Efficacy of Narrative Therapy for Older People With Depression
ConditionDepression
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age60+
SponsorCity University of Hong Kong
About this trial
The research aims to investigate the efficacy of a narrative therapy group in reducing depressive symptoms among older people.
This study adopts a mixed methods research design, involving both quantitative and qualitative approaches. In the quantitative study, a randomised controlled trial will compare a narrative therapy group with a waitlist control group to determine whether an eight-session narrative therapy group can reduce depressive symptoms in older people. The eight-session narrative therapy group will be delivered by a trained and experienced social worker or counsellor, and intervention outcomes will be assessed before and after the intervention using a standardised assessment tool for depressive symptoms. The qualitative study aims to examine the benefits, advantages, and limitations of the narrative therapy group from the users' perspective.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
aged 60 years or above;
exhibiting depressive symptoms as assessed using a standardised assessment tool, namely the Chinese Beck Depression Inventory-II (BDI; Byrne et al., 2004), with a BDI score between 10 and 30;
being a service user of an elderly centre; and
providing informed consent to participate in this research.
Disqualifiers
Individuals with severe depression (i.e. a BDI score ≥ 31), dementia, psychosis, or self-reported suicidal thoughts are excluded from this study; and
Individuals currently receiving a therapeutic intervention are not excluded from this study.
Trial design
Design model
Parallel
Treatments tested in this trial
Narrative therapy group
BehavioralNarrative therapy group consists of 8 sessions, with one session will be conducted per week, with each session lasting for about 90 minutes. A social worker and a counsellor will be recruited to run narrative groups at collaborative elderly centres. The narrative therapy group provides the following intervention strategies: engagement, de-construction, re-construction, and co-construction of personal identities. A standardized program manual of this narrative group will be developed by the research team. The social workers delivering the narrative therapy group in this project will receive the program manuals, training and supervision from the project team and an experienced clinical psychologist to ensure that the intervention groups follow the program manual.
Treatment as usual (TAU)
Other interventionWaitlist control group will receive will receive treatment as usual provided by the elderly centre, including recreational activities and interest classes, at the initial stage and will receive a brief narrative therapy program at a later stage
Treatment groups
110 Participants
are divided into 2 treatment groupsGroup A: 8-session narrative therapy groupActive comparator 1 intervention
Group B: Waitlist ControlOther 1 intervention
Trial outcomes
Primary outcomes
1
Chinese Beck Depression Inventory-II (BDI)
BDI is a 21-item scale with excellent validity, and reliability (Cronbach's α = 0.91), used to assess self-reported depression. The severity scale is as follows: a score of 0-13 represents minimal or no depression; 14-19 indicates mild depression; 20-28 indicates moderate depression; and 29-63 indicates severe depression. A cut-off point of a BDI score ≥ 14 was adopted in this study as indicative of clinical depression. Each item (e.g. Past failure) is rated on a 4-point scale with scores ranging from "0" to "3". The scores are summed over the items, with higher scores indicating a higher severity of symptoms
Time frame
Before and after the 8-week interventionSecondary outcomes
1
Chinese Internalised Stigma of Mental Illness (ISMI)
The Chinese Internalised Stigma of Mental Illness (ISMI; Young et al., 2017b) is a 10 -item self-reported scale to measure changes in self-stigma in four dimensions, i.e. shame/alienation (ISMI-SH), stereotype endorsement (ISMI-SE), perceived discrimination (ISMI-PD) and social withdrawal (ISMI-SW), with good validity and reliability (Cronbach's α = 0.93; 0.85; 0.75; 0.84 and for ISMI total scale, ISMI-SH, ISMI-SE, ISMI-PD, ISMI-SW). Each item (e.g. People discriminate against me because I have a mental illness) is rated on a 4-point scale from "1" (strongly agree) to "4" (strongly disagree). Scores are averaged over the items, with higher scores indicating greater self-stigma.
Time frame
Before and after the 8-weeks intervention.2
Chinese Rosenberg Self-Esteem Scale (RSES)
The Chinese Rosenberg Self-Esteem Scale (RSES; Leung \& Wong, 2008) is a 10-item scale to assess participants' self-reported self-esteem in two dimensions, i.e. self-worth (RSES-SW) and self-depreciation (RSES-SD) with good validity and reliability (Cronbach's α = 0.63; 0.74, and 0.81 for RSES, RESE-SW, and RSES-SD). Each item (e.g. I feel that I have a number of good qualities) is rated on a 4-point scale from "1" (strongly agree) to "4" (strongly disagree). Scores are summed over the items, with higher scores indicating better self-esteem
Time frame
Before and after the 8-weeks intervention3
The Chinese Dispositional Hope Scale (DHS)
The Chinese Dispositional Hope Scale (DHS; Sun et al., 2012) is a 12-item scale used to assess participants' self-reported hope in tow dimensions, i.e., agency (i.e., goal-directed energy) and pathways (i.e., planning to accomplish goals) with good validity and reliability (Cronbach's α = 0.81; 0.70 and 0.76 for the Hope total scale, agency subscale and pathway subscale). Each item (e.g. I can think of many ways to get out of a jam) is answered using a 4-point scale ranging from "1" (definitely false) to "4" (definitely true). Scores are summed over the items, with higher scores indicating a higher level of hope.
Time frame
Before and after the 8-weeks intervention4
The Chinese WHO 5-item Well-Being Index (WHO-5)
The Chinese WHO 5-item Well-Being Index (WHO-5; Fung et al., 2022) is a 5-item scale for assessing subjective wellbeing with satisfactory validity and internal consistency (Cronbach's α = 0.85; Fung et al., 2022). Each item (e.g., feel a sense of companionship in life) is rated on a 5-point Likert-type scale ranging from 1 (very dissatisfied) to 5 (very satisfied).
Time frame
Before and after the 8-weeks interventionSponsors and contacts
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Source ClinicalTrials.gov