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The rapid development of counselling began after World War II. Meanwhile, texting services became available in the 1980s. Texting has been widely applied in both health area and mental health areas. A chatbot is a specific type of artificial intelligence (AI) that can have conversations with humans through texting. The combination of counselling and texting is known as chat counselling. The effectiveness of chatbots in alleviating psychological symptoms was supported by scientific research. Nonetheless, people hold different perceptions towards chatbots. Some common factors in counselling, including empathy and warmth, were also important in evaluating AI chatbots. Other important factors included acceptability, satisfaction and trust. The current study is the first to use AI as a counsellor. This study investigates people’s perceptions of human and AI counsellors (ChatGPT) and whether people can differentiate between human and AI. Participants needed to rate the counsellors in three scenarios: the original scenario taken from a training book, the human counsellor scenario generated from a text conversation with a human counsellor and the AI counsellor scenario produced by texting with ChatGPT, which acts as the counsellor. Prompts used to generate conversation with ChatGPT are included. The dialogues were parts of the conversations containing similar client responses and were presented using the WhatsApp interface. Questionnaires were delivered both online and in paper form. Results demonstrated that people’s ratings of human counsellors and AI counsellors did not differ in perceived empathy, acceptability, and satisfaction. While the warmth and trustworthiness of AI counsellors were perceived to be higher than those of human counsellors. On the other hand, people were unable to differentiate between human and AI counsellors in uncertain conditions. Younger people and the general population are more accurate in identifying between humans and AI, while people above 40 and psychologists or counsellors are less capable of doing so. The current study supports the potential of utilising ChatGPT in counselling. Having people experience and evaluate real chat counselling with human and AI counsellors can potentially eliminate some limitations of the current studies. Future studies can investigate how prior knowledge contributes to AI detection and examine AI counsellors' efficiency in longitudinal studies

Adverse Childhood Experiences (ACEs) are common in life trajectories, and continued exposure to childhood adversities has long-term consequences that can lead to lifelong physical, mental, and emotional deficiencies. This study aims to address the research gap in the ACEs context in Macao by enhancing our understanding of the cultural sensitivity, applicability, and acceptability associated with assessing ACEs among Chinese childhood and adolescents in Macao. The study utilized the Chinese version of The International Trauma Exposure Measure – Children and Adolescents (ITEM-CA) to facilitate the exploration of cultural adaptation needs related to ACEs measurement tools in Macao. Employing a qualitative methodology with an explanatory and descriptive design, the study collected opinions and suggestions through an online questionnaire from professionals working with children aged 7-17 years old, as well as parents or caregivers of children within the same age group. Several key findings emerged from the study. Firstly, it underscored the adequacy and pertinence of the Chinese ITEM-CA in covering the topics of traumatic events and deeming it more suitable for children aged 12 or above. Secondly, it emphasized the importance of maintaining anonymity and the involvement of dedicated and trained personnel throughout the ACEs assessment process. Lastly, it highlighted the need to increase public awareness regarding traumatic events and ACEs in Macao society. These findings have significant implications for researchers studying the prevalence of ACEs in Macao and for policymakers in Macao implementing ACEs surveillance. Additionally, there is a recommendation for organization, especially schools, to respond to ACEs using trauma-informed approaches, supporting the well-being of children, fostering resilience, and minimizing the risk of re-traumatization

This thesis explores the impact of the exploration of methadone treatment programs in heroin-dependent the perspective from use and the quality of life. The primary objective of this research is to investigate how different types of participants that methadone will affect their quality of life. A mixed-methods approach was employed, combining quantitative surveys with qualitative interviews to gather comprehensive data from a sample of 59 participants, 8 female, and 51 male, for the questionnaire to know about their quality of life and well-being. A structured questionnaire was used to quantitatively assess participants' quality of life, well-being, and satisfaction with methadone treatment. The survey included standardized scales measuring various dimensions of quality of life, such as physical health, mental health, social functioning, and overall life satisfaction. A mixed-methods approach was adopted, combining quantitative and qualitative research methods to provide a comprehensive understanding of treatment efficacy and genetic influences. In the course of this research on the impact of methadone treatment programs on the quality of life for heroin-dependent individuals, several key findings emerged from both the quantitative surveys and qualitative interviews. To overall improvement in quality of life the participants reported significant improvements in various dimensions of quality of life after starting methadone treatment. On average, scores for emotional well-being, social functioning, and physical health showed marked increases over the treatment period

The current quantitative study aims to understand/investigate the perception of Macao society towards couple therapy and therapists and the perception of Macao's professionals working with couples about couple therapy services in Macao. Given the small sample of this study of professionals who work as therapists for couples in Macao, this indicates that there is not a large number of them. The result of the research indicates also a general positive attitude of professionals towards clients but also indicates that couple therapy needs improvement. The sample used to measure the society shows that the society manifested moderate positive attitudes toward couple therapy. However, the findings may reveal that there are still weak points of societal knowledge and contact for couples therapy services. The outcome manifested that Macao has limited literature about Family and Couple Therapy which may be relevant to understand the poor knowledge of the society related to this field. The current study suggests the elaboration of future studies about Couple Therapy services and about the concept of couple therapy to promote therapeutic service to couples and academic researchers that promote governmental support to offer professionals validation.

