Daniel F. K. Wong

Enhancing staff attitudes, knowledge and skills in supporting the self-determination of adults with intellectual disability in residential settings in Hong Kong: A pretest-posttest comparison group design

BACKGROUND The ecological perspective recognizes the critical role that is played by rehabilitation personnel in helping people with intellectual disability (ID) to exercise self-determination, particularly in residential settings. In Hong Kong, the authors developed the first staff training programme of its kind to strengthen the competence of personnel in this area. The purpose of this study was to examine the effectiveness of staff training in enhancing residential staffs attitudes, knowledge and facilitation skills in assisting residents with ID to exercise self-determination. METHODS A pretest-posttest comparison group design was adopted. Thirty-two participants in an experimental group attended a six-session staff training programme. A 34-item self-constructed scale was designed and used for measuring the effectiveness of the staff training. RESULTS The results showed that the experimental group achieved statistically significant positive changes in all domains, whereas no significant changes were found in the comparison group. CONCLUSIONS The findings provided initial evidence of the effectiveness of staff training that uses an interactional attitude-knowledge-skills model for Chinese rehabilitation personnel. The factors that contributed to its effectiveness were discussed and recommendations for future research were made.

Difficulties and patterns of social support of mature college students in Hong Kong: Implications for student guidance and counselling services

Abstract The extent and nature of the difficulties faced by mature college students in a university in Hong Kong were examined. Who provided which types of support in which aspects of the lives of mature students was investigated. The results showed that time constraints were a major concern of many such students. Differences were found in the problems experienced in different modes of study and with different marital statuses. Spouses were support generalists who provided all types of support to their mature student partners, while lovers, friends and family members were support specialists who provided specific types of social support. The findings lend support to the hypothesis that the more sufficient the perceived social support received by mature students, the less the degree of difficulty they experience in their lives. Implications for service approach and for the provision of services are discussed, and recommendations on how to improve services are made.

The maintenance effect of cognitive–behavioural treatment groups for the Chinese parents of children with intellectual disabilities in Melbourne, Australia: a 6-month follow-up study

BACKGROUND Caring for a child with intellectual disability can be stressful. No data on the longer-term effects of cognitive-behavioural treatment (CBT) on parents from a Chinese-speaking background who have children with intellectual disabilities are available in the literature. This study attempted to fill this research gap by examining the maintenance effect of CBT among the Chinese parents of such children in Melbourne, Australia. METHOD Thirty-nine participants took part in our CBT groups and attended follow-up meetings. A questionnaire comprising four instruments, the Parenting Stress Index (PS) - Parent Domain, General Health Questionnaire-12 (GHQ-12), Abbreviated Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-18) and Dysfunctional Attitude Scale (DAS), was administered to the participants at the pre- and post-test stage and at the 6-month follow-up. RESULTS One-way repeated-measures analyses of variance revealed significant time and group effects in the PS (F(2,27) = 16.93, P < 0.001), Q-LES-Q-18 (F(2,27) = 15.98, P < 0.001), GHQ-12 (F(2,27) = 81.93, P < 0.001) and DAS (F(2,27) = 15.50, P < 0.001) scores at the three measurement times. The participants continued to maintain significant improvements in mental health and quality of life and declines in the severity of parenting stress and dysfunctional attitudes at the 6-month follow-up. Effect size analyses revealed mostly large differences in the foregoing measurements (Cohens d = 0.76-2.18) between the pre-test and 6-month follow-up. Employing a cut-off score of 3/4 in the GHQ-12 to identify at-risk and not-at-risk cases, approximately 90.5% of the participants could be classified as not-at-risk at the follow-up. Lastly, regression analyses showed that changes in DAS scores significantly predicted changes in the GHQ-12 and Q-LES-Q-18 scores at the follow-up. CONCLUSIONS This study provides preliminary evidence of the 6-month maintenance effect of CBT groups for the Melbourne-resident Chinese parents of children with intellectual disabilities.

Evaluating the Effectiveness of Mental Health First Aid Program for Chinese People in Hong Kong

Purpose: Chinese people generally lack knowledge of mental illness. Such phenomenon may lead to a delay in seeking psychiatric treatments. This study evaluated the effectiveness of Mental Health First Aid (MHFA) program in improving mental health knowledge of the general public in Hong Kong. Methods: A quasi-experimental design was adopted whereby 138 participants received MHFA training and 139 partook in seminars on general health, respectively. All participants filled out a standardized questionnaire before, at the end, and 6-month after the training. Results: Findings demonstrated that MHFA training might be effective in enhancing participants’ knowledge of mental disorders, reducing stigma, and improving perceived confidence in providing help to people with mental illness. Effect size statistics revealed mostly modest to moderate improvements in major variables in the experimental group. Conclusion: It is recommended that culturally attuned MHFA program can be used as prevention strategy to promote good mental health in Chinese communities.

