Sound Bite-- a Therapeutic Song-writing Program

The research aims to investigate the effectiveness of the therapeutic song-writing program on young people with depressive symptoms. This study adopts a multicentre randomized control trial two arms research design. A randomised controlled trial will compare a typical 7-session therapeutic song-writing program with a waitlist-control group to determine whether the 7-session therapeutic song-writing program can produce better outcomes for young people with depressive symptoms, including improvement in depressive symptoms, self-stigma, self-esteem, sense of hope and social support at post-intervention. The 7-session therapeutic song-writing program will be delivered by trained and experienced social workers and helping professionals who are familiar with music therapy. A research staff, who does not involve in the group allocation and delivery of group intervention, conduct the intervention outcomes assessment of the participants before and after the intervention. Standardized assessment tools are used to assess the intervention outcomes. The ethical considerations of this study were reviewed and approved by the Human and Artefacts Ethics Sub-Committee of the City University of Hong Kong in 2025.

Mental health problems are very common among adolescents and youth in Hong Kong and worldwide. In Hong Kong, 24.4% of children and adolescents had at least one mental health problem in 2022. Mental health problems have negative effects on adolescents' health and academic performance, including suicide, alcohol and drug abuse, smoking, binge eating, diabetes, asthma and poor school performance. In particular, the risk of suicide among secondary school students is alarming in Hong Kong. 8.4%, 3.8% and 2.3% of secondary school students had a suicidal idea, plan or attempt in 2022, and the number of students who took their own lives in 2023 has increased by about 30% compared to the average of the past three years. Psychosocial interventions have been shown to be effective in improving the mental health of adolescents and youth. Among the different types of psychosocial interventions, therapeutic song-writing has been shown to be effective in improving depressive symptoms and social support. Therapeutic song-writing facilitates ongoing self-exploration by enabling participants to explore, question, and challenge their sense of self, personal narratives, and ways of being. Meaning-making occurs in the outcomes and process of song-writing. The therapeutic song-writing program, named Sound Bite, is a part of the "Everyone is a Hope Builder" organized by The Salvation Army of Hong Kong. As far as we know, no research study has been conducted on the effectiveness of a therapeutic song-writing program on improving the mental health of adolescents and youth in Hong Kong. Given this research gap, this research aims to explore the effectiveness of the therapeutic song-writing on young people with depressive symptoms. Research Method This research study adopts mixed methods research design, involving both quantitative and qualitative study. The quantitative study aims to investigate the effectiveness of the therapeutic song-writing program for adolescent and youth people with depressive symptoms. The qualitative study aims to examine the benefits, advantages and limitations of the therapeutic song-writing program from the users' perspective. The ethical considerations of this study were reviewed and approved by the Human and Artefacts Ethics Sub-Committee of the City University of Hong Kong in 2025. Quantitative Research Method Objective. This quantitative study aims to investigate the effectiveness of the therapeutic song-writing program for adolescents and youth with depressive symptoms. Research Design. This study is a multicentre randomised waitlist-control study. Eligible participants will be recruited from local secondary schools and Salvation Army social service centres, through open recruitment via promotional activities and referrals from these units. A total of 120 participants will be recruited over a study period of approximately 18 months. Using block randomisation, 120 eligible participants will be randomly allocated in a 1:1 ratio to an int trial.show_full_description

Inclusion Criteria: 1. aged between 13 to 24 years; 2. having mild to moderate depression and/or anxiety as assessed using a standardized assessment tool, i.e. Chinese Depression Anxiety Stress Scale-Youth (DASS-Y) with a DASS-Y Depression score between 5 and 12; 3. service users of The Salvation Army social service unit; and 4. giving informed consent to this research work. For those aged below 18, parental consent will be obtained. Exclusion Criteria: Those with severe depression (i.e. a DASS-Y Depression score ≥ 13) and/or severe anxiety (i.e. a DASS-Y Anxiety score ≥ 8) are excluded from this study.