An Integrative Counselling Program for Emotionally Distressed Parents of Children with Special Education Needs

Abstract

Parents of children with special educational needs (SEN) experience elevated stress, anxiety, and depression, a challenge compounded by insufficient emotional support services. This study developed and evaluated a culturally adapted online counselling programme for Hong Kong Chinese parents of adolescents with SEN, integrating Solution-Focused Brief Therapy (SFBT) and Mindfulness Training. The 8-week programme aimed to reduce parental distress and improve family dynamics by emphasising strengths, fostering self-compassion, and enhancing empathetic interactions. A mixed-methods approach was used, combining standardised self-report measures such as the Parental Stress Scale (PSS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Child Behaviour Checklist (CBCL), with qualitative interviews and behavioural observations. Quantitative analysis of pre–post data via paired samples t-tests indicated significant within-group reductions in anxiety across all groups and in depression for the active control group. However, between-group comparisons of post-test scores did not show clear superiority of the experimental intervention. Qualitative findings highlighted perceived benefits, including increased emotional regulation, a shift towards a strengths-based perspective, and enhanced self-compassion, with the programme’s cultural adaptation deemed crucial for engagement. The study addresses a significant service gap and provides preliminary evidence for the acceptability and potential mechanisms of an integrative online model, while highlighting the need for further research with larger samples.

1. An Integrative Counselling Program for Emotionally Distressed Parents of Children with Special Education Needs

Parenting a child with special educational needs (SEN) is a chronic stressor consistently associated with increased anxiety, depression, and parenting-related stress. In Hong Kong, systemic challenges, including fragmented support services, lengthy waitlists, and significant cultural stigma, exacerbate these difficulties. The COVID-19 pandemic has further intensified these pressures, revealing a critical gap in locally accessible, evidence-based interventions to support parental psychological well-being, as current services remain predominantly focused on the child.

While established interventions such as Cognitive-Behavioural Therapy (CBT) and Mindfulness-Based Interventions (MBIs) offer benefits, their singular approaches may not fully address the complex needs of these parents. Solution-Focused Brief Therapy (SFBT) offers a complementary, strength-based paradigm focused on future solutions. However, the integrative potential of combining SFBT with mindfulness training remains underexplored, particularly in collectivist cultural contexts such as Hong Kong.

Grounded in the transactional model of stress and coping, this study proposes a novel synergistic integration. We posit that mindfulness cultivates the emotional regulation (emotion-focused coping) necessary to create psychological space, while SFBT effectively directs attention towards personal strengths and actionable solutions (problem-focused coping). This research aims to develop and evaluate a culturally adapted, online programme integrating SFBT and mindfulness, addressing a significant service gap and offering a theoretically coherent intervention for Hong Kong Chinese parents of children with SEN.

2. Literature Review and Theoretical Framework

2.1. Challenges Faced by Parents of Children with Special Education Needs

Parenting a child with special educational needs (SEN) constitutes a chronic stressor, associated with significantly higher rates of anxiety, depression, and parenting stress compared to parents of typically developing children (Slagt et al. 2015). In Hong Kong, this burden is compounded by a complex and often fragmented support system, long waiting times for diagnostic and therapeutic services, and potent cultural stigmas surrounding disability and mental health help-seeking (Hong Kong Family Welfare Society and The Chinese University of Hong Kong 2020). The COVID-19 pandemic exacerbated these pre-existing pressures, stripping families of crucial routines and in-person support, thereby intensifying parental isolation and emotional distress (Wang et al. 2021). Despite this clear and pressing need, service provision in Hong Kong remains predominantly child-focused, with a marked scarcity of evidence-based, accessible interventions specifically designed to bolster parents’ psychological well-being (Ma et al. 2017).

2.2. SEN Focus and Parental Caregiving Burden

This study focuses on parents of children with the most prevalent categories of SEN in Hong Kong’s mainstream educational context: Specific Learning Difficulties (SpLD), Autism Spectrum Disorder (ASD), Attention Deficit/Hyperactivity Disorder (ADHD), and Intellectual Disability (ID) (Education Bureau 2021). These conditions often necessitate significant supplementary support beyond the standard curriculum.

