Multiple Family Narrative Therapy for Chinese Families of Children With Dyslexia

The goal of this randomized controlled trial (RCT) is to develop and to implement a multiple family narrative therapy (MFNT) intervention consisting of parent-child relationships training among Chinese families of children with Dyslexia (CFCDs). The intervention aims to reduce the psychological distress of parents and their child, thus improving parent-child relationships, and the trial aims to assess the effectiveness of MFNT among them. A RCT design supplemented by qualitative interviews will be used to evaluate the effectiveness of MFNT on family welfare.

Dyslexia is a learning disability that causes problems with reading, writing, sequential learning, and phonological processing. It is a diagnosable disorder that commonly coexist with attention-deficit and hyperactivity disorder (ADHD). The estimated percentage of dyslexia in Hong Kong ranges from 9.7 to 12.6%. From 2016 to 2019, the number of students with special learning difficulties in both primary and secondary schools increased by 8.3%. These current statistics project that the number of children with dyslexia will continue to rise in the near future.

International studies indicated that dyslexia impacts the whole family. There are three common problems experienced by families of children with dyslexia: 1) problematic parent-child relationship; 2) parental and psychological distress; and 3) lack of social support. Statistics in Hong Kong also show that Chinese families of children with dyslexia experience similar problems. With daily academic demands, parents are constantly looking for effective ways to manage problems faced by their children with dyslexia even though they do not fully understand their child's dyslexia conditions. In Hong Kong, few studies of psychoeducational models have focused on parent-child relationships, parental stress, and social support for families of children with learning disabilities. The psychological approaches mainly address the behavioural changes of children with Special Educational Needs (SEN). To offset this research gap, it is important to adopt a psychoeducational model and evaluate the effects of the model's intervention on both parents and their children with SEN.

This study addresses a need in the Hong Kong Chinese community and has four expected outcomes: 1) it tests the effectiveness of Multiple Family Narrative Therapy (MFNT) as a brief-targeted intervention model; 2) it facilitates a participatory approach that engages both parents and children; 3) it designs a practice manual that is culturally applicable in the Chinese context; and 4) it encourages the use of the practice manual that outlines a tested model in school and integrative family services.

This study is an evidence-informed and knowledge-building study that aims to test the effectiveness of a brief-targeted MFNT integrative family therapy in Hong Kong compared to a "Treatment as Usual" school-focused approach to work with Chinese family of children with Dyslexia (CFCDs). This approach will target the importance of shifting from academic achievement driven approach, which intensify conflictual parent-child relationship to a collaborative model where family members can review one's identity and re-choose the pattern of interaction among the family members.

The first objective of this study is to test the effectiveness of a brief-targeted Multiple Family Narrative Therapy (MFNT) for Chinese families of children with dyslexia (CFCDs) in Hong Kong, in reducing psychological distress of parents and children, building healthy parent-child relationships, and promoting the use of social support. The second objective is to examine the process of change in attitudes and interactions among family members participating in MFNT.

Eligibility Criteria:
Inclusion Criteria:

* Participants 7-13 years old and their parents
* Dyslexia diagnosis (by psychiatrist or educational psychologist or clinical psychologist)
* Diagnosis with comorbidity of other learning disabilities
* Cantonese speaking participants (child and parents)
* At least one of the parents, but not siblings nor grandparents, can commit to all four sessions
* Participants able to comply with all testing and study requirements

Exclusion Criteria:

* Formal current diagnosis of psychosis
* Limitation in daily communication
* Previous service recipients of Narrative Therapy or Multiple Family Group
* Non-Cantonese speaking child or parent
* Parents or children who refuse to give written consent for their participation in the study