Trial Review

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Trial registered on ANZCTR


Registration number
ACTRN12625000642482
Ethics application status
Approved
Date submitted
16/05/2025
Date registered
17/06/2025
Date last updated
17/06/2025
Date data sharing statement initially provided
17/06/2025
Type of registration
Retrospectively registered

Titles & IDs
Public title
Mindfulness Based Art Therapy Doodling Intervention for Teacher Stress
Scientific title
Mindfulness Based Art Therapy Doodling Intervention for Teacher Stress
Secondary ID [1] 314585 0
Nil known
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Stress 337501 0
Condition category
Condition code
Mental Health 333868 333868 0 0
Other mental health disorders

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
The Mindfulness Doodling Intervention is a 2-hour online workshop delivered via Zoom, designed to support self-awareness, self-compassion, and burnout prevention through mindful creative expression. The session is facilitated by a highly experienced and credentialed art therapist with over 20 years of practice. The facilitator is also trained in yoga and mindfulness, which she integrates into her therapeutic approach.

Each workshop accommodates approximately 20 participants and can be accessed remotely, typically from participants’ homes or private workspaces, ensuring accessibility and convenience.

The session begins with a brief guided mindfulness practice to help participants ground themselves in present-moment awareness, focusing on internal sensations and thoughts. Participants are then invited to engage in spontaneous doodling using lines and shapes without judgment, serving as a visual method for externalizing their inner experiences. From these doodles, they identify elements that feel personally supportive or meaningful and enhance them using color, guided by sensory awareness and intuitive choice.

These enriched elements are then cut out and arranged within a pre-drawn circle, symbolizing containment, wholeness, and focused intention. The creative process concludes with a reflective integration practice, during which participants identify one small, supportive action they can carry forward into everyday life. The session ends with structured sharing in triads and a full-group discussion, fostering compassionate listening, peer support, and deepened self-reflection.

To support fidelity and adherence to the intervention, Dr. Isis follows a standardized facilitation guide developed for the program. Adherence is further monitored through brief facilitator check-ins during the workshop, observation of process engagement during breakout activities, and optional post-workshop participant feedback surveys that assess perceived usefulness, emotional engagement, and clarity of instruction.
Intervention code [1] 331089 0
Treatment: Other
Comparator / control treatment
A within-subjects, non-concurrent multiple baseline design will be implemented. In this design, each participant serves as their own control, allowing for individual differences to be accounted for while examining the intervention's impact over time. Participants will complete assessments at three key time points:

T1 (Baseline): Collected online before any intervention-related activity.

T2 (Pre-Intervention): Administered 72 hours after T1, immediately before the workshop. This interval introduces a short baseline phase to observe potential natural changes in the absence of intervention.

T3 (Post-Intervention): Collected within 24 hours following attendance at the MBAT-DI workshop, designed to capture the immediate effects of the intervention.
Control group
Active

