Evaluation of Training Curriculum and Service of Improving Access to Community Therapies
NCT ID: NCT06111820
Last Updated: 2023-11-01
Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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Recruitment Status
UNKNOWN
Clinical Phase
NA
Total Enrollment
330 participants
Study Classification
INTERVENTIONAL
Study Start Date
2022-05-22
Study Completion Date
2024-09-30
Brief Summary
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The current study aims to conduct a comprehensive evaluation of a training curriculum designed for teaching low-intensity psychological interventions to bachelor's degree holders, specifically focusing on principles of Acceptance and Commitment Therapy (ACT) and its intervention effectiveness. This evaluation is divided into two integral parts.
In the first part, the curriculum, which encompasses a 120-hour intensive teaching block followed by a nine-month placement, will be evaluated. To assess the trainees' competencies in applying the principles of ACT, a series of role-play examinations will be administered at various time points, including pre-training, pre-placement, mid-placement, and end-of-placement. Focus groups will be conducted.
The second part of the evaluation is to examine the outcomes of low-intensity psychological interventions, delivered by the trainees, targeting adult individuals screened with mild to severe symptoms of depression and anxiety. To achieve this, a series of questionnaires will be administered at several stages: pre-intervention, during each session, and at a three-month follow-up. Outcome measures will include the assessment of depressive and anxiety symptom severity, quality of life, functional impairment, therapeutic alliance, and the level of experiential avoidance. Individual exit interviews and focus groups will be conducted.
The aim of the study:
1. To evaluate the effectiveness of the training program
2. To evaluate the effectiveness of the low-intensity psychological intervention based on the Acceptance and Commitment Therapy (ACT) principle
Hypotheses:
It is hypothesised that the competency level of the training participants will increase after the intensive training block and the placement. It is also hypothesised that after receiving the low-intensity psychological intervention based on the ACT principle, the depression and anxiety scores, functioning impairment, and experiential avoidance level will reduce, and quality of life and therapeutic relationship will improve.
In the first part, the curriculum, which encompasses a 120-hour intensive teaching block followed by a nine-month placement, will be evaluated. To assess the trainees' competencies in applying the principles of ACT, a series of role-play examinations will be administered at various time points, including pre-training, pre-placement, mid-placement, and end-of-placement. Focus groups will be conducted.
The second part of the evaluation is to examine the outcomes of low-intensity psychological interventions, delivered by the trainees, targeting adult individuals screened with mild to severe symptoms of depression and anxiety. To achieve this, a series of questionnaires will be administered at several stages: pre-intervention, during each session, and at a three-month follow-up. Outcome measures will include the assessment of depressive and anxiety symptom severity, quality of life, functional impairment, therapeutic alliance, and the level of experiential avoidance. Individual exit interviews and focus groups will be conducted.
The aim of the study:
1. To evaluate the effectiveness of the training program
2. To evaluate the effectiveness of the low-intensity psychological intervention based on the Acceptance and Commitment Therapy (ACT) principle
Hypotheses:
It is hypothesised that the competency level of the training participants will increase after the intensive training block and the placement. It is also hypothesised that after receiving the low-intensity psychological intervention based on the ACT principle, the depression and anxiety scores, functioning impairment, and experiential avoidance level will reduce, and quality of life and therapeutic relationship will improve.
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Detailed Description
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'Training Participants': Participants from the Psychological Wellbeing Practitioners (PWPs) Programme will be invited to participate in the research. The PWPs are bachelors. Degree holders will undergo 120 hours of intensive training block, followed by a 9-month placement to practise the learnt skills. Given therapist competency will be part of the program, this research will request the participants to consent to the use of the data collected in the program.
'Service Participants': Individuals with depression or anxiety symptoms will be sampled in this study. Participants will be recruited from the placement organisations and promotions on social media, web pages, and at mental health centres. The sample size is estimated to be 300 individuals for initial screening for LIACT-guided self-help services.
Research design:
For training evaluation, given the current training programme already consists of a therapist competency assessment to ensure the quality of the training participants. Recorded role-play videos will be rated the ACT therapist competency by trained psychologists at pre-training, post-training block, mid-placement and post-placement. A consent form will be sent to the training participant to authorise the use of data for analysis.
