A Virtual Resiliency Treatment for Parents of Children with Autism: A Randomized Pilot Trial

Background:

Parents of children with autism experience high levels of distress.Evidence-based resiliency treatments for parents of children with autism have not been developed or tested.

Objectives:

This pilot study examines a Stress Management And Resiliency Training-Relaxation Response Resiliency Program (SMART-3RP) program, a 9-session mind-body intervention that seeks to decrease distress and increase resiliency, stress coping, social support and mindfulness.

Methods:

We randomized 48 parents into immediate treatment vs. delayed intervention (control group). Assessments took place at baseline (T1) and three months later (T2) – post-intervention for immediate group and pre-intervention for the control group. For immediate treatment subjects, we examined feasibility and acceptability by examining attendance and responses to a feedback form. We examined pre-post change for the immediate treatment vs. control groups alone, controlling for relevant sociodemographic baseline characteristics. Outcomes include: distress (visual analog scale; primary [VAS]) resiliency (Current Experiences Scale [CES]), stress coping (Measure of Current Status part A [MOCS-A]), social support (Medical Outcome social support survey [MOS]) and mindfulness (Cognitive and Affective Mindfulness Scale – Revised [CAMS-R]).

Results:

The vast majority of participants were mothers (89%), white (78%), non-Latino (96%), married/partnered (76%), had at least a college degree (80%). In terms of feasibility, 65% of intervention participants completed ≥6 sessions. Among 72% of intervention group participants who completed the post-treatment survey, 83% reported practicing relaxation response exercises at least a few times a week. In response to the question, “How successfully do you think this treatment will reduce your stress-related symptoms” (1=not at all to 9=very), intervention participants responded on average 7.9. When comparing immediate treatment to control group participants for change in efficacy (see table 1), distress as measured by the VAS did not show a statistically significant change (p=.31). All secondary outcomes showed significant change in the expected direction. Immediate treatment participants showed improvements on the CES (M difference 6.17; p=.028), MOCS-A (M difference 7.66; p=.002), MOS (M difference 7.67; p=.036) and CAMS-R (M difference 2.55; p=032).

Conclusions:

Findings from our randomized pilot trial showed promising feasibility, acceptability, and efficacy. All between group differences were in the expected direction. The distress measure did not reach statistical significance although other measures did. Next steps include modifications to improve the intervention and a larger trial.