Open Feasibility Study: Navigator ACT for Parents to Children of Autism Spectrum Disorders (ASD) and/or Other Disabilities

Background:

Parents of children with disabilities, especially Autism Spectrum Disorders, report psychological distress, e.g., depression, anxiety and parenting stress (e.g., Mak & Kwok, 2010, Hayes & Watson, 2013). While psychological problems of these parents have gained attention, a little is done to investigate the usefulness and affectiveness of the treatments available. However, Acceptance- and Commitment Therapy (ACT) have shown promising results in a few open pilot studies (e.g. Blackledge & Hayes, 2006; Kowalskovski, 2012). At Habilitation & Health (disability service clinics in Stockholm, Sweden), ACT has been used since 2007 as part of parent support services. During the recent years, a manual-based ACT group intervention “Navigator ACT” was developed to enhance psychological well-being of these parents.

Objectives:

An open study was conducted to evaluate the feasibility, parent satisfaction and preliminary efficacy of the 5-session “Navigator ACT” for parents to children with ASD and/or other disabilities. The following research questions were considered: 1. Is the Navigator ACT a feasible treatment method in an out-patient clinical disability services context? 2. Are parents satisfied with the intervention? 3. Is the Navigator ACT (preliminary) an effective method in increasing parental psychological/behavioral flexibility and mindfulness skills as well in reducing symptoms of depression, anxiety and parenting stress. Furthermore, a possible effect on behavioral problems of the child with disability was investigated.

Methods:

The open feasibility study was conducted at 7 outpatient disability service clinics in Sweden. A total of 94 parents were allocated to treatment. The feasibility criteria was defined as 75 % of the parents participating in at least 4/5 sessions. Parent satisfaction was measured by session- and treatment evaluations as well as evaluation of treatment credibility. For preliminary efficacy measures, pre, post and 3-month follow-up was conducted by using several self-rating questionnaires concerning e.g., symptoms of depression and anxiety, parenting stress and behavioral flexibility.

Results: 80 % of the parents attended at least 4/5 sessions. Treatment satisfaction was good and stable over the five sessions. The preliminary efficacy measures showed statistically significant increases in psychological/behavioral flexibility and mindfulness as well as reductions in symptoms of depression and anxiety.

Conclusions:

The Navigator ACT was a feasible intervention in a clinical disability service context. Navigator ACT shows promising preliminary efficacy regarding psychological flexibility and well-being of parents to children with ASD and/or other disabilities. We are currently preparing for a pragmatic multi-center randomized controlled trial concerning Navigator ACT.