Repeated measures design will be adopted for this study. Individual guided self-help LIACT service, eligible participants will receive 6-8 sessions of guided self-help LIACT over three to four months. Clinical outcomes (depression and anxiety levels) will be measured at every session, it will take around 5 minutes to complete these two routine outcome measures. Other primary and secondary outcome measures, including functioning impairment, quality of life, psychological flexibility, experiential avoidance, absenteeism, and therapeutic alliance will be at 3 time points, namely pre-treatment, post-treatment (at the end of the last session) and 3-month follow-up. Participants will take around 30 minutes to complete the full package of assessments. These outcome variables will be additionally measured after each session to avoid missing data if participants drop out. The recovery rate and reliable improvement rate will also be used as indicators to evaluate the efficacy of LIACT. Focus groups will be conducted on participants who drop out and complete the programme to understand their experience and journey.
Curriculum The LIACT training curriculum is designed by registered clinical psychologists with consultation from local ACT experts from the Association of Contextual and Behavioural Science (Hong Kong Chapter). There are 5 modules in the intensive training block including introduction, professional and ethics issues, application of ACT low-intensity intervention, troubleshooting and preparation for clinical placement. The LIACT protocol is also piloted and revised by clinical psychologists to ensure its adaptability to local situations. After 120- hour intensive training, the training participants will attend a role play exam to ensure their competency to proceed with the 9-month placement. During the 9-month placement, each PWP is expected to see at least 15 direct service beneficiaries to provide LIACT. During this supervision will be provided regularly to ensure the quality of service delivery and risk management. There will be a mid-placement review and final placement review, and the training participants will submit audio recordings for supervisors to rate for their competence.
A focus group will be conducted for the training participants to understand their learning experience.
Treatment Guided self-help LIACT will be provided to eligible participants. For individual guided self-help LIACT service, an intake assessment will be conducted to assess the presenting problem of the participants at pre-treatment to ensure the suitability to receive LIACT service. Participants will be given the LIACT self-help workbook collaboratively with a PWP. Between each session, clients will read through the workbook and complete the exercises suggested in the workbook. In subsequent sessions, PWP will guide clients to overcome the difficulties in performing the LIACT exercises.
Therapists PWPs will be responsible for providing LIACT to the participants. PWPs have completed a 120-hour intensive training and pass the role play examination prior to placement provision. The training was provided by experienced clinical psychologists and counsellors. Moreover, PWPs are under regular supervision by clinical psychologists, experienced counsellors, or social workers with extensive ACT training.
'Service Participants': Individuals with depression or anxiety symptoms will be sampled in this study. Participants will be recruited from the placement organisations and promotions on social media, web pages, and at mental health centres. The sample size is estimated to be 300 individuals for initial screening for LIACT-guided self-help services.
Research design:
For training evaluation, given the current training programme already consists of a therapist competency assessment to ensure the quality of the training participants. Recorded role-play videos will be rated the ACT therapist competency by trained psychologists at pre-training, post-training block, mid-placement and post-placement. A consent form will be sent to the training participant to authorise the use of data for analysis.
Repeated measures design will be adopted for this study. Individual guided self-help LIACT service, eligible participants will receive 6-8 sessions of guided self-help LIACT over three to four months. Clinical outcomes (depression and anxiety levels) will be measured at every session, it will take around 5 minutes to complete these two routine outcome measures. Other primary and secondary outcome measures, including functioning impairment, quality of life, psychological flexibility, experiential avoidance, absenteeism, and therapeutic alliance will be at 3 time points, namely pre-treatment, post-treatment (at the end of the last session) and 3-month follow-up. Participants will take around 30 minutes to complete the full package of assessments. These outcome variables will be additionally measured after each session to avoid missing data if participants drop out. The recovery rate and reliable improvement rate will also be used as indicators to evaluate the efficacy of LIACT. Focus groups will be conducted on participants who drop out and complete the programme to understand their experience and journey.
Curriculum The LIACT training curriculum is designed by registered clinical psychologists with consultation from local ACT experts from the Association of Contextual and Behavioural Science (Hong Kong Chapter). There are 5 modules in the intensive training block including introduction, professional and ethics issues, application of ACT low-intensity intervention, troubleshooting and preparation for clinical placement. The LIACT protocol is also piloted and revised by clinical psychologists to ensure its adaptability to local situations. After 120- hour intensive training, the training participants will attend a role play exam to ensure their competency to proceed with the 9-month placement. During the 9-month placement, each PWP is expected to see at least 15 direct service beneficiaries to provide LIACT. During this supervision will be provided regularly to ensure the quality of service delivery and risk management. There will be a mid-placement review and final placement review, and the training participants will submit audio recordings for supervisors to rate for their competence.
A focus group will be conducted for the training participants to understand their learning experience.