Outcomes
Primary outcome [1] 341496 0
Mindfulness
Assessment method [1] 341496 0
Mindfulness was measured using the Toronto Mindfulness Scale (TMS), which includes two subscales: Curiosity and Decentering. Each item was rated on a 5-point Likert scale ranging from 0 ("not at all") to 4 ("very much"), with higher scores indicating greater state mindfulness. The TMS demonstrates strong internal consistency, with Cronbach’s alpha reported at .95.
Timepoint [1] 341496 0
T1 (Baseline): Initial assessment completed online, prior to any intervention procedures. T2 (Pre-Intervention): Completed 72 hours after T1, immediately before attending the intervention. This interval provides a short baseline phase to observe any natural fluctuations prior to the intervention. T3 (Post-Intervention): Completed within 24 hours after T2, and immediately following the MBAT-DI workshop. This timepoint is designed to capture the acute effects of the intervention.
Primary outcome [2] 341692 0
Self-Compassion
Assessment method [2] 341692 0
Self-compassion is assessed using the State Self-Compassion Scale (SSCS), which evaluates momentary self-compassion. Participants respond to 18 items on a 5-point Likert scale, producing a mean score that could range from 1 to 5, with higher scores indicating greater self-compassion; the scale shows good reliability (a = .86).
Timepoint [2] 341692 0
T1 (Baseline): Initial assessment completed online, prior to any intervention procedures. T2 (Pre-Intervention): Completed 72 hours after T1, immediately before attending the intervention. This interval provides a short baseline phase to observe any natural fluctuations prior to the intervention. T3 (Post-Intervention): Completed within 24 hours after T2, and immediately following the MBAT-DI workshop. This timepoint is designed to capture the acute effects of the intervention.
Primary outcome [3] 341693 0
Teaching Self-Efficacy (Classroom Management)
Assessment method [3] 341693 0
To measure classroom management self-efficacy, the Teachers’ Sense of Self-efficacy Scale-Short Form (TSES) [44] will be used. This scale, modified to assess state-based self-efficacy, prompts participants to rate each item on a 9-point scale in response to “how they were feeling right now.” Higher scores indicate stronger classroom management efficacy, and the internal consistency of this modified version was reassessed in this study.
Timepoint [3] 341693 0
T1 (Baseline): Initial assessment completed online, prior to any intervention procedures. T2 (Pre-Intervention): Completed 72 hours after T1, immediately before attending the intervention. This interval provides a short baseline phase to observe any natural fluctuations prior to the intervention. T3 (Post-Intervention): Completed within 24 hours after T2, and immediately following the MBAT-DI workshop. This timepoint is designed to capture the acute effects of the intervention.
Secondary outcome [1] 448379 0
N/A
Assessment method [1] 448379 0
N/A
Timepoint [1] 448379 0
N/A

Eligibility
Key inclusion criteria
Participants are to be currently employed as teachers in rural Victoria and available to attend the two-hour workshop.
Minimum age
21 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
Yes
Key exclusion criteria
Not currently teaching.

Study design
Purpose of the study
Educational / counselling / training
Allocation to intervention
Non-randomised trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Other
Other design features
This study employed a non-concurrent multiple baseline design, a variation of single-case experimental methodology.
The non-concurrent format allowed each participant to act as their own control, with comparisons made between their own baseline and post-intervention scores rather than across participants. This structure increases the ecological validity of the findings while maintaining internal validity through replication of effects across multiple individuals at staggered intervals.

The non-concurrent format allowed each participant to act as their own control, with comparisons made between their own baseline and post-intervention scores rather than across participants. Importantly, the stability of scores between T1 and T2 confirmed the absence of maturation or testing effects, strengthening causal inferences about the immediate impact of the MBAT-DI intervention. This structure increases the ecological validity of the findings while maintaining internal validity through replication of effects across multiple individuals at staggered intervals.

Phase
Not Applicable
Type of endpoint/s
Efficacy
Statistical methods / analysis
Data analysis will be conducted using IBM SPSS (version 29). A one-way repeated measures multivariate analysis of variance (MANOVA) will initially be planned to examine whether scores on the SSCS, TSES, and TMS significantly increase from pre-intervention (T2) to post-intervention (T3), while remaining stable from baseline (T1) to pre-intervention (T2). Before running the analysis, the differences in dependent variable (DV) scores across each time point will be inspected for univariate outliers (z-scores ±3.29) and assessed for normality using the Shapiro-Wilk test (p > .05), as well as skewness and kurtosis ratios (z ±3.29). Bivariate scatterplots will be reviewed to determine whether the DV difference scores exhibit approximate linear relationships, and Pearson’s correlations will be calculated to assess multicollinearity (r > .85) and to verify that the DVs are suitably correlated for MANOVA.

