The goal of this clinical trial is to learn if a combined intervention of summer camp and letter-writing support works to improve psychological resilience in disadvantaged adolescents in Liangshan, Sichuan. The main questions it aims to answer are:
Does the "summer camp + letter-writing" intervention improve resilience in adolescents who face poverty, lack of parental care, or social risks?
Does this intervention reduce depression and anxiety symptoms?
Researchers will compare adolescents who join the summer camp and receive monthly letters to those who do not receive this program to see if the intervention helps their mental health and coping skills.
Participants will:
Attend a 5-day summer camp that includes group games, emotion expression activities, life education, and learning support
Receive monthly letters from trained university student volunteers for about 10 months after the camp. The letters will encourage them, give advice, and help them practice what they learned in the camp
Complete surveys about their resilience, depression, and anxiety before the intervention, during it, at the end, and 6 months later
This study will also look at whether the program is cost-effective, meaning if it brings mental health benefits at a reasonable cost.
Students enrolled in Grade 7 or Grade 8 (junior middle school) in selected schools in Yuexi County, Liangshan Prefecture, Sichuan Province.
Identified as "children in adversity," including those from economically disadvantaged families, left-behind children, children with disabilities, or other children deemed at-risk by school officials.
Able to understand and complete psychological questionnaires.
Mentally and physically able to participate in group activities and engage in written communication.
Children with serious psychiatric or developmental disorders (e.g., autism spectrum disorder, intellectual disability) that impair comprehension or participation.
Currently receiving professional psychological counseling or treatment that may interfere with the study protocol.
Participation in other mental health interventions in the past year.
Planning to transfer, drop out, or leave the region during the study period.
Parallel
Combined Resilience Intervention
BehavioralA two-phase behavioral intervention aimed at improving psychological resilience among socioeconomically disadvantaged adolescents. The intervention includes: 1. a 5-day structured summer camp led by trained university student volunteers, featuring psychoeducational group sessions, emotional expression activities, and life skills training, based on SEL, CBT, and positive psychology frameworks; and 2. a 10-month pen-pal letter-writing component, where each child is matched with a trained university volunteer to receive monthly supportive letters. This stage reinforces the gains from the summer camp through sustained emotional support, skill reminders, and positive guidance. The intervention is designed to be low-cost, scalable, and ethically safe, and has been standardized through manuals and training protocols.
Psychological resilience (RSCA score) at post-intervention
Psychological resilience will be assessed using the Resilience Scale for Chinese Adolescents (RSCA), a 27-item validated instrument measuring five dimensions of resilience. Each item is rated on a 5-point Likert scale, and the total score ranges from 27 to 135, with higher scores indicating greater resilience.
Change in depressive symptoms from baseline to follow-up (PHQ-9)
Depressive symptoms will be measured using the 9-item Patient Health Questionnaire (PHQ-9), a validated screening tool for depressive symptoms. Each item is scored from 0 (not at all) to 3 (nearly every day), with a total score range of 0-27. Higher scores indicate more severe depressive symptoms. Clinically significant depression is defined as a score ≥10.
Change in anxiety symptoms from baseline to follow-up (GAD-7)
Anxiety symptoms will be assessed using the 7-item Generalized Anxiety Disorder scale (GAD-7), a validated self-report measure for generalized anxiety. Each item is rated from 0 (not at all) to 3 (nearly every day), with total scores ranging from 0 to 21. A score of ≥10 is considered clinically significant.
Change in mobile device addiction symptoms from baseline to follow-up (SAS-SV)
Digital device addiction will be assessed using the Short Version of the Smartphone Addiction Scale (SAS-SV), adapted for general mobile device use. The scale includes 10 items rated on a 6-point Likert scale (1 = strongly disagree to 6 = strongly agree). Higher scores indicate greater risk of device addiction. A total score above 32 is considered indicative of problematic use.
Change in life satisfaction from baseline to follow-up
Life satisfaction will be assessed using a brief validated adolescent life satisfaction scale. Participants rate their overall satisfaction with life on a 5-point Likert scale. Higher scores indicate greater life satisfaction.
Change in future orientation from baseline to follow-up
Participants' future orientation will be assessed using a brief validated scale measuring goal-setting, planning, and optimism toward future outcomes. Higher scores reflect stronger future orientation.
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Xiaoxuan Liu
Lead sponsor
Zhejiang University
Sponsor institution
This trial is not recruiting at the moment. You can still explore other options:
