Clinical trial NCT06522243: Mindful Parenting for Parents With SEN Adolescents
Official title: Effectiveness of Mindfulness Program for Parents of Children With SEN
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Expressed Emotion
Stress
Well-Being, Psychological
Lead sponsor: The University of Hong Kong
Sponsor class: OTHER
First posted: 2024-07-26
Enrollment: 120
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: waitlist randomized controlled trial
Primary purpose: TREATMENT

Brief summary: The goal of the study is to evaluate the effectiveness of an online eight-week mindful parenting program for parents of adolescents with special needs and its impact on parents' wellbeing and behaviors of their adolescents with SEN(s).

Researchers will randomize the participants into the immediate intervention group (to start the intervention soon after recruitment) and the waitlist control group (to start the intervention after the immediate intervention group) so as to compare the changes between the two groups.

The participants will join the 8-week mindful parenting intervention and one follow-up session. They will be asked to fill in the questionnaires at baseline, after the 8-week intervention, and at the follow-up sessions. Training sessions will be audio-taped and transcripted. The conversation during the zoom classes and participants' sharing on their subjective experience related to mindfulness practices will be analysed.

Detailed description: Being a parent is inherently a demanding and stressful job, and raising children with SEN may pose additional stressors to parents. Parents of SEN children have higher parenting stress compared to those of typically developed children in facing daily challenges with their children's learning and development, which may lead to a higher risk of child maltreatment. Adolescence and emerging adulthood are a transition period which may impose increased stress and challenges on both young people and their parents. As a result, parents of young people with SEN(s) require more support in both parenting skills and their own psychological wellbeing.

Parents not only provide care for their children but also create an everyday environment under which their children are raised. Improvements in parenting skills and parents' mental health could lead to positive outcomes for child and youth mental wellbeing (while malfunctioning parenting may also impose an aversive effect on children's development. For instance, a critical and over-involvement of parental-child interaction, i.e., high expressed emotion (high EE) in the family, was found to be a robust predictor of relapse in different psychiatric illnesses.

Parenting is by nature a highly challenging and complex job and raising a child with mental illness could be even more stressful and strain parents' experience. It was reported that the severity of children's emotional and behavioral disturbances was closely related to parents' stress levels. On the other hand, parenting stress is an essential factor contributing to parenting effectiveness. When parents experience a high level of stress, their parenting effectiveness may decrease. Hence, reducing parents' stress levels would not only benefit parents themselves but also enhance effective parenting so as to benefit the wellbeing of their children with mental illness.

Mindful parenting Mindful parenting has been defined as the ability to pay attention to your children and parenting in an intentional, non-judgmental, and moment-to-moment awareness. Mindful parenting intervention does not directly teach parenting skills like other parenting training programs. Being mindful in everyday parenting is to perceive their children with an unbiased and open attitude, providing more sensible and responsive reactions to the children instead of reacting automatically based on past experience of parenting or being parented. By decentering from the current thoughts or affects, it enables parents to observe their internal experiences objectively without overidentifying with them. This, in turn, strengthens their capacity to endure the intense emotions and allow them to be more fully present with their child. Mindful parenting was also found to be negatively correlated with parental stress, yet positively associated with the levels of adopting authoritative parenting style. Furthermore, one of the features of the mindful parenting program is to practice non-judgmental awareness when interacting with children instead of automatically reacting to children's behaviours. It is thus speculated that mindful parenting practice could also promote less high EE interactions between parents and adolescents, which has been sparsely studied in the existing literature. The current pilot study may thus provide a possible mechanism in explaining the effectiveness of mindful parenting in improving the wellbeing of both parents and their children with SEN(s).

Mindful parenting had been applied in parenting for children with special needs, childbirth and parenting, and parenting for children with mental illness. The results of various mindful parenting programs (with a minimum of 6-8 weekly group sessions) showed some evidence of improvements for parenting stress, parents' psychopathology, and their children's mental health symptoms. However, the study sample had mainly focused on parents whose children were in their early or middle childhood.

The current study thus aims to recruit a more diverse sample of adolescents with different types of SENs. The data and experience gained from the current pilot study would also shed light on a clearer picture of whether a nine-session mindful parenting program would benefit both parents and their adolescent children with SENs.

A mixed methods design with qualitative journaling and quantitative experimental design could leverage the benefits of both methods. The data collected from participants' journal writing would elucidate the benefits, challenges, and personal growth through mindfulness practices from a subjective experiential perspective. It will also provide valuable insights for designing a larger-scale study to understand the underlying mechanism of mindful parenting on wellbeing of both parents and their children with SEN.

Aims and Hypotheses to be Tested:

The current study aims to (i) to evaluate the effectiveness of mindfulness training in enhancing the wellbeing of both parents and behaviors of their adolescents with SEN(s); (ii) to assess the feasibility and acceptability of adopting a nine-session Mindful Parenting program among parents of adolescents with SEN(s); (iii) to formulate useful suggestions and guidelines on mindfulness training for parents of adolescents with SEN(s).

Eligibility criteria: Inclusion Criteria:

* with one adolescent child with special educational need(s)
* being the major caregiver for the adolescent for at least one year
* Cantonese speaker

Exclusion Criteria:

* schizophrenia-spectrum disorder
* bipolar disorder
* substance abuse
* developmental disabilities
* with active psychotic symptoms
* high suicidal risks
* experiencing a recent personal crisis

Primary outcomes:
measure: Emotional Disturbances
timeFrame: 16 weeks
measure: Wellbeing Literacy
timeFrame: 16 weeks
measure: Mindfulness in Parenting
timeFrame: 16 weeks
measure: Parents' Expressed Emotion
timeFrame: 16 weeks
measure: Children's behaviors
timeFrame: 16 weeks
Secondary outcomes:
measure: General Mindfulness Awareness
timeFrame: 16 weeks
measure: Decentering
timeFrame: 16 weeks
measure: Parenting Skills
timeFrame: 16 weeks
Other outcomes:
measure: Subjective experiences with mindful parenting
timeFrame: 16 weeks
Locations:
Study officials:
References:
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