Disaster Mental Health
Is Acceptance and Commitment Therapy via Telehealth Effective? A Pilot Study During the Covid-19 Pandemic to Support Parents of Children with Developmental Disabilities
Sadaf Khawar, M.A., Other
Doctoral Candidate/Adjunct Faculty
Montclair State Univeristy
West Orange, New Jersey
Chana Tilson, M.A., Other
Doctoral Candidate
The Chicago School of Professional Psychology
.New York, New York
Mary I. Cargill, B.A.
Doctoral Student
Montclair State University
Montclair, New Jersey
Nardin Yacoub, M.S.
Doctoral Student
Montclair State University
Newark, New Jersey
Rachel G. McDonald, M.S.
PhD Student
Montclair State University
Montclair, New Jersey
Kristen R. Schiavo, B.A.
Graduate Student
Montclair State Univeristy
Scotch Plains, New Jersey
Britney Jeyanayagam, B.S.
Masters Candidate
Montclair State University
Montclair, New Jersey
Asha Thomas, None
Undergrduate Student
Montclair State Univeristy
., New Jersey
Kaitlyn Andolena, None
Undergrduate Student
Montclair State Univeristy
.Stanhope, New Jersey
Erin Kang, Ph.D.
Assistant Professor
Montclair State University
Montclair, New Jersey
Prior research suggests that mothers of youth with developmental disabilities (DD), such as autism spectrum disorder (ASD) and Down Syndrome, report higher rates of depression and parenting stress when compared to mothers of typically-developing youth (Tekinarslan, 2013; Davis & Carter, 2008; Singer et al., 2002). Similar patterns have been reported during the Covid-19 pandemic (Yilmaz et al., 2021; Brown et al., 2020), underscoring the need for identifying the main areas of struggles and effective interventions for parents to address these concerns. Acceptance and commitment therapy (ACT) has shown to improve parent psychopathology and psychological flexibility in parents of children with ASD (Blackledge and Hayes, 2006), decrease both parent and child internalizing and externalizing problem behaviors, and improved parental stress levels and marital relations (Bögels, 2013; Gould et al., 2017). Moreover, ACT delivered via telehealth to parents suggests similar promising results (Thorne, 2018), and may be an effective approach in supporting parents during the pandemic. This two-phase study 1) assessed the impact of the Covid-19 pandemic on parents of children with DD, and 2) examined the efficacy of a six-week telehealth-ACT parent training program.
In phase one, 40 parents (87.5% female; 60% non-white; 80% ages 35- 54) of children with DD (72.5% ASD; 10% Down Syndrome; Mage= 11.60, SDage= 5.62; 77.7% male) participated in this study. Parents completed a measure of parental depression (BDI-II; Beck, 1996), parenting stress (PSI-4-SF; Abidin, 1995), psychological flexibility (Bond et al., 2011; AAQ-II), and open-ended questions to identify their main struggles. Results revealed that parents reported mild-to-moderate depression (M=18.56, SD=9.95), less psychological flexibility (M=29.25, SD=9.60), and clinically significant levels of parent stress (M=85.13, SD=23.0). Lack of emotional and social support emerged as main areas of struggle from qualitative analyses.
In phase two, nine parents from phase one participated in a six-week pilot telehealth-ACT intervention. Weekly researcher-created video trainings (on values identification, mindfulness, cognitive defusion, committed action, and self-care) were provided based on the ACT parent training manual (Gould et al., 2017). Paired-samples t-tests revealed improvements in depression (d=1.42, p=0.003), parenting stress (d=1.27, p=0.009), and psychological flexibility (d=0.90, p=0.038).
Taken together, our results suggest negative impacts of Covid-19 pandemic on parent psychopathology and clinically significant parenting stress in parents of those with DD, and preliminarily suggest that the pilot, telehealth ACT intervention may be a promising approach in addressing these concerns. Our findings underscore two critical notions particularly at a time when effective strategies for disaster preparedness are warranted in the aftermath of the pandemic:1) the urgent need to provide support to parents of those with DD who are at elevated risk of mental health problems, and 2) the value of telehealth as a modality of intervention delivery. Future studies should examine the effects of telehealth ACT intervention using a larger, diverse sample with a control group.