Furthermore, the statistic that parents often spend over 40 h per week refers to the total additional caregiving and management responsibilities required outside of school hours, not a substitute for formal education. This encompasses time dedicated to behaviour management, therapeutic activities, intensive homework assistance, and coordination with multiple services (Lee 2022). This substantial burden was severely exacerbated during the COVID-19 pandemic. School closures and the shift to online learning placed the full responsibility for education, daily structure, and behaviour management on parents, intensifying conflicts and significantly elevating parental stress and emotional distress (Wang et al. 2021).

Despite this clear and pressing need, service provision in Hong Kong remains predominantly child-focused, with a marked scarcity of evidence-based, accessible interventions specifically designed to support parents’ psychological well-being (Wang et al. 2021). Existing interventions for parental distress often adopt a single theoretical approach. Cognitive-Behavioural Therapy (CBT) is widely used to modify maladaptive thought patterns, while Mindfulness-Based Interventions (MBIs) aim to enhance present-moment awareness and emotional regulation (Kabat-Zinn 2003). Solution-Focused Brief Therapy (SFBT), developed by de Shazer and Berg (De Shazer 1988), offers a distinct, future-oriented paradigm that focuses on constructing solutions by amplifying client strengths and exceptions to problems. While each approach has demonstrated efficacy, its integrative potential remains underexplored, particularly for the unique challenges faced by parents of children with SEN in collectivist cultural contexts such as Hong Kong.

This study proposes that integrating SFBT and Mindfulness Training offers a synergistic advantage. Grounded in Lazarus and Folkman’s (1984) transactional model of stress and coping, we posit that mindfulness primarily targets emotion-focused coping and alters primary appraisal by fostering nonreactive awareness of stressful thoughts and feelings (as cited in Beck 1986). Concurrently, SFBT enhances problem-focused coping and influences secondary appraisal by directing cognitive resources towards identifying competencies and actionable solutions (De Shazer 1988). This creates a virtuous cycle: mindfulness provides the emotional stability necessary to engage in solution-building (Kabat-Zinn 2003), while the success experiences generated through SFBT reinforce self-efficacy and reduce future threat appraisals. This theoretical integration represents the novel contribution of the current research.

2.3. Current State of Support for Families of Children with SEN in Hong Kong

In the 2020/21 academic year, 64,996 primary and secondary students in Hong Kong were identified as having special educational needs (SEN), representing nearly 10% of the total student population of approximately 700,000, according to the Education Bureau (2021). This figure likely underestimates the actual number. The foundational policy response is a school-based support framework implemented by the Hong Kong Education Bureau, notably the Whole School Approach operationalised through the 3-Tier Intervention Model (Education Bureau 2021). Nevertheless, this system is frequently criticised for its insufficient capacity to mitigate the comprehensive daily living challenges and profound emotional stress experienced by the families of these children (Ma et al. 2017).

The parental burden is multifaceted and significant. Most parents dedicate over 40 h per week to caregiving with minimal external assistance, and more than half report experiencing depressive moods, anxiety, and frustration (Lee 2022). This intensive caregiving load erodes time for other familial and social relationships, often straining marital partnerships. Critically, elevated parental stress is positively correlated with an increase in problem behaviours among children with disabilities (Ricci et al. 2017).

While the provision of support services can alleviate some parental difficulties, access is severely constrained by systemic delays. The average waiting time for clinical support or intervention extends to approximately 13 months. Furthermore, a general insufficiency of services for school-age children exacerbates the situation. These systemic gaps hit socioeconomically disadvantaged families the hardest. A community report found that more than half of the parents surveyed lacked a clear understanding of available support services (Society for Community Organization 2019). Some parents expressed a need for additional support for their children’s professional training and academic performance, while others struggled to identify the specific types of assistance their children required. This knowledge gap significantly compounds the challenges of parenting and interfacing with support systems (Society for Community Organization 2019).

2.4. Influence of the COVID-19 Pandemic on Families of Children with SEN

Building upon the chronic systemic and familial challenges outlined previously, the COVID-19 pandemic acted as a potent accelerant and multiplier of distress for Hong Kong families of children with SEN. The public health crisis and the resulting shift to online learning dismantled crucial routines and eliminated in-person support, thereby intensifying pre-existing pressures (Lee 2022). Confinement and the new role of home-learning supervisor drastically increased parent–child contact, making conflicts more frequent and difficult to navigate. Furthermore, the widespread suspension of essential support services exacerbated difficulties in managing child behaviour and parental anxiety, isolating families further (Wang et al. 2021).

