Acceptance and Commitment Therapy for Parental Management of Childhood Asthma: An RCT

Abstract

BACKGROUND: Few trials have been conducted to address the psychological difficulties of parents in managing their child's asthma. Fostering parental psychological flexibility through Acceptance and Commitment Therapy (ACT) may help parents to accept these psychological difficulties and improve their management of childhood asthma. METHODS: In this randomized controlled trial, a 4-session, group-based ACT plus asthma education (ACT group) was compared with an asthma education talk plus 3 telephone followups (control group) to train parents of children diagnosed with asthma. The use of health care services due to asthma exacerbations in children and the psychological well-being of their parents were assessed before, immediately after, and at 6 months after the intervention. RESULTS: A total of 168 parents and their children aged 3 to 12 years with asthma were consecutively recruited in a public hospital in Hong Kong. When compared with the control group, children whose parents were in the ACT group made significantly fewer emergency department visits (adjusted 6-month incidence rate ratio = 0.20; confidence interval [CI] 0.08 to 0.53; P = .001) due to asthma exacerbations at 6 months postintervention. These parents also reported a decrease in psychological inflexibility (mean difference = 25.45; CI 27.71

Acceptance and commitment therapy for family caregivers: A systematic review and meta-analysis

“…Participants were family caregivers who provided care to: children with chronic conditions ( n = 5); family members with dementia ( n = 2); and family members with an advanced lung cancer ( n = 1). ACT interventions were delivered individually ( n = 4; Losada et al., 2015; Márquez-González et al., 2020; Mosher et al., 2019; Sairanen et al., 2019) or in a group format ( n = 4; Brown et al., 2015; Chong et al., 2019; Hahs et al., 2019; Whittingham et al., 2016). Of the 8 RCTs, ACT sessions were delivered by face-to-face ( n = 6), telephone (Mosher et al., 2019), or online guided by a personal coach (Sairanen et al., 2019).…”

“…The included seven studies with a control group, including 6 RCTs plus one nonrandomized control group pretest-posttest design study (i.e. Corti et al., 2018), tested the effects of ACT interventions on stress of family caregivers, compared to either a treatment as usual control group (four studies including Brown et al., 2015; Davis et al., 2020; Sairanen et al., 2019; Whittingham et al., 2016) or an attention control group providing education or an early intensive behavioral intervention (three studies including Chong et al., 2019; Corti et al., 2018; Mosher et al., 2019). Participants involved parents of children with chronic conditions ( n = 5) and family caregivers of people with advanced cancer or in palliative care ( n = 2).…”

“…Participants involved parents of children with chronic conditions ( n = 5) and family caregivers of people with advanced cancer or in palliative care ( n = 2). ACT interventions were delivered in a group format ( n = 4; Brown et al., 2015; Chong et al., 2019; Corti et al., 2018; Whittingham et al., 2016) or individually ( n = 3; Davis et al., 2020; Mosher et al., 2019; Sairanen et al., 2019). Of the seven studies, ACT interventions were delivered as face-to-face sessions ( n = 4), telephone sessions (Mosher et al., 2019), online sessions guided by a personal coach (Sairanen et al., 2019), or using self-help booklets with minimal telephone support by a trained clinician (Davis et al., 2020).…”

“…The included 3 RCTs tested the effects of ACT interventions on self-efficacy of family caregivers, compared to either a treatment as usual control group (Brown et al., 2015; Whittingham et al., 2016) or an attention control group providing education (Chong et al., 2019). Participants were parents of children with acquired brain injury (Brown et al., 2015), parents of children with asthma (Chong et al., 2019), and parents of children with cerebral palsy (Whittingham et al., 2016). ACT interventions were delivered face-to-face in a group format in all 3 studies.…”

“…ACT interventions were delivered face-to-face in a group format in all 3 studies. These studies involved 2 ACT sessions in 2 studies (Brown et al., 2015; Whittingham et al., 2016) and 4 ACT sessions in Chong et al. (2019).…”