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Internet-based versus face-to-face Acceptance and Commitment Therapy for parental psychological flexibility

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Abstract

This study aimed to evaluate the efficacy of Internet vs. in-person Acceptance and Commitment Therapy intervention. The intervention aims to promote parental psychological flexibility and parental emotional regulation strategies in a 6-week/session program. Format efficacy was analyzed independently and comparatively in a non-randomized controlled clinical trial. The intervention protocol is the same, but the internet intervention was applied through a self-applied platform, and the in-person intervention was applied in a group setting. The sample consisted of 82 participants with a mean age of 42.79 (SD = 5.75), 62.2% of whom were women. The mean age of children was 8.41 (SD = 3.9). There were 41 parents each in online and in-person experimental groups. Parental psychological flexibility, experiential avoidance, emotion regulation skills, parental stress, satisfaction with life, and the effects of the intervention on their children’s psychological adjustment were measured at baseline, six-week postintervention, and follow-up at 91 days. The results showed no differences between groups were found in post-treatment. In the follow-up, the results showed that the workshop group reported significantly better scores in goal-oriented emotional regulation skills (F = 4.978; p < .05; η2 = .119) and children’s difficulties (F = 4.679; p < .05; η2 = .112) with a large effect size. The online group reported significant differences with a large effect size in satisfaction with life (F = 10.896; p < .005; η2 = .182) The subgroup analysis found that in-person intervention is more powerful with larger effect size than online intervention. The results of this study provide useful evidence for the use of Acceptance and Commitment Therapy strategies in a parenting intervention.

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References

  • Alexander, K. (2018). Integrative Review of the Relationship Between Mindfulness-Based Parenting Interventions and Depression Symptoms in Parents. Journal of Obstetric, Gynecologic & Neonatal Nursing, 47(2), 184–190. https://doi.org/10.1016/j.jogn.2017.11.013

    Article  Google Scholar 

  • APA. (2021). APA. APA Dictionary of Psychology. https://dictionary.apa.org/

  • Bariola, E., Gullone, E., & Hughes, E. K. (2011). Child and Adolescent Emotion Regulation: The Role of Parental Emotion Regulation and Expression. Clinical Child and Family Psychology Review, 14(2), 198–212. https://doi.org/10.1007/s10567-011-0092-5

    Article  PubMed  Google Scholar 

  • Behbahani, M., Zargar, F., Assarian, F., & Akbari, H. (2018). Effects of mindful parenting training on clinical symptoms in children with attention deficit hyperactivity disorder and parenting stress: Randomized controlled trial. Iranian Journal of Medical Sciences, 43(6), 596–604.

    PubMed  Google Scholar 

  • Berry, J. O., & Jones, W. H. (1995). The Parental Stress Scale: Initial Psychometric Evidence. Journal of Social and Personal Relationships, 12(3), 463–472. https://doi.org/10.1177/0265407595123009

    Article  Google Scholar 

  • Bond, F. W., Hayes, S. C., Baer, R. A., & Carpenter, K. M. (2001). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42(4), 676–688.

    Article  Google Scholar 

  • Brassell, A. A., Rosenberg, E., Parent, J., Rough, J. N., Fondacaro, K., & Seehuus, M. (2016). Parent’s psychological flexibility: Associations with parenting and child psychosocial well-being. Journal of Contextual Behavioral Science, 5(2), 111–120. https://doi.org/10.1016/J.JCBS.2016.03.001

    Article  Google Scholar 

  • Brown, F. L., Whittingham, K., Boyd, R. N., McKinlay, L., & Sofronoff, K. (2014). Improving child and parenting outcomes following paediatric acquired brain injury: A randomised controlled trial of Stepping Stones Triple P plus acceptance and commitment therapy. Journal of Child Psychology and Psychiatry, 55, 1172–1183. https://doi.org/10.1111/jcpp.12227

    Article  PubMed  Google Scholar 

  • Burke, K., & Moore, S. (2015). Development of the parental psychological flexibility questionnaire. Child Psychiatry & Human Development, 46, 548–557.

    Article  Google Scholar 

  • Byrne, G., Ghráda, Á. N., O’Mahony, T., & Brennan, E. (2020). A systematic review of the use of acceptance and commitment therapy in supporting parents. Psychology and Psychotherapy: Theory, Research and Practice. https://doi.org/10.1111/papt.12282

    Article  Google Scholar 

  • Cachia, R. L., Anderson, A., & Moore, D. W. (2016). Mindfulness, Stress and Well-Being in Parents of Children with Autism Spectrum Disorder: A Systematic Review. Journal of Child and Family Studies, 25(1), 1–14. https://doi.org/10.1007/s10826-015-0193-8