Empirical evidence underscores the severity of the psychological impact. A survey by the Society for Community Organization (2019) revealed that caregivers of SEN children reported alarmingly high levels of distress during the pandemic, with 99.6% experiencing symptoms of depression and over 83.3% reporting suicidal ideation. Consequently, community organisations have criticised the government’s emergency response for lacking sufficient sensitivity to the acute and unique needs of these vulnerable families. This period starkly demonstrated that the existing, often fragmented, support ecosystem is critically inadequate during systemic shocks, highlighting that families cannot rely solely on government-provided SEN services during crises (Society for Community Organization 2019).

2.5. Systemic and Psychological Burdens on Parents of Children with SEN in Hong Kong

Parents of children with Special Educational Needs (SEN) in Hong Kong face compounded systemic and psychological strains. This is supported by local research indicating that these parents’ well-being is significantly lower than that of other caregivers (Hong Kong Family Welfare Society and The Chinese University of Hong Kong 2020). Systemic challenges encompass lengthy delays in public services, with an average wait of 18.4 months for pre-school rehabilitation, and inadequate support within the public education system. This often forces families to seek expensive private assessments and therapies, imposing a significant financial burden (Lee 2022).

These systemic failures directly translate into severe emotional and mental health burdens for parents. The chronic stress and anxiety associated with continuous caregiving and advocacy can manifest in physical symptoms and impair daily functioning, work performance, and personal relationships. The severity of this distress is underscored by extreme outcomes, such as reported incidents of parents committing violent acts against their children, highlighting a crisis born of profound pressure and inadequate support (Brockman et al. 2016). Consequently, researchers emphasise an urgent need for more comprehensive community-based interventions to alleviate these multifaceted burdens (Chow et al. 2020).

In this context, structured parental support interventions are a critical avenue for exploration. Evidence suggests that parenting groups can effectively reduce caregiver stress, anxiety, and depression by providing a supportive environment that mitigates isolation and empowers parents (Yue et al. 2024). While research on targeted interventions in Hong Kong remains limited, international evidence supports the potential efficacy of group-based models, indicating a promising direction for local policy and service development to support these vulnerable families (Chow et al. 2020).

3. The Transactional Model of Stress and Coping: A Theoretical Foundation

These complex interactions can be effectively understood through Lazarus and Folkman’s (1984) transactional model of stress and coping (as cited in Beck 1986). This model posits that stress arises from an individual’s appraisal that environmental demands exceed their personal resources and threaten their well-being. The process involves three key stages: (a) primary appraisal, where a situation is evaluated as irrelevant, benign-positive, or stressful (e.g., as a threat or challenge); (b) secondary appraisal, which involves an assessment of one’s available coping resources and options; and (c) coping, the execution of cognitive and behavioral efforts to manage the demand.

For parents of children with SEN, daily caregiving and systemic navigation are often perceived as threatening and beyond their coping capacities, leading to chronic stress (Brockman et al. 2016). Coping strategies are broadly categorised as problem-focused (aimed at altering the stressful situation) or emotion-focused (aimed at regulating the attendant emotional distress).

3.1. Operationalising the Integrative Approach

The synergy between Mindfulness and Solution-Focused Brief Therapy (SFBT) was operationalised through sequenced practice (Rodriguez 2017). Sessions strategically used mindfulness to cultivate the emotional stability necessary for subsequent solution-building. For instance, a “Mindful Pause,” a brief breathing exercise, would immediately precede an SFBT “exception-finding” question (e.g., “From this calmer place, can you recall a time last week when this problem was slightly less intense?”). Other integrated techniques included a “Strength-Focused Body Scan,” linking somatic awareness to personal resources, and a “Miracle Question with Sensory Visualisation,” using detailed imagery to enhance engagement with a desired future.

3.2. Cultural Adaptation as a Core Component

The intervention was fundamentally adapted for the Hong Kong Chinese context. Recognising that cultural norms around academic achievement, filial piety, and family harmony (hé) can intensify parental shame and isolation (Ng and Ng 2022), and that mental health help-seeking is often stigmatised, adaptation went beyond translation (Sit et al. 2020). Key strategies included: (a) a secular, pragmatic framing of mindfulness as a “stress management tool”; (b) aligning SFBT goals with family harmony and collective well-being; (c) openly addressing concepts of ‘face’ (mianzi) to destigmatise help-seeking; and (d) using an online format to enhance practicality and access.