Coronavirus disease (COVID-19) is a public health emergency happening worldwide. It brought tremendous impacts to the global economy and people’s mental health (Jiaqi Xiong et al., 2020). Many people suffered physically and psychologically with the sudden arrival of COVID-19. Among the different age groups, studies identified that undergraduate students as a vulnerable group with a higher risk of mental health problems, such as depression and anxiety (Silva et al., 2022; King et al., 2022; Mansor & Ahmad, 2022). This qualitative study collected data from six focus group interviews with undergraduate students studying in Macao. Thematic analysis was used to understand the COVID-19 impact on students' mental well-being and coping strategies, as well as to explore the protective and risk factors that contribute to students’ mental well-being in the local context of Macao. Results showed four themes with 15 contributory sub-themes: COVID-19’s impact on students’ mental well-being, key impacting sources, coping strategies, and risk and protective factors. This study provides a picture of the mental health condition of undergraduate students during the zero-COVID period in Macao and raises an urgent call for extra attention to university students’ mental health during crises, showing the social and mental needs of undergraduates. This research also uniquely contributes insight into how the dysfunctionality of families could be a significant risk factor for students’ mental health during the crisis, which is rarely found in other COVID-19 studies. This research suggests a promotion of future programs or workshops that would strengthen and benefits students’ relationship with their family. Future research could explore the family function in Macao and its relationship with students’ mental well-being

The current study aimed to analyse the differences in the internalising problems including anxious/depressed, withdrawn-depressed and somatic complaints, from the perspective of parents and high school students. Considering varying levels of academic achievement. Additionally, the gender differences in the level of internalising problems will also be examined. Finally, we analysed the different perspectives of parents and high school students according to internalising problems. The Achenbach System of Empirically Based Assessment (ASEBA) was used for data collection in Macao. The sample consisted of 698 high school students (316 males and 382 females). There were no significant differences in internalising problems according to three levels of academic achievement (low, average and high) from the perspective of parents and high school students. Furthermore, from the high school students' perspectives, adolescent females present more interesting problems than males. Finally, the findings indicate a low agreement between parents and students concerning internalising problems. It is suggested that parents should learn and explore different parenting styles in order to reduce their children's internalising problems.

The purpose of this study was to explore the correlation between empathy, love maintenance behaviors, relationship satisfaction in a convenience sample of young adult lovers in Macau. Participants were N = 183 (84 males, 99 females) recruited from the social media platform (e.g. Instagram, WeChat, Facebook). Firstly, young adult lovers who tended to have high relationship satisfaction and empathy are tended to use positive love maintenance behaviors but less likely to use negative love maintenance behaviors. Besides, there were differences found by gender in empathy (affective empathy & total empathy), some dimensions of positive love maintenance behaviors (openness & advice), and negative love maintenance behaviors (causing jealousy, destructive conflict & negative love maintenance behaviors in general). Lastly, the findings in this study supported the hypotheses that love maintenance behaviors mediated the relationship between relationship satisfaction and empathy among young adult lovers in Macau. It was revealed that there was higher satisfaction in younger adult lovers in younger group (18-24 years) compared to older groups (32-40 years). For empathy, it correlated positively with relationship satisfaction and most positive love maintenance behaviors, but also with certain negative love maintenance behaviors. Positive love maintenance behaviors mediate the relationship between relationship satisfaction and empathy, highlighting their critical role in maintaining healthy relationships

The present study aimed to analyse the differences in the internalising problems (anxiety, depression, somatic complaints), assessed by different informants (teachers and students), according to the level of academic achievement and school adaptation level in secondary students. Furthermore, we examine the gender difference in the level of internalising symptoms. Finally, we analyzed the differences between teacher-rated and adolescents' self-reported internalising symptoms. The Achenbach System of Empirically Based Assessment (ASEBA) was used for collecting informants’ data. The sample consisted of 882 secondary students (349 males and 473 females), while 50 came from public schools and 772 from private schools. No significant differences are found in internalising problems according to the level of academic achievement from both teachers’ and students’ perspectives. Generally, students who are well-adapted to the school context have the least symptoms of internalising problems compared to average and less-adapted groups from the teachers' perspective. In addition, from students’ perspectives, adolescent females present more internalising problems than males. Finally, teachers rated fewer internalising problems when compared to the students. In conclusion, the low level of awareness of teachers towards the internalising problems of students arouse attention. It is suggested that teachers should attend professional development programs in order to address to students’ internalising problems

