Efficacy of Narrative Therapy for Older People With Depression

NCT07371988 | Recruiting

• 2 other identifiers: HU-STA-000017939231614
• Study Type: interventional
• Target: 110
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Depression

Keywords

Randomized controlled trial; Depressive Disorders; Narrative Therapy group; Self-stigma; Hope; Wellbeing

Outcome Measures

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

  Before and after the 8-week intervention

Secondary Outcomes (4)

• Chinese Internalised Stigma of Mental Illness (ISMI)

  Before and after the 8-weeks intervention.

• Chinese Rosenberg Self-Esteem Scale (RSES)

  Before and after the 8-weeks intervention

• The Chinese Dispositional Hope Scale (DHS)

  Before and after the 8-weeks intervention

• The Chinese WHO 5-item Well-Being Index (WHO-5)

  Before and after the 8-weeks intervention

Study Arms (2)

8-session narrative therapy group

ACTIVE COMPARATOR

This study includes a two arms parallel groups for comparison. Participants in the intervention group will receive an eight-session narrative therapy group in addition to treatment as usual provided by the elderly centres such as interest classes and recreational activities. The narrative therapy group will be conducted by an experienced and trained social worker and counselor.

Behavioral: Narrative therapy group

Waitlist Control

OTHER

Waitlist 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

Other: Treatment as usual (TAU)

Interventions

Narrative therapy group BEHAVIORAL

Narrative 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.

8-session narrative therapy group

Treatment as usual (TAU) OTHER

Waitlist 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

Waitlist Control

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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.

You may not qualify if:

• 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.

Sponsors & Collaborators

• City University of Hong Kong: lead

Study Sites (1)

City University of Hong Kong

Kowloon Tong, Hong Kong, Hong Kong

RECRUITING

Related Publications (9)

• Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates

  BACKGROUND

• Lee SW, Stewart SM, Byrne BM, Wong JP, Ho SY, Lee PW, Lam TH. Factor structure of the Center for Epidemiological Studies Depression Scale in Hong Kong adolescents. J Pers Assess. 2008 Mar;90(2):175-84. doi: 10.1080/00223890701845385.

  PMID: 18444112 BACKGROUND

• Madigan, S. (2019). Narrative Therapy (2nd edition). American Psychological Association

  BACKGROUND

• White, M. (2007). Maps of Narrative Practice. W. W. Norton & Company

  BACKGROUND

• Young, D. K. W., Ng, P. Y., Pan, J. Y., & Cheng, D. (2017b). Validity and reliability of internalized stigma of mental illness (Cantonese). Research on Social Work Practice, 27(1), 103-110. https://doi.org/10.1177/1049731515576209

  BACKGROUND

• Sun, Q., Ng, K.-M., & Wang, C. (2012). A validation study on a new Chinese version of the Dispositional Hope Scale. Measurement and Evaluation in Counseling and Development, 45(2), 133-148. https://doi.org/10.1177/0748175611429011

  BACKGROUND

• Peng W, Zhou Y, Chu J, Liu Z, Zheng K, Yao S, Yi J. Factorial and Criterion Validities of the Chinese Version of Rosenberg Self-Esteem Scale Among Undergraduate Students. Psychol Res Behav Manag. 2024 Dec 5;17:4135-4144. doi: 10.2147/PRBM.S494452. eCollection 2024.

  PMID: 39654814 BACKGROUND

• Lamarca M, Espinosa V, Acuna V, Vila-Badia R, Balsells-Mejia S, Moritz S, Berna F, Konig C, Gaweda L, Group P, Barajas A, Ochoa S. Reducing self-stigma in psychosis: A systematic review and meta-analysis of psychological interventions. Psychiatry Res. 2024 Dec;342:116262. doi: 10.1016/j.psychres.2024.116262. Epub 2024 Nov 16.

  PMID: 39549598 BACKGROUND

• Fung SF, Kong CYW, Liu YM, Huang Q, Xiong Z, Jiang Z, Zhu F, Chen Z, Sun K, Zhao H, Yu P. Validity and Psychometric Evaluation of the Chinese Version of the 5-Item WHO Well-Being Index. Front Public Health. 2022 Mar 30;10:872436. doi: 10.3389/fpubh.2022.872436. eCollection 2022.

  PMID: 35433612 BACKGROUND

MeSH Terms

Conditions

Depression; Depressive Disorder

Interventions

Therapeutics

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior; Mood Disorders; Mental Disorders

Study Officials

• Kim-wan Daniel Young, PhD

  City University of Hong Kong

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Kim-wan Daniel Young, PhD

CONTACT

+852 3442 8954; dkwyoung@cityu.edu.hk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: INVESTIGATOR
• Masking Details: A research assistant, who is not involve in the randomized allocation of participants and delivery of intervention group, will conduct pre- and post-intervention outcome assessments using standardised assessment tools.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Model Details: Participants in the intervention group will receive an narrative therapy group in addition to treatment as usual provided by the elderly centre such as interest classes and recreational activities. Narrative therapy group consists 8 session, 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. 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.

Study Record Dates

• First Submitted: January 20, 2026
• First Posted: January 28, 2026
• Study Start: November 10, 2025
• Primary Completion (Estimated): August 31, 2026
• Study Completion (Estimated): August 31, 2026
• Last Updated: April 24, 2026

Record last verified: 2026-02

Locations

HK (1)