If the assumptions for MANOVA are not met, such as excessive multicollinearity or insufficient correlation strength between DVs, a series of paired-samples t-tests will be used instead to assess mean differences in wellbeing indicators from T1 to T2 (baseline stability) and T2 to T3 (post-intervention change), thereby addressing hypotheses 1 and 2. To examine hypothesis 3, a median split will classify participants into two groups based on teaching experience (<15 years vs. 15+ years), followed by 2 × 2 mixed ANOVAs to evaluate whether teaching experience moderates the intervention effects. Assumptions of normality, absence of outliers, and homogeneity of variance and covariance will be tested, including Levene’s test and Box’s M test, to ensure the validity of the analyses.

Recruitment
Recruitment status
Completed
Date of first participant enrolment
Anticipated
Actual
1/11/2024
Date of last participant enrolment
Anticipated
Actual
5/03/2025
Date of last data collection
Anticipated
Actual
26/03/2025
Sample size
Target
49
Accrual to date
Final
49
Recruitment in Australia
Recruitment state(s)
VIC

Funding & Sponsors
Funding source category [1] 319001 0
University
Name [1] 319001 0
Honours Psychology Student Theses La Trobe University
Country [1] 319001 0
Australia
Primary sponsor type
University
Name
La Trobe University
Country
Australia
Secondary sponsor category [1] 321599 0
None
Name [1] 321599 0
Country [1] 321599 0

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 317614 0
La Trobe University Human Research Ethics Committee
Ethics committee address [1] 317614 0
Ethics committee country [1] 317614 0
Australia
Date submitted for ethics approval [1] 317614 0
16/05/2024
Approval date [1] 317614 0
01/07/2024
Ethics approval number [1] 317614 0
Ethics committee name [2] 317617 0
Victorian Department of Education
Ethics committee address [2] 317617 0
Ethics committee country [2] 317617 0
Australia
Date submitted for ethics approval [2] 317617 0
06/06/2024
Approval date [2] 317617 0
26/11/2024
Ethics approval number [2] 317617 0
24-10-455

Summary
Brief summary
Trial website
Public notes

Contacts
Principal investigator
Name 141570 0
Dr Theresa Van Lith
Address 141570 0
School of Psychology and Public Health, Department of Psychology, Counselling and Therapy, La Trobe University, Plenty Rd. Bundoora 3086, Victoria
Country 141570 0
Australia
Phone 141570 0
+61 403317375
Email 141570 0
t.vanlith@latrobe.edu.au
Contact person for public queries
Name 141571 0
Theresa Van Lith
Address 141571 0
School of Psychology and Public Health, Department of Psychology, Counselling and Therapy, La Trobe University, Plenty Rd. Bundoora 3086, Victoria
Country 141571 0
Australia
Phone 141571 0
+61 403317375
Email 141571 0
t.vanlith@latrobe.edu.au
Contact person for scientific queries
Name 141572 0
Theresa Van Lith
Address 141572 0
School of Psychology and Public Health, Department of Psychology, Counselling and Therapy, La Trobe University, Plenty Rd. Bundoora 3086, Victoria
Country 141572 0
Australia
Phone 141572 0
+61 403317375
Email 141572 0
t.vanlith@latrobe.edu.au

Data sharing statement
Will the study consider sharing individual participant data?
Yes
Will there be any conditions when requesting access to individual participant data?
Persons/groups eligible to request access:
• Researchers
Conditions for requesting access:
• Yes, conditions apply:
• Requires review on a case-by-case basis by the trial custodian, sponsor or data sharing committee
• Requires a scientifically sound proposal or protocol
• Requires approval by an ethics committee
• Requires a data sharing agreement between data requester and trial custodian or sponsor
What individual participant data might be shared?
• All de-identified individual participant data
What types of analyses could be done with individual participant data?
• Any type of analysis (i.e. no restrictions on data re-use)
When can requests for individual participant data be made (start and end dates)?
From:
At the end of the study
To:
No end date
Where can requests to access individual participant data be made, or data be obtained directly?
• Email of trial custodian, sponsor or committee: t.vanlith@latrobe.edu.au

Are there extra considerations when requesting access to individual participant data?
No


What supporting documents are/will be available?

No Supporting Document Provided


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.