    Article  Google Scholar 

  • Carreras, J., Carter, A. S., Heberle, A., Forbes, D., & Gray, S. A. O. (2019). Emotion Regulation and Parent Distress: Getting at the Heart of Sensitive Parenting among Parents of Preschool Children Experiencing High Sociodemographic Risk. Journal of Child and Family Studies, 28(11), 2953–2962. https://doi.org/10.1007/s10826-019-01471-z

    Article  PubMed  PubMed Central  Google Scholar 

  • Casselman, R. B., & Pemberton, J. R. (2015). ACT-Based Parenting Group for Veterans With PTSD: Development and Preliminary Outcomes. The American Journal of Family Therapy, 43(1), 57–66. https://doi.org/10.1080/01926187.2014.939003

    Article  Google Scholar 

  • Chan, T. O., & Lam, S.-F. (2017). Mediator or moderator? The role of mindfulness in the association between child behavior problems and parental stress. Research in Developmental Disabilities, 70, 1–10. https://doi.org/10.1016/j.ridd.2017.08.007

    Article  PubMed  Google Scholar 

  • Chaplin, T. M., Turpyn, C. C., Fischer, S., Martelli, A. M., Ross, C. E., Leichtweis, R. N., Miller, A. B., & Sinha, R. (2018). Parenting-Focused Mindfulness Intervention Reduces Stress and Improves Parenting in Highly Stressed Mothers of Adolescents. Mindfulness. https://doi.org/10.1007/s12671-018-1026-9

    Article  Google Scholar 

  • Chong, Y. Y., Mak, Y. W., Leung, S. P., Lam, S. Y., & Loke, A. Y. (2019). Acceptance and commitment therapy for parental management of childhood asthma: An RCT. Pediatrics, 143(2). https://doi.org/10.1542/peds.2018-1723

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences. https://content.taylorfrancis.com/books/download?dac=C2010-0-30830-5&isbn=9781134742707&format=googlePreviewPdf

  • Corralejo, S. M., & Domenech Rodríguez, M. M. (2018). Technology in Parenting Programs: A Systematic Review of Existing Interventions. Journal of Child and Family Studies, 27(9), 2717–2731. https://doi.org/10.1007/s10826-018-1117-1

    Article  Google Scholar 

  • Corti, C., Pergolizzi, F., Vanzin, L., Cargasacchi, G., Villa, L., Pozzi, M., & Molteni, M. (2018). Acceptance and commitment therapy-oriented parent-training for parents of children with autism. Journal of Child and Family Studies, 27, 2887–2900. https://doi.org/10.1007/s10826-018-1123-3

    Article  Google Scholar 

  • Coyne, L. W., & Wilson, K. G. (2004). The Role of Cognitive Fusion in Impaired Parenting: An RFT Analysis. International Journal of Psychology and Psychological Therapy, 4(3), 469–486.

    Google Scholar 

  • Diener, E., Emmons, R. A., Larsem, R. J., & Griffin, S. (1985). The Satisfaction With Life Scale. Journal of Personality Assessment, 49(1), 71–75. https://doi.org/10.1207/s15327752jpa4901_13

    Article  PubMed  Google Scholar 

  • Español-Martín, G., Pagerols, M., Prat, R., Rivas, C., Sixto, L., Valero, S., Artigas, M. S., Ribasés, M., Ramos-Quiroga, J. A., Casas, M., & Bosch, R. (2020). Strengths and Difficulties Questionnaire: Psychometric Properties and Normative Data for Spanish 5- to 17-Year-Olds. Assessment, 107319112091892. https://doi.org/10.1177/1073191120918929

  • Ferrajão, P. C. (2020). The role of parental emotional validation and invalidation on children’s clinical symptoms: A study with children exposed to intimate partner violence. Journal of Family Trauma, Child Custody & Child Development, 1–17. https://doi.org/10.1080/15379418.2020.1731399

  • Firouzkouhi Moghaddam, M., Rakhshani, T., Assareh, M., & Validad, A. (2017). Child self-esteem and different parenting styles of mothers: A cross-sectional study. Archives of Psychiatry and Psychotherapy, 19(1), 37–42. https://doi.org/10.12740/APP/68160

  • Flujas-Contreras, J. M., García-Palacios, A., & Gómez, I. (2019). Technology-based parenting interventions for children’s physical and psychological health: A systematic review and meta-analysis. Psychological Medicine, 49(11), 1787–1798. https://doi.org/10.1017/S0033291719000692

    Article  PubMed  Google Scholar 

  • Flujas-Contreras, J. M., García-Palacios, A., & Gómez, I. (2020a). Spanish validation of the Parental Acceptance Questionnaire (6-PAQ). International Journal of Clinical and Health Psychology, 20(2), 163–172. https://doi.org/10.1016/j.ijchp.2020.03.002

    Article  PubMed  PubMed Central  Google Scholar 

  • Flujas-Contreras, J. M., García-Palacios, A., & Gómez, I. (2020b). Intervención en flexibilidad parental a través de una intervención grupal en familias. Behavioral psychology, 28(1), 25–57.

