Online Writing Intervention for Parent-Child Relationships

(SPACES Trial)

Recruiting at 4 trial locations

Overseen By Danielle Chiaramonte, Ph.D.

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Yale University

Disqualifiers: Active mania, psychosis, suicidality, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 5

129 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores two types of online writing activities designed to help parents become more accepting of their sexual and gender minority youth (SGMY). The goal is to determine if specific writing exercises can improve relationships by reducing stress and enhancing understanding. Participants will either write about their experiences as a parent of an SGMY, focus on attachment and family therapy principles, or simply describe their day's activities. The trial suits parents or guardians living in the Southeast United States who identify as heterosexual and cisgender and are struggling to accept their 15-29-year-old SGMY. As an unphased trial, this study offers a unique opportunity to contribute to innovative research that could enhance family relationships.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your doctor.

What prior data suggests that this online writing intervention is safe?

Research shows that expressive writing is generally easy for people to do. Studies have found that most people can handle this type of writing without major problems. For example, in a small trial, participants found expressive writing both doable and acceptable, completing it easily with few complaints.

Attachment-based writing draws inspiration from attachment-based family therapy, which aims to improve emotional connections. This therapy is commonly used and lacks serious side effects. Research on similar methods shows they are safe and effective for enhancing relationships and emotional well-being.

Overall, both expressive and attachment-based writing have been used in other settings without serious issues reported. This suggests they are safe options for participants in writing-based studies. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores innovative ways to strengthen parent-child relationships, especially when parenting sexual and gender minority youth (SGMY). Unlike traditional methods that might involve lengthy therapy sessions, this trial uses brief online writing exercises. The expressive writing intervention focuses on releasing stress through free-form writing, while the attachment-based writing approach uses prompts inspired by attachment-based family therapy to enhance emotional bonds. This online format is convenient, potentially more accessible, and allows parents to engage in self-reflection and relationship-building at their own pace.

What evidence suggests that this trial's writing interventions could be effective for improving parental acceptance of SGMY?

This trial will compare different writing interventions to improve parent-child relationships. Studies have shown that expressive writing, one approach in this trial, can enhance health by encouraging the use of more positive words and fewer negative ones. This method also correlates with feeling healthier and happier. Another approach, attachment-based writing, draws from Attachment-Based Family Therapy, which has successfully treated depression by fostering secure relationships and trust. Research indicates that these methods can reduce stress for parents and improve their relationships with their children. Both approaches aim to enhance emotional communication and acceptance, which is especially important for parents of sexual and gender minority youth. ^{1 2 6 7 8}

Who Is on the Research Team?

John E Pachankis, Ph.D.

Principal Investigator

Yale University

Lea Dougherty, Ph.D.

Principal Investigator

University of Maryland

Are You a Good Fit for This Trial?

This trial is for guardians like parents or grandparents in the Southeast U.S. who care for a sexual and gender minority youth (SGMY) aged 15-29, identify as heterosexual and cisgender, and struggle with accepting their SGMY's identity. Those with active mania, psychosis, suicidality, or unable to consent are excluded.

Inclusion Criteria

I am a guardian of a young person aged 15-29.

Parents must live in the Southeast United States (Louisiana, Mississippi, Alabama, Georgia, South Carolina, North Carolina, Tennessee, Arkansas, Kentucky, Florida)

My parents do not accept my sexual or gender identity.

Exclusion Criteria

I am unable to understand and give consent for treatment.

Individuals with active mania, psychosis, or suicidality

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Intervention

Participants engage in one of two brief online writing interventions to improve parental acceptance of SGMY

2 weeks

Online sessions

Follow-up

Participants are monitored for changes in parental acceptance and rejection, as well as other psychological measures

3 months

Assessments at Baseline, 5 Days Post-Baseline, and 3 Months Post-Baseline

What Are the Treatments Tested in This Trial?

Interventions

• Brief online writing intervention

Trial Overview The study is testing two brief online writing interventions aimed at improving acceptance of SGMY by their guardians. Participants will either receive one of these interventions or be placed in a control group without intervention.

How Is the Trial Designed?

Group I: Neutral Writing Experimental Treatment 1 Intervention

Participants in the control condition will be asked to write about what they have done since waking up that morning.

Group II: Expressive Writing Experimental Treatment 1 Intervention

Participants in the expressive writing (EW) condition will be instructed to write in a free-form manner about the most stressful aspects of being a parent of an SGMY, following standard EW procedures.

