Parent-Child Single-Session Growth Mindset Intervention on Adolescent Depression and Anxiety Problems

Effects of Parent-Child Single-Session Growth Mindset Intervention on Adolescent Depression and Anxiety Problems: A Three-Arm Waitlist Randomised Controlled Trial

Depression and anxiety are common mental health problems among adolescents worldwide. In Hong Kong, one in every four secondary school students reports clinical-level depression or anxiety symptoms. Extant research has found that a fixed mindset on intelligence and emotions and failure-is-debilitating belief are closely related to more depression and anxiety symptoms, hopelessness, and suicidality. At the same time, recent research also points to the importance of parental mindset. Parents are the primary social support of adolescents; parental belief systems can strongly influence children's affect, behaviour, and mental health. However, the effects of parent-child mindset interventions on a child's internalising problems have not yet been empirically examined. As emerging evidence has shown the promise of single-session interventions in reducing and preventing youth internalising problems, this project develops and examines a parent and child single-session intervention on mindsets of intelligence, failure, and emotion (PC-SMILE) - to tackle depression and anxiety in young people and promote parental well-being.

Using a three-arm randomised controlled trial, the proposed study will examine the effectiveness of PC-SMILE on reducing depression and anxiety symptoms among children, enhancing well-being and parent-child relationships.

A total of 549 parent-child dyads will be recruited from six secondary schools and randomly assigned to either the PC-SMILE intervention group, the C-SMILE intervention group, or the no-intervention waitlist control group. The intervention is approximately 45 minutes in length. In the PC-SMILE group, both parent and child will receive intervention, and their mental health and family relationship will be assessed at three time points: baseline before intervention (T1), within two weeks post-intervention (T2), and three months post-intervention (T3). In the C-SMILE group, only the child will undergo intervention, while both the child and parent will be required to complete the repeated assessments. A pilot test (n = 9) has supported the feasibility and acceptability of the PC-SMILE intervention. We hypothesise that compared to the waitlist control group, the PC-SMILE intervention group and C-SMILE group will significantly improve child depression and anxiety (primary outcome) and significantly improve secondary outcomes, including children's academic self-efficacy, hopelessness, psychological well-being, and parent-child interactions and relationships, and PC-SMILE group is more effective than C-SMILE group. The intention-to-treat principle and linear-regression-based maximum likelihood multi-level models will be used for data analysis.

As of May 2024, we enrolled 75 students and their parents in the study.

This study will not only provide evidence on parent-child growth mindset intervention for adolescent internalising problems but can also serve as a scalable and accessible intervention for improving the well-being of young people and their parents.

Inclusion Criteria:

• The inclusion criteria for adolescent participants are:

  1. aged between 11-16 (inclusive) with one parent willing to participate;
  2. Chinese youth who can read and write in Chinese;
  3. sufficient visual and auditory abilities to complete the intervention and assessment;
  4. ability to give consent to participate in the study.

• The inclusion criteria for parent participants are:

  1. living with the child participant;
  2. Chinese-language proficiency and comfort with completing computer-based activities;
  3. sufficient visual and auditory abilities to complete the intervention and assessment;
  4. ownership of personal internet-equipped devices.

Exclusion Criteria:

• Exclusion criteria for adolescent participants are:

  1. no parental consent;
  2. inability to remain focused to complete the intervention and the survey, which take approximately 45 and 25 minutes respective;
  3. intellectual disability or severe illness or pain that would lead to significant bias in students' health and mental health situation.

• Exclusion criteria for parent participants are:

  1. having a mental illness;
  2. inability to remain focused to complete the intervention and the survey, which take approximately 45 and 25 minutes respective;
  3. intellectual disability or severe illness or pain that would lead to significant bias in students' health and mental health situation.