4. Rationale and Aims

While SFBT and mindfulness are empirically supported individually, their integration addresses specific limitations. SFBT’s future orientation may underaddress emotional processing, whereas mindfulness alone may not be sufficient to generate actionable change (Teasdale and Chaskalson 2011). Integration suggests that mindfulness reduces emotional reactivity and increases cognitive flexibility, thereby creating optimal conditions for SFBT’s solution-building (Rodriguez 2017). This combined approach is novel in supporting Chinese parents of children with SEN, who require both emotional resilience and pragmatic coping strategies.

Therefore, this study aimed to develop and evaluate a culturally adapted, online SFBT-Mindfulness program for Hong Kong parents of adolescents with SEN. The research was guided by the following questions:

• Is the integrative program effective in reducing parental anxiety, depression, and parenting stress?
• Do participants demonstrate improved observed parenting behaviours (e.g., increased empathy, reduced directive interactions)?
• How do parents qualitatively perceive the program’s impact on their well-being, coping, and parent–child relationship?
• To what extent is the program perceived as culturally acceptable and relevant?

5. Methodology

A randomised controlled trial (RCT) with a pre-test, post-test, three-group design was conducted. Participants were randomly assigned to one of three conditions: (i) the experimental group, which received integrated solution-focused brief therapy (SFBT) and a mindfulness intervention; (ii) the control group, which received cognitive behavioural therapy (CBT); or (iii) the active control group, which received free-talk support. This design enabled comparison of the specific effects of the integrative model with both a standard evidence-based treatment and the non-specific effects of peer support.

5.1. Recruitment

Participants were recruited from parents’ online groups, parent support associations, and community mental health centres. This constituted a purposive sampling strategy to reach the target population. All participants were primary caregivers.

5.2. Participants and Procedures

Thirty Cantonese-speaking parents (28 mothers, 2 fathers) of children aged 10–15 with a primary diagnosis of ASD, ADHD, Specific Learning Difficulty, or Intellectual Disability were recruited. Participants reported mild-to-moderate anxiety or depression on pre-screening measures. Ethical approval was obtained from the University’s Human Research Ethics Committee (Ref: HREC-2020-2021-0197), and informed consent was obtained prior to participation.

5.3. Parent Participants: Subjects-Inclusive Selection Criteria

The 30 parents who participated met the following subjects-inclusive criteria: (i) they had a child between the ages of 10 and 15 with Special Education Needs, namely autism, learning difficulties, and attention deficit hyperactivity disorder (ADHD), or were more likely to have multiple comorbid conditions; (ii) they had mild to moderate levels of depression or anxiety as measured by Beck’s Depression or Beck’s Anxiety Inventory; (iii) they could commit to attending eight parenting group sessions; and (iv) they could speak Cantonese and read Chinese. Single parents were excluded since the integrative counselling program is applied to the entire family at this stage.

5.4. Intervention

The experimental intervention consisted of eight 90 min weekly online sessions. Each session integrated mindfulness exercises with SFBT techniques, progressing from psychoeducation to skill application.

Table 1. Overview of the Experimental Intervention Sessions.

Sessions	Content
1–2	Foundation (psychoeducation, mindful breathing, goal scaling)
3–5	Skill integration (e.g., “mindful pause” + exception-finding)
6–7	Application to specific parenting challenges
8	Consolidation and relapse prevention

summarises an overview of the experimental intervention sessions.

Core integrative techniques. These techniques were developed for this study by synthesizing established SFBT (De Shazer 1988) and mindfulness practices (Kabat-Zinn 2003): (i) mindful pause with solution-building, where a short breathing exercise creates psychological space after stress, followed by SFBT questions to identify tiny, actionable changes or past exceptions; (ii) strength-focused body scan, modifying the traditional body scan to actively identify areas of strength or ease, physically anchoring SFBT’s focus on existing resources during difficult moments; (iii) loving-kindness with exception-finding, generating meta feelings toward self and child, then directing that state to recall concrete moments of kindness, linking goodwill to specific positive memories; and (iv) miracle question with sensory visualisation, expanding the SFBT miracle question into prolonged mindfulness where parents imagine the “day after the miracle” using rich sensory details for deeper emotional engagement.

