To Increase Psychological Well-being by the Implementation of Forgiveness Education

Anxiety Clinical Trial

Official title:

Implementation of Forgiveness Education to Increase Psychological Well-being in Three Culturally Distinct Areas: Northern Ireland, Israel/Palestine, and Taiwan

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04403126
• Other study ID #: 2020-0432
• Secondary ID: EDUC/EDUC PSYCHA
• Status: Completed
• Phase: N/A
• Start date: September 3, 2021
• Est. completion date: July 31, 2022

Study information

• Verified date: August 2022
• Source: University of Wisconsin, Madison
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This project examines the development of psychological well-being in children and teachers through a 12- week forgiveness education program conducted in three conflict zones of the world, Northern Ireland, Israel/Palestine, and Taiwan.

A 12-week forgiveness education program will be investigated in elementary schools in three conflict zones of the world, Northern Ireland, Israel/Palestine, and Taiwan. The responsibilities of the sub-team in each of the three research sites will be:

• a. recruiting schools, assisting the teacher training before the forgiveness education program starts

• b. shepherding teachers, doing the fidelity checks, administering the instruments and collecting data during the forgiveness education program.

Once a school gives permission to be part of this study, the forgiveness curriculum will be implemented as a 12-week standard curriculum for the grade 5 (US equivalency) students. Teachers of the grade 5 classes will be trained to administer the program. Teachers, students and their parents must give the consent to take part in the measures of the study.

Description:

Classrooms participating in this study will be randomly assigned to either an experimental or a control group. The experimental group will receive the 1st forgiveness intervention for 12 weeks and then the control group will turn into an experimental group to receive a 2nd forgiveness intervention for 12 weeks.

In order to assess if such education increases psychological well-being in students (children) and teachers (adults), teachers and students in both groups will receive the same measures for four times in the study: within one week before the 1st forgiveness intervention, within one week after the 1st forgiveness intervention, within one week after the 2nd forgiveness intervention, four weeks after the 2nd forgiveness intervention.

The instruments include: for teachers, the assessment data will consist of the Enright Forgiveness Inventory Short Form (EFI-30), the Patient-Reported Outcomes Measurement Information System (PROMIS): Anger, Anxiety, and Depression scales, the Ethnic Prejudice Scale, the Herth Hope Index, the Rosenberg Self-Esteem Scale, a Classroom Cooperation scale, and a Cross-Cultural Exit Interview (written questionnaire). For students, the assessment data will consist of the Enright Forgiveness Inventory for Children (EFI-C), the PROMIS measures for pediatric self-report (ages 8-17): Anger, Anxiety, and Depressive Symptoms scales, the Ethnic Prejudice Scale for children, the Children's Hope Scale, the Coopersmith Self-Esteem Inventory (School Form), and academic achievement (likely to be scores/grades of Math, writing and reading in their own language). After the 2nd forgiveness intervention, select participants (teachers and children) will take part in individual interviews.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1300
• Est. completion date: July 31, 2022
• Est. primary completion date: July 31, 2022
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 10 Years to 65 Years

Eligibility

Inclusion Criteria:

• Students in 5th grade (US equivalency, aged 10-12)

• Teachers in 5th grade (US equivalency)

Exclusion Criteria:

• Students who are in grades other than 5th grade

• Teachers who are in grades other than 5th grade

Related Conditions & MeSH terms

• Anger
• Anxiety
• Depression
• Depressive Symptoms

Intervention

Other:
• forgiveness education intervention
The forgiveness education intervention primarily teaches the concept of forgiveness through stories. We chose the kind of stories that should appeal to children ages 10 through 12. Each lesson is planned according to the following procedure: story-telling/movie-watching, discussion, and in-class activities.

Locations

Country	Name	City	State
United States	University of Wisconsin-Madison	Madison	Wisconsin

Sponsors (4)

Lead Sponsor	Collaborator
University of Wisconsin, Madison	Hebrew University of Jerusalem, National Chung Cheng University, Taiwan, Stranmillis University College, Northern Ireland

Country where clinical trial is conducted

United States, 

References & Publications (12)

Akhtar S, Barlow J. Forgiveness Therapy for the Promotion of Mental Well-Being: A Systematic Review and Meta-Analysis. Trauma Violence Abuse. 2018 Jan;19(1):107-122. doi: 10.1177/1524838016637079. Epub 2016 Mar 23. — View Citation

Baxter SD, Smith AF, Litaker MS, Baglio ML, Guinn CH, Shaffer NM. Children's Social Desirability and Dietary Reports. J Nutr Educ Behav. 2004 Mar-Apr;36(2):84-9. — View Citation

Cattell RB. The Scree Test For The Number Of Factors. Multivariate Behav Res. 1966 Apr 1;1(2):245-76. doi: 10.1207/s15327906mbr0102_10. — View Citation

CRANDALL VC, CRANDALL VJ, KATKOVSKY W. A CHILDREN'S SOCIAL DESIRABILITY QUESTIONNAIRE. J Consult Psychol. 1965 Feb;29:27-36. — View Citation

CROWNE DP, MARLOWE D. A new scale of social desirability independent of psychopathology. J Consult Psychol. 1960 Aug;24:349-54. — View Citation

Enright RD, Santos MJ, Al-Mabuk R. The adolescent as forgiver. J Adolesc. 1989 Mar;12(1):95-110. — View Citation

