Effectiveness of Integrative Therapy on Psychological Hardiness Among Hard-of-Hearing Female Students (Integrative)

March 31, 2026 updated by: Nourah Ibrahim Albash, King Faisal University

The Effectiveness of an Integrative Therapeutic Program in Enhancing Psychological Hardiness Among Hard-of-Hearing Female Students in Saudi Arabia

The goal of this clinical trial (quasi-experimental study) is to learn whether an integrative therapeutic program can enhance psychological hardiness among hard-of-hearing (HOH) female students in Saudi Arabia (Al-Ahsa Governorate). The main questions it aims to answer are:

  1. What is the level of psychological hardiness among DHH female students in the Kingdom of Saudi Arabia?
  2. Are there statistically significant differences in the level of psychological hardiness among DHH female students attributable to the study variables (degree of hearing loss, grade level, hearing assistive device, communication method used, parents' hearing status, and type of educational environment attended)?
  3. Are there statistically significant differences at the level of (α = 0.05) between the mean scores of the experimental group on the psychological hardiness scale in the pre- and post-measurements?
  4. Are there statistically significant differences at the level of (α = 0.05) between the mean scores of the experimental and control groups on the post-measurement of the psychological hardiness scale?

Researchers will compare students who participate in the integrative therapeutic program (experimental group) with those who do not (control group) to see if the program leads to improved psychological hardiness.

Participants will:

Complete a psychological hardiness scale before and after the program Participate in the integrative therapeutic training sessions (experimental group only) Continue their regular educational activities without intervention (control group)

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study was conducted to evaluate the effectiveness of an integrative therapeutic program in enhancing psychological hardiness among hard-of-hearing (HOH) female students in inclusive educational settings in Al-Ahsa Governorate, Kingdom of Saudi Arabia. HOH students often face multiple psychological and social challenges that may negatively affect their adaptive functioning and overall well-being. Therefore, this study aimed to provide an evidence-based intervention to strengthen psychological resilience and improve coping capacities within this population.

A quasi-experimental design with a non-randomized experimental and control group structure was adopted. The study initially involved a broader sample of 69 deaf and hard-of-hearing (DHH) female students. All participants were assessed using a Psychological Hardiness Scale developed and validated by the researchers. Based on (pre-test) results, a purposive sample of 25 HOH students who demonstrated relatively low levels of psychological hardiness was selected to participate in the intervention phase.

The selected participants were divided into two groups: an experimental group (n = 15), which received the integrative therapeutic program, and a control group (n = 10), which did not receive any intervention during the study period. The intervention program was designed to enhance key dimensions of psychological hardiness, including commitment, control, and challenge, through structured therapeutic activities and training sessions tailored to the communication abilities and learning needs of HOH students.

All participants underwent pre-test and post-test assessments using the same psychological hardiness scale. The primary outcome measure was the change in psychological hardiness scores between pre-test and post-test evaluations. The effectiveness of the intervention was determined by comparing within-group changes (pre- vs. post-test) and between-group differences (experimental vs. control group). The higher the student's score on the scale, the greater the improvement in her level of psychological hardiness.

The independent variable in this study was the integrative therapeutic program, while the dependent variable was psychological hardiness. Although the study design aimed to control for confounding variables, several external factors may have influenced the outcomes, including parental support, teacher preparedness, peer interactions, and the broader educational and social environment.

The findings demonstrated statistically significant improvements in psychological hardiness among participants in the experimental group compared to the control group, indicating the effectiveness of the implemented program. These results support the integration of structured therapeutic interventions within educational support services for HOH students to enhance their psychological well-being and quality of life.

Study Type

Interventional

Enrollment (Actual)

25

Phase

  • 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

  • Saudi Arabia
      • Al Mubarraz, Saudi Arabia, 31982
        • Schools for the hearing impaired in Al-Ahsa

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

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

No

Description

After administering the scale, a purposive sample of 25 HOH female students was selected to participate in the intervention program. These participants were divided into two groups: 15 students in the experimental group and 10 students in the control group. This selection was determined due to the sensitivity of the research topic and the practical difficulty of conducting the intervention with the entire target population.