Treatment Guided self-help LIACT will be provided to eligible participants. For individual guided self-help LIACT service, an intake assessment will be conducted to assess the presenting problem of the participants at pre-treatment to ensure the suitability to receive LIACT service. Participants will be given the LIACT self-help workbook collaboratively with a PWP. Between each session, clients will read through the workbook and complete the exercises suggested in the workbook. In subsequent sessions, PWP will guide clients to overcome the difficulties in performing the LIACT exercises.
Therapists PWPs will be responsible for providing LIACT to the participants. PWPs have completed a 120-hour intensive training and pass the role play examination prior to placement provision. The training was provided by experienced clinical psychologists and counsellors. Moreover, PWPs are under regular supervision by clinical psychologists, experienced counsellors, or social workers with extensive ACT training.
Conditions
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Depression
Anxiety
Mental Health Issue
Stress
Distress, Emotional
Study Design
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Allocation Method
NA
Intervention Model
SINGLE_GROUP
Primary Study Purpose
TREATMENT
Blinding Strategy
NONE
Study Groups
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iACT service users
All participants enrolled in the programme will participate in the iACT service referring to the aforementioned details.
Group Type
EXPERIMENTAL
Improving Access to Community Therapies (iACT)
Intervention Type
BEHAVIORAL
The Low-intensity Acceptance and Commitment Therapy (LIACT) protocol is based on the empirically supported Acceptance and Commitment Therapy (ACT), and is designed by registered clinical psychologists with consultation from local ACT experts from the Association of Contextual and Behavioural Science (Hong Kong Chapter). The LIACT protocol is also piloted and revised by clinical psychologists to ensure its adaptability to local situations. For individual guided self-help LIACT service, an intake assessment will be conducted to assess the presenting problem of the participants at pre-treatment to ensure the suitability to receive LIACT service. Participants will be given the LIACT self-help workbook collaboratively with a Psychological Wellbeing Practitioner (PWP). Between each session, clients will read through the workbook and complete the exercises suggested in the workbook. In subsequent sessions, PWP will guide clients to overcome the difficulties in performing the LIACT exercises.
Interventions
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Improving Access to Community Therapies (iACT)
The Low-intensity Acceptance and Commitment Therapy (LIACT) protocol is based on the empirically supported Acceptance and Commitment Therapy (ACT), and is designed by registered clinical psychologists with consultation from local ACT experts from the Association of Contextual and Behavioural Science (Hong Kong Chapter). The LIACT protocol is also piloted and revised by clinical psychologists to ensure its adaptability to local situations. For individual guided self-help LIACT service, an intake assessment will be conducted to assess the presenting problem of the participants at pre-treatment to ensure the suitability to receive LIACT service. Participants will be given the LIACT self-help workbook collaboratively with a Psychological Wellbeing Practitioner (PWP). Between each session, clients will read through the workbook and complete the exercises suggested in the workbook. In subsequent sessions, PWP will guide clients to overcome the difficulties in performing the LIACT exercises.
Intervention Type
BEHAVIORAL
Other Intervention Names
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Manualised Acceptance and Commitment Therapy (ACT)
Low-intensity Acceptance and Commitment Therapy (LIACT)
Eligibility Criteria
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Inclusion Criteria
18-65 years old adults with any of the following problem(s):
* Anxiety problem (including social, generalised, health anxiety, work anxiety)
* Mild to moderate depression
* Other emotional challenges including (but not limited to) low self esteem, perfectionism, mild anger issues, interpersonal or relational challenges, low motivation, lack of purpose, numbness.
* Anxiety problem (including social, generalised, health anxiety, work anxiety)
* Mild to moderate depression
* Other emotional challenges including (but not limited to) low self esteem, perfectionism, mild anger issues, interpersonal or relational challenges, low motivation, lack of purpose, numbness.
Exclusion Criteria
Adults with the following features/ presentations are not eligible for the PWP programme and should automatically lead to an onward referral:
* High severity on the depressive score (PHQ9 \>= 20)
* High or imminent risk (according to scores on PHQ9 question no. 9 and information emerging at triage assessment, including indication of plan and action or the lack of protective factor)
Individuals with any of the following diagnoses or situations are also excluded:
* Obsessive-compulsive disorder
* Post-traumatic stress disorder
* Bipolar disorder
* Schizophrenia and other psychotic disorders
* Dissociative disorders
* Personality disorders
* Eating disorders
* Gender dysphoria
* Paraphilic disorders
* Anger issues as primary presenting concern (without anxiety or depression)
* Sleep issues as primary presenting concern (without anxiety or depression)
* Substance-related disorders
* History of trauma or abuse that is considered highly relevant to the current presenting problem they are seeking support for
* Planned changes to psychotropic medication during the period of PWP intervention
* Currently receiving regular psychological counselling or support from another practitioner.