Freedman SR, Enright RD. Forgiveness as an intervention goal with incest survivors. J Consult Clin Psychol. 1996 Oct;64(5):983-92. — View Citation

Herth K. Abbreviated instrument to measure hope: development and psychometric evaluation. J Adv Nurs. 1992 Oct;17(10):1251-9. — View Citation

HORN JL. A RATIONALE AND TEST FOR THE NUMBER OF FACTORS IN FACTOR ANALYSIS. Psychometrika. 1965 Jun;30:179-85. — View Citation

Reed GL, Enright RD. The effects of forgiveness therapy on depression, anxiety, and posttraumatic stress for women after spousal emotional abuse. J Consult Clin Psychol. 2006 Oct;74(5):920-9. — View Citation

Snyder CR, Hoza B, Pelham WE, Rapoff M, Ware L, Danovsky M, Highberger L, Rubinstein H, Stahl KJ. The development and validation of the Children's Hope Scale. J Pediatr Psychol. 1997 Jun;22(3):399-421. — View Citation

Wade NG, Hoyt WT, Kidwell JE, Worthington EL. Efficacy of psychotherapeutic interventions to promote forgiveness: a meta-analysis. J Consult Clin Psychol. 2014 Feb;82(1):154-70. doi: 10.1037/a0035268. Epub 2013 Dec 23. — View Citation

* Note: There are 12 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in forgiveness in adult (teachers) after forgiveness intervention assessed by EFI-30.	Enright Forgiveness Inventory Short Form (EFI-30), scores range from 30 to 180 with higher scores representing higher levels of forgiveness, which is a better outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Primary	Change in forgiveness in child (students) after forgiveness intervention assessed by EFI-C.	Enright Forgiveness Inventory for Children (EFI-C): scores range from 30 to 120 with higher scores representing higher levels of forgiveness, which is a better outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Primary	Change in anger in adult (teachers) after forgiveness intervention assessed by PROMIS Measures.	The Patient Reported Outcome Measurement Information System (PROMIS) Anger Short Form: scores range from 5 to 25 with higher scores representing higher levels of anger, which is a worse outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Primary	Change in anger in child (students) after forgiveness intervention assessed by PROMIS Measures.	The Patient Reported Outcome Measurement Information System (PROMIS) Measures for Pediatric (ages 8-17) Anger Short Form: scores range from 5 to 25 with higher scores representing higher levels of anger, which is a worse outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Primary	Change in anxiety in adult (teachers) after forgiveness intervention assessed by PROMIS Measures.	The Patient Reported Outcome Measurement Information System (PROMIS) Anxiety Short Form: scores range from 5 to 40 with higher scores representing higher levels of anxiety, which is a worse outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Primary	Change in anxiety in child (students) after forgiveness intervention assessed by PROMIS Measures.	The Patient Reported Outcome Measurement Information System (PROMIS) Measures for Pediatric (ages 8-17) Anxiety Short Form: scores range from 5 to 40 with higher scores representing higher levels of anxiety, which is a worse outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Primary	Change in depression in adult (teachers) after forgiveness intervention assessed by PROMIS Measures.	The Patient Reported Outcome Measurement Information System (PROMIS) Depression Short Form, scores range from 5 to 40 with higher scores representing higher levels of depression, which is a worse outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Primary	Change in depression in child (students) after forgiveness intervention assessed by PROMIS Measures.	The Patient Reported Outcome Measurement Information System (PROMIS) Measures for Pediatric (ages 8-17) Depressive Symptoms Short Form: scores range from 5 to 40 with higher scores representing higher levels of depression, which is a worse outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Primary	Change in prejudice in adult (teachers) after forgiveness intervention assessed by the Ethnic Prejudice Scales.	The Ethnic Prejudice Scale: scores range from 20 to 100 with higher scores representing higher levels of prejudice, which is a worse outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Primary	Change in prejudice in child (students) after forgiveness intervention assessed by the Ethnic Prejudice Scales.	Ethnic Prejudice Scales: wording changes in the adult form of the Ethnic Prejudice Scale will be made to bring it to the level of 5th grade students (aged 10-12). Scores range from 20 to 100 with higher scores representing higher levels of prejudice, which is a worse outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Primary	Change in hope in adult (teachers) after forgiveness intervention assessed by Herth Hope Index.	Herth Hope Index: scores range from 12 to 48 with higher scores representing more hopefulness, which is a better outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Primary	Change in hope in child (students) after forgiveness intervention assessed by Children's Hope Scale.	The Children's Hope Scale: scores range from 6 to 36with higher scores representing more hopefulness, which is a better outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Primary	Change in self-esteem in adult (teachers) after forgiveness intervention assessed by the Rosenberg Self-Esteem Scale.	The Rosenberg Self-Esteem Scale: scores range from 10 to 40 with higher scores representing higher self-esteem, which is a better outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Primary	Change in self-esteem in child (students) after forgiveness intervention assessed by the Coopersmith Self-Esteem Inventory.	Coopersmith Self-Esteem Inventory Short Form: scores range from 0 to 25 with higher scores representing higher self-esteem, which is a better outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.
Primary	Change in classroom cooperation in students after forgiveness intervention assessed by the Classroom Cooperation Scale.	The Classroom Cooperation Scale is teachers' measure of student cooperation, scores range from 10 to 40 with higher scores representing higher level of cooperation, which is a better outcome.	Baseline, up to 14 weeks, up to 31 weeks, up to 34 weeks.