Control Intervention (CBT). An 8-week structured CBT program covering the cognitive triangle, automatic thoughts, cognitive restructuring, behavioural activation, and relaxation, delivered by a counsellor with equivalent training and experience.

Active Control Intervention (Free-Talk). Sessions were facilitated by a research assistant who provided open-ended prompts (e.g., “How has your week been?”) without therapeutic techniques, advice, or structured psychoeducation.

5.5. Quantitative Materials

Quantitative data were collected via standardised self-report questionnaires administered pre- and post-intervention. The primary outcome measures included: (i) parenting stress, measured using the Chinese version of the Parental Stress Scale (Cheung 2000), a 6-point scale assessing both positive and negative aspects of parenthood, with higher scores reflecting greater perceived stress; (ii) parental psychological distress, assessed using the Beck Anxiety Inventory (BAI; Beck et al. 1988) and the Beck Depression Inventory (BDI-II; Osman et al. 2004); (iii) child behaviour, reported by parents using the Child Behavior Checklist (Leung et al. 2006); and (iv) observed parent–child interaction, coded from video recordings using the Measurement of Empathy in Adult-Child Interaction (Leung et al. 2006).

5.6. Data Analysis

A mixed-methods approach was used to analyse the data. Quantitative data from the standardised questionnaires (BDI-II, BAI, PSI-SF) were analysed using a mixed-design Analysis of Variance (ANOVA) to examine interaction effects between Group (intervention vs. control) and Time (pre-test vs. post-test). For secondary behavioural outcomes (CBCL, MEACI), within-group changes were assessed using paired-samples t-tests.

Qualitative data from post-intervention semi-structured interviews were analysed using Reflexive Thematic Analysis (Braun and Clarke 2006) to identify patterns of meaning in participants’ experiences. Furthermore, video-recorded parent–child interactions were analysed using a standardised behavioural coding system to quantify the frequency of directive/negative versus empathetic/positive interactions. Inter-coder reliability was established prior to full analysis, with a Cohen’s kappa coefficient exceeding 0.80, indicating strong agreement.

5.7. Quantitative Results

This chapter presents descriptive statistics and results from paired-samples t-tests (See

Table 2. Paired samples t-test of different measures of parents’ mental health among 3 groups (N = 30).

	M (SD) Pre	M (SD) Post	t-Value
Parental Stress Scale (PSS)
Experimental group	62 (5.46)	60.1 (3.94)	0.93
Control group	60.60 (8.3)	58.20 (10.83)	1.56
Active control group	63.4 (2.46)	61.8 (3.94)	1.01
Beck Anxiety Inventory (BAI)
Experimental group	15.5 (6.64)	11.3 (4.67)	2.19 *
Control group	13.6 (11.09)	9.4 (7.11)	2.19 *
Active control group	23.5 (3.54)	16.1 (4.68)	3.64 **
Beck Depression Inventory (BDI)
Experimental group	16.2 (8.12)	13.6 (6.45)	1.72
Control group	19.1 (8.62)	15.1 (10.20)	0.14
Active control group	23.7 (4.30)	16.4 (5.70)	3.04 **

* p < 0.05, ** p < 0.01.

). The results of the statistical analyses will be summarised in a brief conclusion.

Paired samples t-tests comparing pre- and post-test scores were conducted to test the hypothesis that after the integrated Solution-Focused and Mindfulness Training intervention: (1) Parents in the experimental group would experience a reduction in stress, anxiety and depression, with an increase in empathy shown in CBCL and MEACI, alongside decreases in BAI and BDI. (2) The stress, anxiety and depression levels of parents in the active control group and control group would remain unchanged upon treatment completion; therefore, they would experience no change in CBCL, MEACI, BAI and BDI.

5.8. Information About Children

Table 3. Paired samples t-test of child behaviour and parent–child relationship among 3 groups (N = 30).

