervention (within 2 days after intervention ends), and at two-week follow-up (15-16 days after intervention completion).
Stress	Stress will be measured by the single-item subjective level of stress (SLS-1). 0 = not at all, 5 = moderate, 10 = extremely.	Measured at three time points: baseline (prior to intervention), immediately post-intervention (within 2 days after intervention ends), and at two-week follow-up (15-16 days after intervention completion).
Anxiety	7 items (Generalized Anxiety Disorder-7, GAD-7). Total scores range from 0 to 21, with higher scores indicating higher levels of anxiety.	Measured at three time points: baseline (prior to intervention), immediately post-intervention (within 2 days after intervention ends), and at two-week follow-up (15-16 days after intervention completion).
Depression	9 items (Patient Health Questionnaire-9, PHQ-9). Total scores range from 0 to 27, with higher scores indicating higher levels of depression.	Measured at three time points: baseline (prior to intervention), immediately post-intervention (within 2 days after intervention ends), and at two-week follow-up (15-16 days after intervention completion).
Sleep quality	1 item (Single-Item Sleep Quality Scale). Possible ratings range from 0 to 10, with higher ratings indicating better sleep quality.	Measured at three time points: baseline (prior to intervention), immediately post-intervention (within 2 days after intervention ends), and at two-week follow-up (15-16 days after intervention completion).
Parenting stress	15 items (Simplified Parenting Stress Index/Short Form-15, S-PSI/SF). Total scores are calculated by summing item scores, ranging from 15 to 75. Higher scores indicate higher levels of parenting stress.	Measured at three time points: baseline (prior to intervention), immediately post-intervention (within 2 days after intervention ends), and at two-week follow-up (15-16 days after intervention completion).
Parenting efficacy	4 items (Me as a Parent Scale-Short Form). Total scores are calculated by summing item scores, ranging from 4 to 20. Higher scores indicate higher levels of parenting efficacy.	Measured at three time points: baseline (prior to intervention), immediately post-intervention (within 2 days after intervention ends), and at two-week follow-up (15-16 days after intervention completion).
Parenting practices	27 items (Multidimensional Assessment of Parenting Scale) that reflect positive and negative parenting practices are used. Scores for positive parenting and negative parenting will be calculated by summing item scores, respectively.	Measured at three time points: baseline (prior to intervention), immediately post-intervention (within 2 days after intervention ends), and at two-week follow-up (15-16 days after intervention completion).
Child adjustment	24 items (Child Adjustment and Parent Efficacy Scale-Developmental Disability, CAPES-DD). To obtain a Behavioral Problems subscale score, sum ratings for items 1, 3, 4, 5, 6, 7, 8, 9, 10, and 12, with a possible range from 0 to 30. To obtain an Emotional Problems subscale score, sum ratings for items 2, 11, and 13 with a possible range from 0 to 9. Higher scores indicate greater levels of child emotional or behavioral problems. To obtain a Prosocial Behavior scale score, sum ratings for items 17, 18, 19, 20, 21, 22, 23, and 24, with a possible range from 0 to 24.	Measured at three time points: baseline (prior to intervention), immediately post-intervention (within 2 days after intervention ends), and at two-week follow-up (15-16 days after intervention completion).
Daily self-compassion	A 3-item measure assessing self-compassion components (mindfulness, common humanity, and self-kindness) immediately after each writing session. Items are rated on a 5-point Likert scale. Higher scores indicate greater self-compassion.	Daily during the 14-day intervention period
Daily positive affect	A single-item measure assessing positive emotions immediately after each writing session. This item is rated on a 5-point Likert scale. Higher scores indicate greater positive emotions.	Daily during the 14-day intervention period.
Daily life satisfaction	A single-item measure assessing life satisfaction immediately after each writing session. This item is rated on a 5-point Likert scale. Higher scores indicate greater life satisfaction.	Daily during the 14-day intervention period
Daily parenting efficacy	A single-item measure assessing parenting efficacy immediately after each writing session. This item is rated on a 5-point Likert scale. Higher scores indicate greater parenting efficacy.	Daily during the 14-day intervention period

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Personality	Will be measured by the Ten-Item Personality Inventory in Chinese. Scale scoring ("R" denotes reverse-scored items): Extraversion: 1, 6R; Agreeableness: 2R, 7; Conscientiousness: 3, 8R; Emotional Stability: 4R, 9; Openness to Experiences: 5, 10R.	Measured at three time points: baseline (prior to intervention), immediately post-intervention (within 2 days after intervention ends), and at two-week follow-up (15-16 days after intervention completion).

Collaborators and Investigators

• Sponsor: University of Macau

Study record dates

Study Major Dates

• Study Start (Actual): December 16, 2025
• Primary Completion (Estimated): February 5, 2026
• Study Completion (Estimated): February 5, 2026

Study Registration Dates

• First Submitted: December 22, 2025
• First Submitted That Met QC Criteria: January 8, 2026
• First Posted (Estimated): January 16, 2026

Study Record Updates

• Last Update Posted (Estimated): January 16, 2026
• Last Update Submitted That Met QC Criteria: January 8, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Digital self-compassion writing intervention
• Additional Relevant MeSH Terms: Behavior; Personal Satisfaction; Psychological Well-Being; Investigative Techniques; Epidemiologic Research Design; Epidemiologic Methods; Research Design; Methods; Control Groups
• Other Study ID Numbers: MYRG-GRG2024-00269-FSS

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: All IPD that underlie results in a publication.
• IPD Sharing Time Frame: The IPD and supporting information will be made available after the publication of study results, anticipated around December 2027. There will be no specified end date for availability.
• IPD Sharing Access Criteria: The IPD and supporting information will be available upon reasonable request to the corresponding author. Researchers or qualified professionals may request access to de-identified data and analytic code for purposes such as secondary analysis or replication. Requests will be reviewed to ensure appropriate use and data protection.
• IPD Sharing Supporting Information Type: 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