(PS12-B35) The Effects of Remote Acceptance and Commitment Therapy on Parent and Child Behavior

Parents of developmentally-and intellectually-disabled children exhibit increased levels of stress, depression and anxiety, along with reduced quality of life and psychological flexibility (Estes et al., 2013; Gould et al., 2017; Schiltz et al., 2018). Prior research has preliminarily manifested Acceptance and Commitment Therapy (ACT) parent training programs to be beneficial in improving parent stress and psychopathology via in-person (Gould et al., 2017; Poddar et al., 2015) and online formats (Thorne, 2018). There is a pressing need for increasing accessibility of ACT programs, particularly in the aftermath of the COVID-19 pandemic.

To this end, this study used a non-concurrent multiple baseline design in conjunction with a within-subject group design employing an asynchronous and synchronous model to deliver an ACT training program via telehealth for parents of children with Prader Willi Syndrome (PWS; n = 4) and global developmental delays (n = 1) during the COVID-19 pandemic (all < 10 years old; female = 4). There were five parents (all mothers; White = 4; all ≥ college degree) who completed a six-week online ACT parent training (Gould et al., 2017) delivered asynchronously (i.e., several 5-10 minutes clips weekly) and synchronously (weekly check-ins via video meetings) followed by a two-week maintenance phase. Each session included specific topics and related exercises on: (a) values identification; (b) present moment awareness; (c) diffusion; (d) the Matrix (moving toward/away); (e) committed action; and (f) self-care. Pretest and posttest measures were completed which assessed parental stress (Abidin, 1995; PSI-4-SF), parental psychological flexibility (Bond et al., 2011; AAQ-II), parental self-compassion (Raes et al., 2021; SC-SF) and child behaviors (Sparrow et al., 2016; VABS-3, Maladaptive Behavior Domain).

Results indicated improvements in parental stress, self-compassion, and psychological flexibility from pre-to-post intervention. Parental stress scores demonstrated a mean decrease of 12.20, 95% CI [-1.24, 25.64] from pretest to posttest; self-compassion scores elicited a mean increase of 9.40, 95% CI [-23.27, 4.47] from pretest to posttest; and psychological inflexibility scores manifested a mean decrease of 2.40, 95% CI [-5.48, 10.28] from pretest to posttest. It is noteworthy to mention that single subject case analysis revealed that clinically significant levels of stress (i.e., percentile scores above 85) presented for all five participants at pretest which speaks to the significance of the decrease during posttest. Additionally, parental overt value-directed behaviors increased from baseline and were maintained post-treatment for all participants. Child behavior outcomes varied across the participants but overall had an increasing trend for desired behavior and a decreasing trend for maladaptive behavior for all five participants.

Encouragingly, these findings offer hope of increased accessibility of psychological interventions with empirical support for parents. Future studies can include caregivers from diverse gender, racial, and SES groups with a larger sample size. Further, conducting the training in other languages (and translating the manual) will target a global audience.