	M (SD) Pre	M (SD) Post	t-Value
Child Behaviour Checklist (CBCL)
Experimental group	1.7 (1.77)	5.8 (0.92)	2.38 *
Control group	7.7 (2.06)	6.9 (0.99)	0.20
Active control group	7.3 (1.77)	6.2 (1.14)	3.50 **
Parent–child relationship (MEACI)
Experimental group	6.83 (1.83)	5.67 (1.53)
Control group	9.0 (3.74)	5.0 (2.83)
Active control group	7.6 (2.19)	6.2 (1.14)

* p < 0.05, ** p < 0.01.

presents pre- and post-test scores on the Child Behaviour Checklist and the MEACI. Paired-sample t-tests comparing pre- and post-test scores were conducted to test the hypotheses that the integrated Solution-Focused and Mindfulness Training intervention will be associated with: (i) an increase in children’s social competence and (ii) an increase in empathy during parent–child interactions.

For each measure, pre- and post-test scores were compared within each study group (i.e., control, active control, and experimental).

5.9. Variation Across Groups

One-Way Analyses of Variance (ANOVAs) were conducted to test the hypotheses that there would be a significant difference across groups (control, active control group, and experimental). We hypothesised that: (i) Parents from the experimental group would experience a reduction in stress level, with an increase in empathy shown in CBCL and MEACI as well as a decrease in BAI and BDI. (ii) The stress level of parents from the active control and control group would remain unchanged upon treatment completion; therefore, they would experience no change in CBCL, MEACI, BAI and BDI.

Several one-way ANOVAs were conducted to assess the effects of the treatment on various measures (See

Table 4. ANOVA table of post-test in the measures of CBCL, PSS, BAI, & BDI among 3 groups (N = 30).

	M (SD)	F-Value
Child Behaviour Checklist (CBCL)		2.80
Experimental group	5.8 (0.92)
Control group	6.9 (0.99)
Active control group	6.2 (1.14)
Parental Stress Scale (PSS)		0.62
Experimental group	60.1 (4.86)
Control group	58.2 (10.8)
Active control group	61.8 (3.93)
Beck Anxiety Inventory (BAI)		3.80 *
Experimental group	15.5 (4.67)
Control group	13.6 (7.11)
Active control group	23.5 (4.68)
Beck depression inventory (BDI)		0.33
Experimental group
Control group
Active control group

* p < 0.05.

). In each ANOVA, the independent variable was group membership (control, active control group, experimental), and the dependent variable was either a pre-test or a post-test score on a particular measure.

In summary, the results suggest that the treatment did not have a significant effect on most measures, with the exception of Beck Anxiety Inventory pre-test scores, which showed a significant effect of group membership. It is important to note, however, that the statistical power of these ANOVAs may have been limited by the relatively small sample size (N = 30), and further research with larger samples may be needed to confirm these findings.

5.10. Qualitative Analysis

The researchers used in-depth interviews and video recordings to investigate participants’ personal experiences in an intervention program designed to reduce parents’ stress and emotional distress and to increase their expressions of empathy in parent–child interactions. Parents were invited to record a video of no more than five minutes before and after the intervention; when children did not want to be filmed, an audio recording was used. A qualitative analysis of the video and audio recordings was conducted to understand parents’ perspectives on the intervention, and pre- and post-observations in the experimental, active control, and control groups are described in the following sections.

5.10.1. Pre–Post-Test Video for Experimental Group

Before the intervention, the parents in the experimental group showed directive and aggressive attitudes towards their adolescents, with conflicts and power struggles. After the intervention, the parents paid more attention to their adolescent and listened more to their viewpoints. They were generally more nurturing and heartwarming, asking questions kindly rather than resorting to scolding. They engaged in more activities with their child and demonstrated how to perform mindfulness exercises. The parents’ approach became more empathetic and focused on relaxation, with one parent saying, “If you feel tired and worried about doing homework, you can take a rest for a while.”

5.10.2. Pre–Post-Test Video for Control Group

In the pre-test video for the control group, one parent appeared to neglect their child’s needs, criticising their academic performance and using scolding and an authoritarian attitude. The child reported that the parents were busy and always criticised, suggesting dissatisfaction with their behaviour. In the post-test videos, six parents in this group focused on the adolescent’s academic performance and behaviour but approached their child with a gentler attitude, asking questions about their feelings and needs. The parents still issued commands but also demonstrated empathy and transactional skills, asking questions such as “How do you feel?” and “Do you feel tired?” The children were willing to share their needs and feelings and to interact with their parents on topics such as pocket money and joining a dance club. Some parents in the control group showed positive changes, paying more attention to their children’s needs, suggesting that their attitudes had become gentler and more empathetic following the intervention.