Eligibility Criteria

Inclusion Criteria:

  1. Female students with hearing impairment (Hard of Hearing, HOH)
  2. Enrollment in inclusive schools in Al-Ahsa Governorate, Saudi Arabia
  3. Within the targeted educational stage of the study
  4. Low scores on the Psychological Hardiness Scale at (pre-test)
  5. Ability to participate in and complete the intervention program
  6. Provision of informed consent

Exclusion Criteria:

  1. Failure to provide informed consent
  2. Incomplete participation in (pre-test) or post-intervention (post-test) assessments
  3. Diagnosis of profound deafness that limits effective communication required for the intervention
  4. Male students (excluded due to logistical and cultural constraints related to intervention delivery)

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: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Integrative Therapeutic Program Group

Participants in this arm will receive an integrative therapeutic program designed to enhance psychological hardiness among hard-of-hearing female students. The program includes structured training sessions focusing on cognitive, emotional, and behavioral strategies to improve resilience, coping skills, and adaptation to psychological stress.

Participants will attend scheduled sessions over 4 Weeks, and their psychological hardiness will be assessed before and after the intervention using a standardized scale.
Other: Integrative Therapeutic Program
The therapeutic program was developed based on the integrative therapy approach, which involves combining techniques and strategies derived from multiple therapeutic schools in accordance with the characteristics of the target population, without adhering to a single theoretical framework. The integrative approach draws on contemporary integrative perspectives that emphasize flexibility in intervention according to the needs of beneficiaries. The program was also grounded in the psychological hardiness theory developed by Suzanne Kobasa, which conceptualizes hardiness through three dimensions: commitment, control, and challenge. In addition, the program incorporated techniques drawn from several therapeutic approaches, including: (Cognitive Behavioral Therapy (CBT), Rational Emotive Behavioral Therapy (REBT), Mindfulness-Based Therapy, Group Therapy, Gratitude Therapy, Reality Therapy, Supportive spiritual techniques)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Psychological Hardiness Scale for deaf and hard of hearing
Time Frame: 8 weeks

The final version of the Psychological Hardiness Scale consisted of two sections. The first section included demographic items related to: (degree of hearing loss, grade level, type of hearing assistive device, preferred communication method, parents' hearing status, type of educational environment attended). The second section, which constitutes the main scale, consisted of 24 items distributed across three dimensions: commitment, control, and challenge. Each item was rated using a four-point Likert scale: (1 = Never, 2 = Rarely, 3 = Often, 4 = Always).

Minimum value 1 Maximum value 4 Therefore, a student who scores higher on the scale will have a higher degree of psychological resilience.
8 weeks
Change in Psychological Hardiness Scores
Time Frame: 8 weeks

This outcome measures the change in psychological hardiness among hard-of-hearing female students using a validated psychological hardiness scale developed by the researchers. The assessment evaluates key dimensions such as commitment, control, and challenge before and after the intervention.

Accordingly, the higher the student's score on the psychological resilience scale between the pre-test and post-test, the more effective the implemented program is considered to be.
8 weeks

Collaborators and Investigators

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

Sponsor

King Faisal University

Investigators

  • Principal Investigator: Nourah I Albash, King Faisal 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)

December 25, 2025

Primary Completion (Actual)

February 26, 2026

Study Completion (Actual)

March 2, 2026

Study Registration Dates

First Submitted

March 26, 2026

First Submitted That Met QC Criteria

March 31, 2026

First Posted (Actual)

April 7, 2026

Study Record Updates

Last Update Posted (Actual)

April 7, 2026

Last Update Submitted That Met QC Criteria

March 31, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Ethics3681
  • It will be added later. (Other Grant/Funding Number: King Faisal University)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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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