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

• 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

• Psychological Distress [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)
• Depression and anxiety Symptoms [Baseline, 6-week, and 10-week]: Depression Anxiety Stress Scales (scores range from 0 to 63 where a higher score indicates more severe symptoms)
• Perceived Control / Self-efficacy [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

• Narrative Identity [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)
• Perceived Social Support [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)
• Loneliness [Baseline, 6-week, and 10-week]: UCLA Loneliness Scale (scores range from 20 to 80 where a higher score indicates a worse outcome)
• Resilience [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)
• Rumination [Baseline, 6-week, and 10-week]: The 22-item Rumination-Reflection Questionnaire (scores range from 22 to 88 where a higher score greater rumination)
• Self-stigma [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)
• Hopefulness / Hopelessness [Baseline, 6-week, and 10-week]: Beck Hopelessness Scale (scores range from 0 to 20 where a higher score indicates greater levels of hopelessness)
• Service Utilization [Baseline, 6-week, and 10-week]: Client Service Receipt Inventory

Sex: All, ages: 12 Years to 24 Years

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

• Christy Lai Ming Hui, PhD, Principal investigator, The University of Hong Kong