School-age children and adolescents face several psychological conditions frequently associated with negative consequences on behavioral and mental problems. Their level of mental resilience may affect their responses to academic or interpersonal issues and coping with challenges, which in turn affects their mental health. This study aims to characterize the current status of the psychopathology and resilience of secondary students and to analyze the relationship between psychopathology and resilience in a sample of 80 girls aged 12–18 was selected by cluster sampling from one private secondary school with six grades in Macao. In this study, we used the Achenbach System of Empirically Based Assessment (ASEBA) to assess behavioral and emotional problems and the Resilience Scale for Chinese Adolescents to assess resilience. A total of 78 valid questionnaires were obtained for CBCL, 78 for TRF, 80 for YSR, and 77 for Resilience Scale and data were analyzed by using SPSS. The results reveal that clinical prevalence of Total Problems (YSR, 27.5% > CBCL, 19.2% > TRF, 15.4%) and Internalizing Problems (YSR, 22.5% > CBCL, 17.9% > TRF, 11.5%) from the perspective of adolescents was higher than that from the perspectives of parents and teachers. Senior students exhibited higher frequency on the borderline clinical range than Junior students. (χ2(2, N=80) =14.56, p<.001). The average score of resilience is 3.24±0.51, which is above the middle level. Regarding the YSR scale and Resilience scale, we found that the score of Affect Control is significantly negatively correlated with the score of Internalizing Problems (r = -.354, p<.01). Family Support is also significantly negatively correlated with the score of Internalizing Problems (r = -.302, p<.01). Good affect control and family support can reduce various emotional and behavioral problems. The results of the study found the resilience level can negatively affect internalizing problem behaviors and externalizing problem behaviors. The results are promising and can give clues for preventing and promoting measures regarding mental health issues to both family and school education contexts, as creating a sustainable development strategy of improving adolescents’ mental resilience quality

This study aims to investigate gender-differentiated parenting and the factors that affect parent-adolescent relationships in Macao families. The study will address the following research questions: A) Does gender-differentiated parenting exist in Macao families? B) How does the academic level of parents relate to conflict resolution and acceptance levels? C) How does the length of time parents have lived together relate to conflict resolution and acceptance levels? D) How does the sibling position of adolescents relate to conflict resolution and acceptance levels? The study employed a quantitative research approach with a purposive and convenient sample of parents with children aged between 12 to 18 years old in Macao. The data were collected using the Parent-Child Interaction Questionnaire—Revised-Parent version (PACHIQ-R-P) through a questionnaire survey from May to August 2022. Out of the 172 completed questionnaires, seven were invalid, resulting in 165 valid questionnaires. The findings showed that gender differentiation in parenting was confirmed, with significant results showing that fathers had lower acceptance and conflict resolution levels when their child was a boy. Mothers showed similar acceptance and conflict resolution levels regardless of their child's gender. Furthermore, the study found that parents' acceptance of their children was influenced by their academic level, length of time living together, and the child's sibling position. This study is the first of its kind in Macao and could provide valuable insights for family and adolescent services in the region

The purpose of the study was to explore the smoking behaviour of the smokers living in Macao. I was part of the 1st group of doctors to have chosen to initiate smoking cessation in Macau. In addition to my diverse academic background of study in laws- a dissertation about the effect of tobacco control program in Macao (submitted in 2011), a master in Public Administration, and five years of working experiences as an Inspector Assistant of tobacco, I had the conviction that I have to write to share my experience and knowledge about smoking cessation to contribute to the field of counselling and psychotherapy as there is little research data concerning smoking prevalence and demographics in Macao. This study consists of two parts – PART I presents the quantitative data collected by a questionnaire-survey over 1378 smokers and PART II qualitative data from semi-structured interviews with 10 adult smokers to explore their experiences of smoking and smoking cessation in Macao. Quantitative data analysis was conducted with the SPSS, while qualitative analysis with coding and theme identification by following the grounded theory procedures. The study found that about 85% smoker surveyed consumed more than half a pack of cigarette per day and about 31% reported various symptoms like irritability, fatigue, loss of appetite and difficulties in concentration. The qualitative study has identified major positive factors related to initiation and maintenance of smoking cessation, namely health concerns, financial concerns and family support. Major negative factors related to relapse of smoking are peer influences, smoking of family members, and impacts of stressful life events. Based on findings of the study, it is argued that preventive anti-smoking education should be implemented among young people. Promotion of health education and preventive anti-smoking strategist and policy in Macao are discussed. The data collected indicate the fact that individuals who have pathologies of the cardiovascular system as a motivating factor for contemplating or taking actions for smoking cessation. Moreover, financial problems, gender (male predominantly), married with family support, higher educational level, without psychological diseases, better economic status, lower nicotine dependent are predictors to success in quit smoking. It also raises the possible need to deepen some evaluation parameters hither to be only superficially addressed. Therefore, and by limitations inherent to the study, this hypothesis needs further investigation. I argue that non-pharmacological treatment methods alone have proven to be effective in the smoking cessation process. However, it is argued that this combined with pharmacological therapy, in particular in specialized consultations, would be more effective and capable in increasing success rates in smoking cessation

