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Trial registered on ANZCTR
Registration number
ACTRN12618000008224
Ethics application status
Approved
Date submitted
7/12/2017
Date registered
10/01/2018
Date last updated
4/08/2022
Date data sharing statement initially provided
11/12/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Adapting Compassion Focused Therapy for Groups with Aboriginal and Torres Strait Islander Clients
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Scientific title
A Pilot Study to Evaluate the Impact of Adapted Compassion Focused Therapy on Psychological Distress in Aboriginal and Torres Strait Islander Groups from 3 Different Services
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Secondary ID [1]
293552
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Nil known
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Universal Trial Number (UTN)
U1111-1206-2676
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Social and Emotional Wellbeing
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Psychological Distress
305778
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Condition category
Condition code
Mental Health
304994
304994
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0
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Other mental health disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention will take the form of a Compassion Focused Therapy (CFT) group based intervention to be know as “The Arts-based Compassion Skills program”, modeled on the work of Paul Gilbert, founder of CFT, Russell Kolts (author of CFT Made Simple) and the Centre for Clinical Interventions (WA) Building Self-Compassion program (modelled on CFT and the work of Kristin Neff, a leading researcher in the area). The total length of the groups will be approximately 18-24 hours. The length and frequency of each session will vary according to the group's specific needs e.g. at the Namatjira Drug and Alcohol Rehabilitation Centre, following feedback from the Learning Circle of Aboriginal staff we have found that 2 sessions/week over 3-4 weeks (up to 8x3hrs each) has worked better than 8 sessions spread over 8 weeks due to rapid turnover of clients. In other contexts (e.g. community groups), it may be that the 8 x 3 hr sessions over 8 weeks works best. Within these parameters, the length and frequency of sessions is agreed with each service, but and totals around 18-24hrs across 5-8 sessions.
Based on feedback from the Aboriginal health professionals group and the Advisory Group, we shall be making the following adaptations from standard protocols for CFT:
1. The program will be focused more broadly on self-care, not just self-compassion (e.g. engaging in self-appreciation, gratitude practices, savoring experience etc.)
2. It makes more use of art and music than standard CFT
3. It makes less use of written materials e.g. forms, writing tasks
Either Natalie Roxburgh or James Bennett-Levy (clinical psychologists) plus an Aboriginal group facilitator leads the sessions, assisted by Aboriginal health workers from the host organisations.
The key components of the program are:
1. Understanding Self-Compassion (e.g. what is it; Why is it important; Self-criticism vs. self-compassion. Why is it hard to be self-compassionate)
2. Barriers to Self-Compassion (e.g. positive beliefs about self-criticism; negative beliefs about self-compassion; kindness vs self-criticism experiment; compassion = courage)
3. Preparing for Self-Compassion (slowing down; soothing-rhythm breathing; attentional retraining; safe place imagery)
4. Compassionate Imagery via Arts Practice (giving compassion to another; creating an ideal compassionate image; building your own compassionate image, self-compassion break)
5. Self-Compassion Thinking (taking in the good, self-appreciation, savoring, gratitude,)
6. Self-Compassionate Behaviour (Taking care of ourselves - impact of the threat system e.g. avoidance, worry, procrastination, numbing through drugs/alcohol vs. engaging the caring/compassion system e.g. self-soothing activities; Taking care of others – acts of kindness, gratitude, appreciation)
7. Reviewing learning and planning for the future
The 5-8 sessions will comprise 1-7 above, with some adaptations and overlap across sessions.
The group-based interventions are conducted at either one of the three partnering organizations in the Northern Rivers region of NSW
o Namatjira Haven Drug and Alcohol Healing Centre - Alstonville
o Rekindling the Spirit - Lismore
o Bunjum Corporation - Ballina
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Intervention code [1]
299797
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Behaviour
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Intervention code [2]
299887
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Treatment: Other
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Change in Psychological Distress as measured by the The Kessler Psychological Distress Scale (K6+1)
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Assessment method [1]
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Timepoint [1]
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K6+1 Assessments will happen
1. Immediately pre-program
2. Immediately post-program
3. 2 month follow-up.
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Primary outcome [2]
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Changes in Care and Compassion as measured by the the Care and Compassion Rating scale (CCRS) - a 3 item instrument developed by the researchers to measure the key outcome variables of care and compassion
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Assessment method [2]
304161
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Timepoint [2]
304161
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1. Immediately pre-program
2. Immediately post-program
3. 2 month follow-up.
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Primary outcome [3]
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Changes in self esteem as measured by The Rosenberg Self-esteem Scale
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Assessment method [3]
304162
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Timepoint [3]
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1. Immediately pre-program
2. Immediately post-program
3. 2 month follow-up.
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Secondary outcome [1]
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Stacey Edwards was a university student who did the first qualitative interviews as part of her Masters thesis in 2017-18. Stacey interviewed 4 participants and 2 staff members in one of our sites - but not the other - in 2018.
Since early 2018, qualitative interviews have been conducted by an independent researcher (not Stacey). The semi-structured interviews are used to explore the participants’ subjective experience of CFT.
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Assessment method [1]
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Timepoint [1]
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Within 4 months of completion of the program
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Eligibility
Key inclusion criteria
Participants will be those Aboriginal clients of the three partnering organisations - Namatjira Haven Drug and Alcohol Rehab Centre, Bunjum Corporation and Rekindling the Spirit - who:
1. choose to be part of the groups
2. are referred as suitable by their services, and
3. who are assessed by the clinical psychologists/group leaders as being suitable (e.g. no serious mental illness, are suitable for group work etc.)