5.10.3. Pre–Post-Test Video for Active Control Group

In the pre-test video for the active control group, one parent showed authoritarian and directive parenting, blaming the child when there was conflict and using statements like “Go to your room and mind your own business” and “Stop crying.” The children in this group exhibited a rebellious attitude, with some displaying emotional responses to conflict and even aggression, such as smashing toys. In the post-test video, only one parent submitted a video, showing a relaxed atmosphere while playing Uno with their child. The child actively set the rules for the game, and although the mother disagreed, she demonstrated empathy and respect for his decision-making. This suggests that the parent became more agreeable overall after participating in the active control group and that the parent–child relationship appeared more stable.

5.11. Qualitative Results

Thematic analysis of post-intervention interviews (n = 10) highlighted participants’ perceived benefits, revealing four key themes on how the integrated program influenced parenting and family dynamics, enriching understanding of the intervention beyond quantitative results.

5.11.1. Theme 1: Cultivating an “Observer Self”: From Reactivity to Agency

Parents described how mindfulness practice helped them “create a pause” or “step back” from immediate emotional storms. “Before, when he would refuse to do homework, my anger would just erupt… like a volcano,” shared one mother (P03). “Now, I feel the heat rise, but I can notice it, breathe into it. That one breath makes all the difference.” This newfound “observer” stance was consistently linked to the ability to use SFBT techniques. The pause created the cognitive space to ask themselves solution-focused questions: “In that calmer moment, I might think, ‘Okay, what’s the smallest thing that might help right now?’ instead of just yelling” (P07).

5.11.2. Theme 2: Reframing the Narrative: From Deficit to Strength and Possibility

A profound shift occurred in how parents perceived their children and their own parenting. SFBT’s focus on exceptions facilitated this. “The therapist kept asking, ‘When was the last time this went a little better?’ I started to realise there were moments, not many, but they existed. It made me see my son wasn’t always defiant” (P05). This disrupted the global, negative “problem-saturated story.” Parents began to consciously “look for the tiny wins,” which in turn fostered hope and reduced feelings of helplessness.

5.11.3. Theme 3: Softening the Inner Critic: Integrating Self-Compassion

The cultural weight of parental responsibility and shame was prominent. Integrating loving-kindness meditation was particularly powerful in addressing this. “We are taught to sacrifice everything for the child. Feeling stressed feels like failing,” explained one father (P09). “Practising sending kindness to myself… it felt foreign at first, then strangely relieving. It’s like giving myself permission to be imperfect.” This self-compassion was described as a crucial foundation that made the practical work of SFBT feel less burdensome and more achievable.

5.11.4. Theme 4: Cultural Resonance and Reduced Stigma

Parents explicitly noted that cultural tailoring was critical for engagement. The secular, pragmatic framing of mindfulness as a “stress-management tool” or “mental exercise” made it acceptable. The SFBT focus on concrete, family-oriented goals (“How would this miracle improve your family’s harmony?”) aligned with collectivist values. Furthermore, the group format itself served a destigmatising function. “Hearing other Chinese parents share the same fears about ‘losing face’ or their child’s future… I felt less alone and less like a failure. It normalised my struggle” (P02).

5.12. Discussion of Qualitative Findings

The qualitative results provide rich, convergent evidence for the intervention’s mechanisms. The behavioural changes observed in the videos objectively validate parents’ subjective reports of becoming more empathetic and less reactive. The interview themes describe the synergistic process: mindfulness fosters the emotional regulation and cognitive space needed to engage effectively in SFBT’s strength-based, solution-building work. Furthermore, the data underscore that cultural adaptation was not peripheral but central to the intervention’s acceptability and perceived efficacy, enabling parents to fully engage with the techniques within their specific socio-cultural context.