"In 2021/2022 academic year, there are 2,244 SEN students in Macau and its growth rate is 36% in ten years. However, at the present, there are 38 schools providing the related education to them. Admittedly, this is an unbalanced supply and demand. In fact, the teachers who work at inclusive education schools are bearing all responsibility to teach SEN students and their mental health is worth to attention. Moreover, there are 1,224 SEN students in primary (2021/2022 academic year), it accounting for 55% of all. That is, the numbers of their teachers are the most and they are representative. Therefore, exploring primary teachers’ burnout at inclusive education schools becomes the topic of this study, even more important, it is including to compare normal and resource teachers. This topic is rarer currently in Macau. On the one hand, emotional exhaustion, depersonalization and (reduced) personal accomplishment are dimensions of burnout (Maslach et al., 1996). These become the dependent variables of this study. According Ecological Systems Theory (Bronfenbrenner, 1979) and the factors of self-efficacy in inclusive education (Sharma et al., 2012), the following hypotheses are provided to guide this study: (1) normal teachers’ emotional exhaustion, depersonalization and reduced personal accomplishment are higher than those in resource teachers; (2) teachers’ attitudes into inclusive education, (3) teachers’ self-efficacy to use inclusive instruction (SEII), (4) teachers’ self-efficacy in collaboration (SEC) and (5) teachers’ self-efficacy in v managing behavior (SEMB) both are negatively related to emotional exhaustion, depersonalization and reduced personal accomplishment; (6) teachers’ stress of Covid19 is positively related to emotional exhaustion, depersonalization and reduced personal accomplishment. On the other hand, quantitative methodology, and snowball sampling are used in this research. At last, 132 responds are collected, including 100 normal teachers and 32 resource teachers. They are from 48 inclusive education schools in Macau. All data were analyzed by SPSS 25.0. The results of this study are followed: (1) teachers’ emotional exhaustion level is middle, their depersonalization and reduced personal accomplishment levels both are low; (2) resource teachers’ emotional exhaustion and depersonalization are higher than normal teachers; (3) teachers’ attitudes into inclusive education negatively related to depersonalization but positively related to reduced personal accomplishment; (4) in the factors of self-efficacy, only SEII is negatively related to reduced personal accomplishment; (5) teachers’ stress of Covid-19 is positively related to emotional exhaustion, depersonalization and reduced personal accomplishment."

There are gaps in the research on gender differences and parental participation and the interaction between gender and parental participation in non-Western cultural contexts, particularly the Macao context. The current study aims to fill these gaps by examining gender and parental participation (i.e., father only, mother only, or both) differences and interactions in externalizing behaviour (oppositional defiant disorder and conduct disorder) during late childhood and adolescence (i.e., from age 10 to 18) in Macao. The methodological approach for the current study was a cross-sectional design with a quantitative methodology based on self-rated questionnaires. In certain items, we did discover gender differences. More boys than girls appeared to concur that they occasionally misbehave at school or start fires. And it appeared that girls were more likely than boys to concur that they occasionally exhibit unexpected mood or emotion changes and strong tempers. The children in the groups where only the mother or father participated tended to agree more than they prefer to hang out with older kids than kids their own age. This is in contrast to the group with more parental participation, which is represented by both parents submitting the questionnaire. Although none of the hypotheses proposed were supported, our outcomes implied culture and subculture may play important roles on youths’ externalizing behaviour

"Parenting styles may have various effects on children’s development and educational outcomes, particularly a relationship with behavioral problems and academic achievement. This study examines the relationship of between parenting styles, behavioral problems and academic achievement. A cross-sectional and questionnaire-design (Parenting Style Scale (Saunders et al., 2013); Strength and Difficulties Questionnaire (Goodman & Goodman, 2009; Goodman, 1999; Goodman, 1997)) study was used with a sample total of 98 parents with the eldest child of the family aged between six to twelve. Results of the findings are mainly inconsistent with the majority of literature. Indulgent and authoritative parenting are the predominant parenting styles, yet parenting styles does not relate to academic achievement. On the other hand, the correlation between behavioral problems, specifically prosocial behaviors and academic achievement are moderate. Furthermore, there is no difference between the type of behavioral problems according to gender. In further studies, a larger sample size, teachers and students as informants, and the inclusion of the analysis of other factors that could be influencing parenting styles, behavioral problems and academic achievement are suggested to be considered. "