The groups will be be same sex groups due to the nature of the services and cultural appropriateness – Namatjira and Rekindling – all male;
Bunjum – all female or all male
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Clients will not be included if they have serious mental illness (e.g. psychosis) or are actively suicidal, or are unlikely to function well in groups.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The study is considered a pilot study and sample size was determined based on the availability of potential participants. No statistical calculations were used.
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Recruitment
Recruitment status
Suspended
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Date of first participant enrolment
Anticipated
22/01/2018
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Actual
22/01/2018
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Date of last participant enrolment
Anticipated
1/03/2023
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Actual
30/01/2018
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
35
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Accrual to date
26
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment postcode(s) [1]
18254
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2478 - Ballina
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Recruitment postcode(s) [2]
18255
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2480 - Lismore
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Recruitment postcode(s) [3]
18256
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2477 - Alstonville
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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North Coast Primary Health Network
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Address [1]
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106/108 Tamar St,
Ballina NSW 2478
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Country [1]
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Australia
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Primary sponsor type
Government body
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Name
North Coast Primary Health Network
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Address
106/108 Tamar St,
Ballina NSW 2478
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
297258
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Country [1]
297258
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299184
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AH&MRC ETHICS COMMITTEE
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Ethics committee address [1]
299184
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Level 3, 66 Wentworth Ave Surry Hills, NSW, 2010
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Ethics committee country [1]
299184
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Australia
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Date submitted for ethics approval [1]
299184
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Approval date [1]
299184
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30/08/2017
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Ethics approval number [1]
299184
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1246/17
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Ethics committee name [2]
299185
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Charles Sturt University Human Research Ethics Committee
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Ethics committee address [2]
299185
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OFFICE OF GOVERNANCE AND CORPORATE AFFAIRS GOVERNANCE SERVICES Private Mail Bag 29 Panorama Avenue Bathurst NSW 2795
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Ethics committee country [2]
299185
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Australia
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Date submitted for ethics approval [2]
299185
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Approval date [2]
299185
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15/11/2017
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Ethics approval number [2]
299185
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H17171
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Summary
Brief summary
New approaches to enhancing Aboriginal and/or Torres Strait Islander mental health are clearly needed. This study aims to development of a culturally relevant and appropriate model of mental health that addresses some of the core issues of disconnection, disrupted attachments and trauma experienced by so many Aboriginal people. We propose adapting compassion-focused therapy (CFT) so that it is culturally appropriate for Aboriginal clients; and will evaluate its effectiveness. As such, this is a pilot study. Our aims are as follows: 1. To develop an Aboriginal-adapted culturally appropriate form of CFT, based initially on feedback from an Aboriginal health professional group. It is anticipated that there will be some further modifications as necessary over the course of the project. 2. To determine if this Aboriginal-adapted form of CFT is viewed as an acceptable and promising approach by Aboriginal health professionals and Aboriginal clients. 3. To conduct a preliminary evaluation of the impact of CFT within the constraints of the timeline, the service contexts, the absence of available control groups and an acceptable evaluation design that meets AHRMC and other ethical guidelines The participants will be clients of three different services: Namatjira Drug and Alcohol Rehabilitation Centre, Bunjum Corporation and Rekindling the Spirit. Different groups will be held in each of the services for their respective clients.. The clients of Namatjira Haven are in the early stages of drug or alcohol rehabilitation and are in-patients; The clients of the other two services live in the community, and may or may not have current mental health problems. People who are assessed as having severe mental health problems (e.g. psychosis, current suicidal ideation) will not be included in the groups.
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Trial website
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Trial related presentations / publications
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Public notes
Below is a list of the questions included in the semi structured interviews to be conducted as part of the evaluation process: 1. Generally speaking, what was it like for you to be part in the group program, GARIMALEH WERLU NA (Taking Care of Yourself)? 2. What was your understanding of self-compassion prior to attending the group? • How has this change as a result of attending the program? • How did it feel to learn about a new way of relating to yourself? 3. Can you tell me if you found the program to be helpful or not? • What were the most helpful aspects of the program? And why? • What aspects of the program were most difficult? And why? 4. Did you feel safe within the program? Can you tell me what contributed to your feelings of safety/insecurity? 5. What if any changes have you experienced as a result of attending the program? • How has attending the program changed your relationship with yourself? With others? • What will you take away from your time in the program and continue to practice? 6. As an aboriginal person, can you comment on whether the program felt culturally appropriate/relevant? • Were there any aspects of the program that were culturally inappropriate/insensitive? • Were there any aspects of the program that you felt were handled particularly well? 7. Do you have any final comments about the program that you would like to share?
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Contacts
Principal investigator
Name
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Prof James Bennett-Levy
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Address
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University Centre for Rural Health
61 Uralba St,
Lismore NSW 2480
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Country
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Australia
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Phone
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+61 2 6620 7570
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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James Bennett-Levy
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Address
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University Centre for Rural Health
61 Uralba St,
Lismore NSW 2480
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Country
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Australia
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Phone
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+61 2 6620 7570
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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James Bennett-Levy
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Address
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University Centre for Rural Health
61 Uralba St,
Lismore NSW 2480
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Country
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Australia
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Phone
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+61 2 6620 7570
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Fax
79572
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Protect privacy of individuals
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
695
Ethical approval
374128-(Uploaded-11-12-2018-16-08-32)-Study-related document.pdf
696
Ethical approval
374128-(Uploaded-11-12-2018-16-09-24)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF