Mental Health Clinical Trial
Official title:
Promoting Mental Well-being for Secondary School Students Through an Experiential Learning Activity
Mental health problems in adolescents are a global problem and are becoming more prevalent in
Hong Kong. Indeed, the rising incidence of emotional disturbances, adjustment and eating
problems, depression, and suicidal tendencies have become major public health concerns.
Over the past few decades, Hong Kong has experienced a significant change in family
structure, with an increase in small nuclear. Therefore, children may be overprotected by
parents and become more fragile and less resilient to psychological distress, in the
meantime, parents' high expectations for children's academic increase the pressure on the
teenagers.
As resilience can promote better mental well-being with reduced anxiety and depressive
symptoms, It is crucial for healthcare professionals to collaborate with youth centers in the
community to build effective health promotion programs in schools that can enhance the
resilience of adolescents and foster the development of their coping mechanisms and positive
mental well-being so that adolescents can better combat mental health problems and lead
healthier lives.
Adventure-based training rests on a theory of experiential learning, which involves a
four-step model of concrete experience, reflective observation, abstract conceptualisation,
and active experimentation. In adventure-based training, participants are required to join
the activities which are psychologically and physically demanding. They may experience
frustration and anxiety in the earlier stages, but this is potentially therapeutic as it can
facilitate the process of concrete experience by encouraging them to accept an innovative
approach in dealing with challenges. During the adventure process, the emphasis is placed on
changing the dysfunctional and negative actions of team members into functional and positive
actions, and on the interaction between team members in accomplishing different challenging
tasks. Participants experience difficulties and look for possibilities, and with the proper
guidance, facilitation and intervention of instructors the objectives of the training are
achieved. Successful experience of this kind can facilitate the personal development and
enhance the resilience and self-esteem of participants.
Mental health problems in adolescents are a global problem and are becoming more prevalent in
Hong Kong. Indeed, the rising incidence of emotional disturbances, adjustment and eating
problems, depression, and suicidal tendencies have become major public health concerns.
Over the past few decades, Hong Kong has experienced a significant change in family
structure, with small nuclear families gradually replacing extended families. Therefore,
children receive more attention and may be overprotected by parents as a result of having
fewer, if any, siblings. It is possible that this explains why children are more fragile,
more vulnerable, and less resilient to psychological distress than were previous generations.
Moreover, parents' high expectations for high academic achievement may also contribute to
increased mental health problems among adolescents in Hong Kong. Most parents in Hong Kong
believe that better careers and brighter futures are the inevitable results of higher
academic achievement. Given this context, Hong Kong Chinese adolescents are exposed to
considerable pressure within their families and schools while growing up.
Evidence suggests that depressive symptoms predict suicidal tendencies among children and
adolescents. Although suicide rates in Hong Kong have dropped significantly from 18.8 per
100,000 in 2003 to 11.7 per 100,000 in 2016, a trend to increases in youth suicides in the
past few years remains a concern. On the other hand, there is some evidence that resilience
effectively prevents the development of mental health problems and is associated with
positive mental health outcomes in adolescents, such as reduced levels of anxiety and
depression [6]. It is therefore crucial for healthcare professionals to collaborate with
youth centers in the community to build effective health promotion programs in schools that
can enhance the resilience of adolescents and foster the development of their coping
mechanisms and positive mental well-being so that adolescents can better combat mental health
problems and lead healthier lives.
We conducted a 'proof-of-principle' randomised controlled trial on the effectiveness of
experiential learning activity (adventure-based training programme) in promoting the
psychological well-being of primary schoolchildren. This study provides some evidence that
the adventure-based training programme is effective in enhancing self-esteem and reducing
depressive symptoms among schoolchildren. Moreover, the study demonstrated the feasibility of
implementing an adventure-based training programme in the Hong Kong Chinese context, with
their content and nature shown to be acceptable to children and their parents.
Adventure-based training rests on a theory of experiential learning, which involves a
four-step model of concrete experience, reflective observation, abstract conceptualisation,
and active experimentation. It aims at changing cognitive thinking and behaviour, on
different levels, through experience and practice in an outdoor environment. At the
adventure-based training camp, participants would have a 'concrete experience' by having some
physical activities. Trainers would observe and note down the important moments for further
discussion and could recap the experiences that participants had had in the activity
(reflective observation). While recapping the experience, trainers could assist the
participants to sum up their experience and help them to discuss what they could do to make
the experience better (abstract conceptualisation). With consolidation, the trainer would
then encourage participants to think of similar situations that they might face in their
daily lives and how they could apply the lessons learnt in this experience into others
(active experimentation).
In adventure-based training, participants are required to join in different activities which
are psychologically and physically demanding. They may experience frustration and anxiety in
the earlier stages, but this is potentially therapeutic as it can facilitate the process of
concrete experience by encouraging them to accept an innovative approach in dealing with
challenges. During the adventure process, the emphasis is placed on changing the
dysfunctional and negative actions of team members into functional and positive actions, and
on the interaction between team members in accomplishing different challenging tasks.
Participants experience difficulties and look for possibilities, and with the proper
guidance, facilitation and intervention of instructors the objectives of the training are
achieved. Successful experience of this kind can facilitate the personal development and
enhance the resilience and self-esteem of participants.
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