An acceptance and commitment therapy–based parenting program significantly reduced parental stress compared with usual care.
Researchers have reported efficacy from an acceptance and commitment therapy (ACT)–based parenting program toward reducing parental stress among parents of children with autism spectrum disorder (ASD), publishing their findings in JAMA Network Open.1
Approximately 12.07 million children worldwide present with autism. Alongside reducing quality of life, this condition often significantly impacts the wellbeing of family caregivers, especially parents. This creates a risk of escalating to severe psychological distress that adversely impacts parents’ ability to effectively support their children.2
“To support parents and their children with ASD, several parent-focused interventions have been developed to equip parents with knowledge and/or skills to manage their psychological experiences and respond flexibly to their children’s needs,” wrote investigators.1 “However, these interventions showed limitations.”
The randomized controlled trial was conducted to determine the efficacy of an ACT-based parenting program against parental stress and competence. Eligibility criteria included being the primary caregiver of a child aged 3 to 9 years with ASD. One adult parent was selected per family.
Individuals with severe medical conditions, unstable behaviors, caregiving for another family member, prior participation in an ACT-based program, planned or imminent child hospitalization, or participation in another parent support intervention were excluded. Participants were randomized 1:1 to receive either an ACT-based parenting program or usual care.
Usual care included public education about ASD rehabilitation provided trice per year, alongside education about psychological health. Both groups received this care, though the intervention group also received 8 weekly 2-hour sessions of an ACT-based parenting program.
This program covered material in the emotional and stress management, parenting skills training, ASD-related education, and self-care domains. The first 4 sessions were performed online, while the final 4 were performed in person with groups of 6 to 8.
Investigators obtained both parental and child sociodemographic and clinical data, while evaluating outcomes at baseline, immediately after the intervention (T1), and at 6 months (T2). Parental stress was reported as the primary outcome based on the Parenting Stress Index–Short Form.
There were 154 parents included in the final analysis, 77 of whom were randomized to the intervention group and 77 to the control group. Of the former, 59.74% completed all 8 sessions, while 92.20% of the latter completed 6 or more sessions. All patients were Asian, with a mean age of 36.55 years and 87.66% being female.
Significant differences in sociodemographic and baseline variables were not observed between groups. However, parental stress was significantly reduced among patients receiving the intervention at both T1 and T2, with reductions in Parenting Stress Index–Short Form total scores of β = −5.21 and β = −4.08, respectively.
Secondary outcomes were also significantly reduced in patients receiving the intervention. At T1, reductions in depressive and anxiety symptoms among these patients compared with controls were β = −1.6 and β = −1.62, respectively. No significant differences were reported at T2.
The intervention group also presented with significantly improved psychological flexibility, with a score of β = 1.64 at T1 and β = 2.25 at T2. Additionally, parenting competence scores among these patients at T1 and T2 were 5.08 and 4.90, respectively. Overall, these results highlighted improved parental stress and competence from the ACT-based program.
“Future studies are recommended to include longer-term follow-ups to assess sustained effects, incorporate booster sessions to enhance ongoing support, [and] include diverse participants and their children with ASD to improve generalizability,” wrote investigators.
References
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