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NCT Number: NCT07231406

Narrative Therapy Among Young People With Moderate Level of Mental Distress in Hong Kong

This cluster randomized controlled trial (cRCT) aims to evaluate the effectiveness of a narrative therapy (NT) intervention in (i) reducing mental distress, depressive symptoms, and anxiety, as well as (ii) enhancing perceived control and fostering a stronger sense of self among at-risk youth in Hong Kong. Participants are youths with moderate mental health concerns, indicated by K6 scores ranging from 11 to 14.

The study involves seven clusters, each based on community hubs, which will be randomly assigned to either the intervention group or a wait-list control group. Clusters assigned to the intervention group will receive six face-to-face sessions led by trained youth workers. Control clusters will receive the same intervention after the initial follow-up period.

Participants will be evaluated at baseline, post-intervention, and one-month follow-up. An interim analysis is built for the sake of evaluation of the collected data from the ongoing trial, in which the primary research question is addressed, and which has the potential for modifying the conduct of the study. Furthermore, a qualitative follow-up will be conducted after the trial, involving both participants and the workers delivering the NT intervention. This qualitative component aims to gather feedback on participants' experiences, and inform potential revisions to enhance future implementation.

It is hypothesized that youths receiving the NT intervention will show significantly greater improvements in perceived control and sense of self, along with reductions in mental distress, as well as depressive and anxiety symptoms, compared to those in the wait-list control group.

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Key information

Conditions

Mental Distress

Age range

12 year–24 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • JC LevelMind @ Community users at risk for mental distress (Tier 2), with K6 scores ranging from 11 to 14
  • Aged between 12 and 24 years
  • Sufficiently proficient in Chinese to comprehend verbal instructions
  • Able to provide written informed consent (parental consent for participant aged 12-17)

Exclusion criteria

  • Known diagnosis of intellectual disability
  • Organic brain disorder
  • Established psychiatric diagnosis
  • Current substance abuse
  • Receiving other structured psychological therapies such as module-based psychological therapy, mentalization-based therapy, low-intensity online interventions, cognitive-behavioral therapy, cognitive-behavioral therapy for insomnia, mindfulness, or art-informed therapy within the hub setting or any others outside the hub setting
  • Presence of current or active suicidal ideation or attempts

Treatment and study plan

Narrative Therapy

Behavioral

In Hong Kong, deeply ingrained norms and expectations shape each stage of life. As young people navigate their growth, they are constantly influenced by mainstream narratives stemming from sociocultural traditions, family, educators, peers, or social media. These narratives often define socially approved notions of "good" versus "bad," "meaningful" versus "meaningless," and "successful" versus "failing." Many youths may not fully realize how these dominant discourses subtly influence their life choices, often leading them to unconsciously accept predetermined paths they believe they "should" follow. Whether they conform successfully or struggle with these expectations, young people frequently experience pressure and negative emotions. Even more concerning, some internalize these societal judgments, resulting in negative self-perceptions. Through this group program utilizing narrative intervention methods, we aim to provide a safe, supportive space for youth to re-examine and explore th

Primary outcomes

  1. Psychological Distress

    Time frame: Baseline, 6-week, and 10-week

    The 6-item Kessler Psychological Distress Scale (scores range from 0 to 24 where a higher score indicates a worse outcome)

  2. Depression and anxiety Symptoms

    Time frame: Baseline, 6-week, and 10-week

    Depression Anxiety Stress Scales (scores range from 0 to 63 where a higher score indicates more severe symptoms)

  3. Perceived Control / Self-efficacy

    Time frame: Baseline, 6-week, and 10-week

    Sense of Mastery Scale (scores range from 7 to 28 where a higher score indicates a a better outcome)

Secondary outcomes

  1. Narrative Identity

    Time frame: Baseline, 6-week, and 10-week

    Narrative Identity Self-Evaluation Scale (scores range from 0 to 200 where a higher score indicates a better outcome)

  2. Perceived Social Support

    Time frame: Baseline, 6-week, and 10-week

    Multidimensional Scale of Perceived Social Support (scores range from 12 to 84 where a higher score indicates a better outcome)

  3. Loneliness

    Time frame: Baseline, 6-week, and 10-week

    UCLA Loneliness Scale (scores range from 20 to 80 where a higher score indicates a worse outcome)

  4. Resilience

    Time frame: Baseline, 6-week, and 10-week

    The 10-item Connor-Davidson Resilience Scale (scores range from 0 to 40 where a higher score indicates a better outcome)

  5. Rumination

    Time frame: Baseline, 6-week, and 10-week

    The 22-item Rumination-Reflection Questionnaire (scores range from 22 to 88 where a higher score greater rumination)

  6. Self-stigma

    Time frame: Baseline, 6-week, and 10-week

    The 9-item Internalized Stigma of Mental Illness Inventory (scores range from 1 to 4 where a higher score indicating high internalized stigma)

  7. Hopefulness / Hopelessness

    Time frame: Baseline, 6-week, and 10-week

    Beck Hopelessness Scale (scores range from 0 to 20 where a higher score indicates greater levels of hopelessness)

  8. Service Utilization

    Time frame: Baseline, 6-week, and 10-week

    Client Service Receipt Inventory

Study contacts

Contact information is provided by the study sponsor or research team.

Christy Lai Ming Hui, PhD

CONTACT

[email protected]

+852 2255 4486

Yi Nam Suen, PhD

CONTACT

[email protected]

+852 3917 6612

Sponsors and collaborators

Lead sponsor

The University of Hong Kong

Other

Collaborators

  • Caritas Medical Centre, Hong Kong
  • Chinese YMCA of Hong Kong
  • Hong Kong Children and Youth Services (HKCYS)
  • Hong Kong Christian Service
  • Hong Kong Federation of Youth's Group (HKFYG)
  • Hong Kong Playground Association (HKPA)
  • Hong Kong Sheng Kung Hui Welfare Council Limited
  • Hong Kong Young Women's Christian Association
  • Neighbourhood Advice-Action Council
  • St. James' Settlement
  • The Boys' and Girls' Clubs Association of Hong Kong
  • The Hong Kong Jockey Club Charities Trust
  • The Salvation Army, Hong Kong and Macau Command
  • Tung Wah Group of Hospitals
  • Yan Oi Tong

Registry information

Official study title

A Cluster Randomized Controlled Trial of Narrative Therapy Among Young People With Moderate Level of Mental Distress in Hong Kong

Important dates

Study start
2025
Primary completion
2027
Study completion
2027
First posted
Nov 17, 2025
Registry last updated
Mar 30, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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