A Preliminary Study on Cognitive–Behavior Interventions for Hong Kong Chinese Delinquent Youth

Objectives: This study evaluated a culturally attuned cognitive–behavior intervention for reducing impulsivity and delinquency-related attitudes and behaviors among Chinese delinquent youth in Hong Kong. Methods: A quasi-experimental design was adopted. Twenty participants received CBI, and 20 received routine counseling for a period of 12 months. All participants filled out a standardized questionnaire before the intervention and at 6 and 12 months of intervention. Results: A series of 2 × 3 analyses of variance were used to examine the Time × Group Effects of the two groups of participants. Results suggested, when compared to the control group, the participants in the experimental group showed greater and continuous positive changes in overall impulsivity, nonplanning impulsivity, cognitive impulsivity, and overall delinquency, with effect sizes showing moderate to large magnitude of change. Conclusion: This culturally attuned CBI program may be a useful inclusion in the outreaching social services for Chinese delinquent youth in Hong Kong.

Evaluating Effectiveness of Cognitive–Behavior Therapy for Hong Kong Adolescents With Anxiety Problems

Objectives: The aims of this study were to examine the effects of group cognitive–behavior therapy (CBT) on improving anxiety symptoms and enhancing personal growth among adolescents at risk of developing anxiety disorders in school settings in Hong Kong. Method: A total of 26 participants received an eight-session CBT group and 20 received treatment as usual in the waitlist control condition. Instruments measuring anxiety symptoms, types of anxiety in children, dysfunctional thoughts, and personal growth were used to assess the changes in severity of anxiety symptoms, dysfunctional thoughts, and personal growth among the participants. Results: A 2 × 2 mixed model analyses of variance were employed, results demonstrated significantly greater improvements in overall anxiety symptoms, generalized anxiety symptoms, and personal growth—use of resources in the participants of the CBT group compared to the control group. Conclusion: Group CBT may potentially improve anxiety symptoms of adolescents in school settings in Hong Kong.

The Effects of Recovery-Oriented Cognitive–Behavior Approach for Chinese With Severe Mental Illness:

Purpose: Hope and meaning in life are essential components of personal growth and happiness. Built on the recovery model, this study attempted to evaluate the effects of a recovery-oriented cognitive–behavior approach (CBA) in enhancing hope and meaning in life among a group of people with severe mental illness in Hong Kong. Method: A matched-pair comparison approach was adopted. Twenty-seven experimental group participants received recovery-oriented CBA, while 25 participants received standard counseling services. Assessments were administered at preintervention and at 6 and 12 months of intervention. Results: Repeated measures analyses of covariance indicated that the recovery-oriented CBA was more effective than the control condition in improving the mental health recovery process (basic functioning, finding new potentials, and spirituality) and a sense of hope (planning in achieving goals). Conclusion: Given these initial positive results, more vigorous studies and refinement of this recovery-oriented CBA are needed to ascertain the effectiveness of this combined intervention approach.

Psychometric properties of the AIR Self‐Determination Scale: the Chinese version (AIR SDS‐C) for Chinese people with intellectual disabilities

BACKGROUND The construct of self-determination has received considerable attention in the international field of intellectual disabilities (ID). Recently, there has been a rapid development of this construct in Chinese societies including Hong Kong. However, there is no locally validated instrument to measure self-determination in people with ID. This article explains the validation process of the AIR Self-Determination Scale - Chinese version (AIR SDS-C) adapted from the 24-item AIR Self-Determination Scale, developed by Wolman and his colleagues, which is used in school setting. METHODS People with mild/moderate ID aged 15 years or above were recruited from special schools and social services units in different regions of Hong Kong. Factor analysis and reliability tests were conducted. RESULTS Data for a total of 356 participants were used for the analysis. A confirmatory factor analysis was performed to test the factorial construct, and Mplus 7.0 was used for the analysis. The factor structure proposed in the original English version was supported by the data, and all factor loadings were between 0.42 and 0.76. The whole scale achieved good reliability (Cronbachs α = 0.88 and ω = 0.90). CONCLUSIONS The AIR SDS-C appears to be a valid and reliable scale. This study examined adult groups as well as student groups. The application of the scale can thus be extended to a wider population. The implications for theory building and practice are discussed.

A brief cognitive behavioural therapy psychoeducational group for Chinese people with chronic illnesses: an evaluation study

ABSTRACT This pilot study attempted to examine the effectiveness of a brief cognitive behavioural therapy (CBT) psychoeducational group for Chinese people with chronic illness in Hong Kong. It adopted a single group design, and 52 participants joined the group. A questionnaire with three outcome measures, measuring general mental health, quality of life and dysfunctional attitudes and beliefs, was administered to participants at pre-test, post-test and six month follow-up. Repeated measures ANOVAs were employed and revealed positive changes in most of the outcome measures across the three time points. Cohen’s d showed a moderate to large effect size for most outcome measures. From a step care perspective, a culturally attuned brief CBT psychoeducational group may serve as an early intervention and a triage to attract suitable people with chronic illness to engage in the treatment process.