Group III: Attachment-Based Writing Experimental Treatment 1 Intervention

Participants in the attachment-based writing (ABW) condition will respond to distinct prompts created for the condition based on components of attachment-based family therapy (ABFT).

Who Is Running the Clinical Trial?

Yale University

Lead Sponsor

Trials

1,963

Recruited

3,046,000+

Vanderbilt University

Collaborator

Trials

714

Recruited

6,143,000+

Ben-Gurion University of the Negev

Collaborator

Trials

64

Recruited

2,446,000+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

University of Maryland

Collaborator

Trials

171

Recruited

325,000+

Published Research Related to This Trial

The COPING parent online program is a 10-week web-based intervention aimed at improving positive parenting strategies for parents of children aged 3-8 years, focusing on enhancing parent-child relationships through praise and rewards.

This pilot randomized controlled trial will assess the program's effectiveness using both parent reports and blind observations of parent-child interactions, with data collected at baseline and 3 months post-intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of the COPING parent online universal programme: study protocol for a pilot randomised controlled trial. Owen, DA., Griffith, N., Hutchings, J.[2018]

Parents participating in parent-child interaction therapy often have varying expectations and competing demands, but their engagement improves when the therapy is personalized to their family's needs and when they have a trusting relationship with the clinician.

By the end of the therapy, most parents feel their child's communication has improved and feel empowered, but they still have concerns about their child's future communication needs, highlighting the importance of ongoing support after the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Qualitative Evidence Synthesis of Parental Experiences and Perceptions of Parent-Child Interaction Therapy for Preschool Children With Communication Difficulties. O'Toole, C., Lyons, R., Houghton, C.[2021]

Virtual parent-coaching interventions are effective in improving disruptive behavior in children under six, with strong evidence supporting their efficacy, especially for behavioral challenges.

The review highlighted a significant gap in research on virtual attachment-based parent-coaching interventions, indicating a need for further studies in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual Delivery of Parent Coaching Interventions in Early Childhood Mental Health: A Scoping Review. Hippman, C., Mah, JWT., MacFadden, M.[2023]

This study aims to synthesize parental views on parent-child interaction therapy, which is crucial for improving communication skills in children, highlighting the importance of caregiver engagement in the intervention's success.

The research will involve a systematic review of qualitative studies, ensuring a comprehensive understanding of parents' experiences and perceptions, which will inform best practices and policies for implementing this therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Stage 1 Registered Report: The experiences and perceptions of parent-child interaction therapy for parents of young children with communication difficulties: A qualitative evidence synthesis protocol. O'Toole, C., Lyons, R., Ó'Doibhlín, D., et al.[2020]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8489519/

Attachment-Based Family Therapy: Theory, Clinical Model ... Attachment theory proposes that children who experience their caregivers as sensitive, responsive, and available develop confident expectations of relational ...

2. preventionservices.acf.hhs.gov preventionservices.acf.hhs.gov/programs/755/show

Attachment-Based Family Therapy Attachment-Based Family Therapy (ABFT) treats depression in adolescents and young adults by repairing trust with parents and promoting secure relationships.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9622506/

Attachment-Based Parenting Interventions and Evidence of ... The current paper seeks to provide an overview of the attachment-based parenting interventions that are currently available for caregivers of toddlers aged 12– ...

4. sciencedirect.com sciencedirect.com/science/article/pii/S0193397323001077

Parent-partner and parent-child attachment: Links to ... Findings suggest that a higher father- and mother-child attachment quality links to children's higher emotion regulation abilities.

5. tandfonline.com tandfonline.com/doi/full/10.1080/17525098.2020.1848345

The effectiveness of an attachment-based parenting ... Results found that the LLL programme significantly reduced parental stress, children's problematic behaviours and improved relationships between family members.

6. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0165032721006844

Attachment-based family therapy: Theory, clinical model, ... ABFT is an empirically supported treatment designed and developed specifically for repairing attachment ruptures that have damaged trust in the caregiver– ...

7. trialsjournal.biomedcentral.com trialsjournal.biomedcentral.com/articles/10.1186/s13063-024-08499-7

The effectiveness and cost-effectiveness of attachment-based ... We predict that, compared to TAU, ABFT will lead to a stronger reduction in suicidality and will be more cost-effective, over the course of all time points.

8. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/10.1111/famp.12887

Middle childhood attachment‐based family therapy: Theory ... Middle childhood ABFT (MCABFT) builds on the theory that insecure attachment develops through a learning process that can be interrupted and ...