    Google Scholar 

  • Flujas-Contreras, J. M., García-Palacios, A., & Gómez, I. (2021a). Effectiveness of a web-based intervention on parental psychological flexibility and emotion regulation: A pilot open trial. International Journal of Environmental Research and Public Health, 18(6), 2958.

    Article  PubMed  PubMed Central  Google Scholar 

  • Flujas-Contreras, J. M., Gómez, I., García-Palacios, A., Chavez, A., & Chavez-Askins, M. (2021b). Protocolo de intervención en flexibilidad psicológica y regulación emocional con terapia contextual en familias: una serie de casos. Revista de Psicología Clínica con Niños y Adolescentes, 8(3), 50–58. https://doi.org/10.21134/rpcna.2021.08.3.6

    Article  Google Scholar 

  • Fonseca, A., Moreira, H., & Canavarro, M. C. (2020). Uncovering the links between parenting stress and parenting styles: The role of psychological flexibility within parenting and global psychological flexibility. Journal of Contextual Behavioral Science, 18, 59–67. https://doi.org/10.1016/j.jcbs.2020.08.004

    Article  Google Scholar 

  • Foody, M., Barnes-Holmes, Y., Barnes-Holmes, D., Törneke, N., Luciano, C., Stewart, I., & McEnteggart, C. (2014). RFT for clinical use: The example of metaphor. Journal of Contextual Behavioral Science, 3(4), 305–313.

    Article  Google Scholar 

  • Gershy, N., Meehan, K. B., Omer, H., Papouchis, N., & Sapir, I. S. (2017). Randomized Clinical Trial of Mindfulness Skills Augmentation in Parent Training. Child and Youth Care Forum, 46(6), 783–803. https://doi.org/10.1007/s10566-017-9411-4

    Article  Google Scholar 

  • Goodman, R. (2001). Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry, 40(11), 1337–1345. https://doi.org/10.1097/00004583-200111000-00015

    Article  PubMed  Google Scholar 

  • Gratz, K. L., & Roemer, L. (2004). Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54. https://doi.org/10.1023/B:JOBA.0000007455.08539.94

    Article  Google Scholar 

  • Greene, R. L., Field, C. E., Fargo, J. D., & Twohig, M. P. (2015). Development and validation of the parental acceptance questionnaire (6-PAQ). Journal of Contextual Behavioral Science, 4(3), 170–175. https://doi.org/10.1016/j.jcbs.2015.05.003

    Article  Google Scholar 

  • Hahs, A. D., Dixon, M. R., & Paliliunas, D. (2019). Randomized controlled trial of a brief acceptance and commitment training for parents of individuals diagnosed with autism spectrum disorders. Journal of Contextual Behavioral Science, 12, 154–159. https://doi.org/10.1016/j.jcbs.2018.03.002

    Article  Google Scholar 

  • Hayes, S. C., Strosahl, K., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press. http://ezproxy.massey.ac.nz/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cat00245a&AN=massey.b2448528&site=eds-live&scope=site

  • Hemm, C., Dagnan, D., & Meyer, T. D. (2018). Social anxiety and parental overprotection in young adults with and without intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 31(3), 360–368. https://doi.org/10.1111/jar.12413

    Article  PubMed  Google Scholar 

  • Hervás, G., & Jódar, R. (2008). Adaptación al castellano de la Escala de Dificultades en la Regulación Emocional The spanish version of the Difficulties in Emotion Regulation Scale. Clínica y Salud, 19(2), 139–156. https://doi.org/10.1128/AEM.01840-06

    Article  Google Scholar 

  • Jamovi. (2021). Jamovi - - Stats. Open. Now. https://www.jamovi.org/

  • Jones, T. L., & Prinz, R. J. (2005). Potential roles of parental self-efficacy in parent and child adjustment: A review. Clinical Psychology Review, 25(3), 341–363.

    Article  PubMed  Google Scholar 

  • Kanstrup, M., Wicksell, R. K., Kemani, M., Wiwe Lipsker, C., Lekander, M., & Holmstrom, L. (2016). A clinical pilot study of individual and group treatment for adolescents with chronic pain and their parents: Effects of acceptance and commitment therapy on functioning. Children, 3, 30–48. https://doi.org/10.3390/children3040030

    Article  PubMed  PubMed Central  Google Scholar 

  • Kohlenberg, R. J., & Tsai, M. (1994). Functional analytic psychotherapy: A radical behavioral approach to treatment and integration. Journal of Psychotherapy Integration, 4(3), 175.