* Diagnosis of a learning disability, cognitive impairment or neurodevelopmental condition that would impair their ability to engage with a structured, manualised intervention (e.g. untreated ADHD or moderate-severe brain injury)
* Clients with unstable or unsafe home environments (e.g. domestic abuse)
* Clear safeguarding concerns requiring multi-agency support (e.g. concerns about child abuse or neglect)
* High severity on the depressive score (PHQ9 \>= 20)
* High or imminent risk (according to scores on PHQ9 question no. 9 and information emerging at triage assessment, including indication of plan and action or the lack of protective factor)
Individuals with any of the following diagnoses or situations are also excluded:
* Obsessive-compulsive disorder
* Post-traumatic stress disorder
* Bipolar disorder
* Schizophrenia and other psychotic disorders
* Dissociative disorders
* Personality disorders
* Eating disorders
* Gender dysphoria
* Paraphilic disorders
* Anger issues as primary presenting concern (without anxiety or depression)
* Sleep issues as primary presenting concern (without anxiety or depression)
* Substance-related disorders
* History of trauma or abuse that is considered highly relevant to the current presenting problem they are seeking support for
* Planned changes to psychotropic medication during the period of PWP intervention
* Currently receiving regular psychological counselling or support from another practitioner.
* Diagnosis of a learning disability, cognitive impairment or neurodevelopmental condition that would impair their ability to engage with a structured, manualised intervention (e.g. untreated ADHD or moderate-severe brain injury)
* Clients with unstable or unsafe home environments (e.g. domestic abuse)
* Clear safeguarding concerns requiring multi-agency support (e.g. concerns about child abuse or neglect)
Minimum Eligible Age
18 Years
Maximum Eligible Age
65 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
Yes
Sponsors
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Chinese University of Hong Kong
OTHER
Sponsor Role
collaborator
Mind Mental Health Hong Kong Limited
OTHER
Sponsor Role
lead
Responsible Party
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Responsibility Role
SPONSOR
Principal Investigators
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Candice LYM Powell
Role: PRINCIPAL_INVESTIGATOR
Mind Mental Health Hong Kong Limited
Patrick WL Leung
Role: PRINCIPAL_INVESTIGATOR
Chinese University of Hong Kong
Locations
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Central Minds
Hong Kong, , China
Site Status
RECRUITING
Fu Hong Society
Hong Kong, , China
Site Status
RECRUITING
HKU Lap-Chee College
Hong Kong, , China
Site Status
RECRUITING
HKUSPACE PLK Stanley Ho Community College
Hong Kong, , China
Site Status
RECRUITING
Hong Kong Physically Handicapped and Able-Bodied (PHAB) Association
Hong Kong, , China
Site Status
RECRUITING
KUNST EXA Academy
Hong Kong, , China
Site Status
RECRUITING
LU Institute of Further Education
Hong Kong, , China
Site Status
RECRUITING
Aberdeen Kai-fong Welfare Association Services Centre
Hong Kong, , China
Site Status
RECRUITING
Baptist Oi Kwan Social Service
Hong Kong, , China
Site Status
RECRUITING
Cedar Communications Ltd
Hong Kong, , China
Site Status
RECRUITING
Central Health
Hong Kong, , China
Site Status
RECRUITING
Mind Mental Health Hong Kong Limited
Hong Kong, , China
Site Status
RECRUITING
MINDSET
Hong Kong, , China
Site Status
RECRUITING
PathFinders Hong Kong
Hong Kong, , China
Site Status
RECRUITING
Run HK
Hong Kong, , China
Site Status
RECRUITING
Society for Community Organisation (SoCO)
Hong Kong, , China
Site Status
RECRUITING
St. John's Cathedral Counselling Service
Hong Kong, , China
Site Status
RECRUITING
The Hong Kong Federation of Youth Groups
Hong Kong, , China
Site Status
RECRUITING
The Mental Health Association of Hong Kong
Hong Kong, , China
Site Status
RECRUITING
WYNG Foundation
Hong Kong, , China
Site Status
RECRUITING
Yuen Long Town Hall
Hong Kong, , China
Site Status
RECRUITING
Countries
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China
Central Contacts
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Facility Contacts
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References
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Provided Documents
Download supplemental materials such as informed consent forms, study protocols, or participant manuals.
Document Type: Study Protocol and Statistical Analysis Plan
Related Links
Access external resources that provide additional context or updates about the study.
https://www.iact.hk/
Enrolment website of the iACT intervention services.
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
MHK/2023/R01-PWP
Identifier Type: -
Identifier Source: org_study_id
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