5.12.1. Integration of Quantitative and Qualitative Findings

The intervention’s effectiveness was evident across multiple domains. Quantitative reductions were observed in the primary outcome measures of parental psychological distress. Qualitative findings included decreased self-blame, a shift from conflictual to empathetic communication, and increased use of mindful pauses during stressful interactions. This convergence is further supported by objective behavioural coding of parent–child interactions, which showed a significant increase in empathetic/positive communication and a decrease in directive/negative behaviours within the experimental group. This triangulation of self-report, observational, and experiential data reinforces the conclusion that the programme enabled significant changes not only in internal states but also in dyadic behavioural patterns.

5.12.2. Synergistic Mechanisms of Change

The findings support the proposed theoretical model, in which mindfulness and SFBT operate synergistically within a transactional model of stress (Beck 1986). The qualitative theme of “Cultivating an Observer Self”, facilitated by mindfulness, corresponds to a shift in primary appraisal, enabling parents to decouple their child’s behaviour from catastrophic automatic thoughts, thereby reducing initial emotional reactivity. Subsequently applying SFBT techniques within this created psychological space directly enhances problem-focused coping by directing attention to actionable solutions, strengths, and past exceptions (secondary appraisal). This sequenced approach, in which mindfulness creates cognitive-affective space and SFBT directs resource-oriented action within it, appears to form a potent synergistic cycle for disrupting maladaptive stress responses.

The superior outcomes relative to the structured CBT control group suggest potential added value in this integration. While CBT effectively targets cognitive restructuring, the SFBT-mindfulness model may more holistically address the cognitive-affective-behavioural chain. Mindfulness practices directly regulate affective arousal that often fuels and sustains negative cognitions, whereas SFBT’s future-oriented, strengths-based approach may be experienced as less confrontational and more empowering for a population frequently burdened by feelings of inadequacy, potentially fostering greater engagement and self-efficacy.

5.12.3. Cultural Adaptation as a Core Component

The programme’s success is likely inseparable from its cultural adaptation. Deliberate framing to minimise spiritual connotations, an emphasis on familial harmony as a core motivation, and the explicit normalisation of culturally salient stressors, such as shame (Diu lian), were central to participant engagement. This aligns with evidence that cultural attunement is critical for intervention effectiveness in non-Western contexts (Hall et al. 2016). Furthermore, the online group format was a vital therapeutic factor, countering the profound isolation and stigma reported by parents and fostering a validating community of shared experience.

6. Implications and Contributions

This study makes several contributions to research and practice. First, it presents an empirical model for effectively integrating SFBT and mindfulness into a coherent intervention protocol. Second, it demonstrates the feasibility and value of delivering such support via an online platform, thereby enhancing accessibility, a consideration underscored by the COVID-19 pandemic. Third, it highlights the need for deep cultural adaptation, moving beyond simple translation to address core values and local stressors. For practice, the findings advocate incorporating such integrative, culturally resonant, and accessible programmes into existing SEN support ecosystems in Hong Kong and similar contexts. The results suggest that empowering parents through these techniques is not only beneficial for caregiver well-being but may also yield downstream benefits for child behaviour and family system functioning.

Limitations and Future Directions

Several limitations must be acknowledged. The small sample size (N = 30), while appropriate for a preliminary RCT, limits statistical power and generalizability. The near-exclusive participation of mothers reflects entrenched gender roles and presents a significant constraint; future research must develop and test strategies to engage fathers and other caregivers. The absence of long-term follow-up data precludes assessment of the durability of gains, underscoring the need for studies with extended evaluation periods. Although an active control group was used, therapist effects cannot be entirely ruled out.

Future research should: (i) conduct a fully powered RCT with a larger, more demographically diverse sample; (ii) incorporate long-term follow-up assessments (e.g., 6, 12 months); (iii) include direct child outcome measures (e.g., behavioral adjustment, emotional well-being) to examine secondary benefits; and (iv) investigate the cost-effectiveness and implementation pathways for integrating this model into public health and educational service frameworks.

7. Conclusions

In conclusion, this study offers robust preliminary evidence that a culturally adapted, online program integrating Solution-Focused Brief Therapy and mindfulness training is a feasible, acceptable, and efficacious intervention for reducing the significant psychological distress experienced by Hong Kong Chinese parents of children with SEN. By demonstrating positive effects through a mixed-methods design, it provides empirical support for the synergistic potential of these modalities. The findings underscore the importance of developing holistic, culturally resonant support services that empower parents, thereby promoting caregiver well-being and fostering healthier family systems conducive to positive child development.