    Article  Google Scholar 

  • LabPsiTec. (2011). Psicología y Tecnología. https://psicologiaytecnologia.labpsitec.es/

  • Lobato, D., Montesinos, F., & Flujas-Contreras, J. M. (2022). Psychological Flexibility Is Associated with Parental Stress in Relatives of People with Intellectual Disabilities. International Journal of Environmental Research and Public Health, 19(10), 6118.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lopez, V., Clifford, T., Minnes, P., & Ouellette-Kuntz, H. (2008). Parental stress and coping in families of children with and without developmental delays. Journal on Developmental Disabilities, 14(2), 99.

    Google Scholar 

  • Martin, C. A., Papadopoulos, N., Chellew, T., Rinehart, N. J., & Sciberras, E. (2019). Associations between parenting stress, parent mental health and child sleep problems for children with ADHD and ASD: Systematic review. Research in Developmental Disabilities, 93, 103463.

    Article  PubMed  Google Scholar 

  • Martin, C. G., Roos, L. E., Zalewski, M., & Cummins, N. (2017). A Dialectical Behavior Therapy Skills Group Case Study on Mothers With Severe Emotion Dysregulation. Cognitive and Behavioral Practice, 24(4), 405–415. https://doi.org/10.1016/j.cbpra.2016.08.002

    Article  Google Scholar 

  • McKinney, C., Steele, E. H., & Story, A. (2019). Effects of Parental Internalizing Problems on Irritability in Adolescents: Moderation by Parental Warmth and Overprotection. Journal of Child and Family Studies, 28(10), 2791–2799. https://doi.org/10.1007/s10826-019-01459-9

    Article  Google Scholar 

  • Montero, I., & León, O. G. (2007). A guide for naming research studies in Psychology 1. International Journal of Clinical and Health Psychology, 7(3), 847–862. ISSN 1697–2600.

  • Murrell, A. R., Wilson, K. G., LaBorde, C. T., Drake, C. E., & Rogers, L. J. (2008). Relational responding in parents. The Behavior Analyst Today, 9(3–4), 196–214. https://doi.org/10.1037/h0100659

    Article  Google Scholar 

  • Newman, K., Harrison, L., Dashiff, C., & Davies, S. (2008). Relationships between parenting styles and risk behaviors in adolescent health: An integrative literature review. Revista Latino-Americana De Enfermagem, 16, 142–150.

    Article  PubMed  Google Scholar 

  • Orgilés, M., Pastor, À. B., Morales, A., & Espada, J. P. (2023). Parental stress as a mediator between parents’ emotion regulation and youth’s psychological symptoms during the COVID-19 lockdown: A cross-sectional study. Psychology, Society & Education, 15(1), 40–47.

    Article  Google Scholar 

  • Oronoz, B., Alonso-Arbiol, I., & Balluerka, N. (2007). A Spanish adaptation of the Parental Stress Scale. Psicothema, 19(4), 687–692.

    PubMed  Google Scholar 

  • Parent, J., McKee, L. G., Rough, J. N., & Forehand, R. (2016). The Association of Parent Mindfulness with Parenting and Youth Psychopathology Across Three Developmental Stages. J Abnorm Child Psychol, 12.

  • Patterson, G. R., DeGarmo, D., & Forgatch, M. S. (2004). Systematic changes in families following prevention trials. Journal of Abnormal Child Psychology, 32, 621–633.

    Article  PubMed  Google Scholar 

  • Pennefather, J., Hieneman, M., Raulston, T. J., & Caraway, N. (2018). Evaluation of an online training program to improve family routines, parental well-being, and the behavior of children with autism. Research in Autism Spectrum Disorders, 54, 21–26. https://doi.org/10.1016/j.rasd.2018.06.006

    Article  Google Scholar 

  • Perry, N. B., Dollar, J. M., Calkins, S. D., Keane, S. P., & Shanahan, L. (2020). Maternal socialization of child emotion and adolescent adjustment: Indirect effects through emotion regulation. Developmental Psychology, 56(3), 541–552. https://doi.org/10.1037/dev0000815

    Article  PubMed  PubMed Central  Google Scholar 

  • Pinquart, M. (2017). Associations of parenting dimensions and styles with externalizing problems of children and adolescents: An updated meta-analysis. Developmental Psychology, 53(5), 873–932. https://doi.org/10.1037/dev0000295

    Article  PubMed  Google Scholar 

  • Poddar, S., Sinha, V. K., & Urbi, M. (2017). Impact of acceptance and commitment therapy on valuing behaviour of parents of children with neurodevelopmental disorders. Psychology and Behavioral Science International Journal, 3(3), 1–5. https://doi.org/10.19080/PBSIJ.2017.03.555614

    Article  Google Scholar 

  • Powers, M. B., Vörding, M. B. Z. V. S., & Emmelkamp, P. M. (2009). Acceptance and commitment therapy: A meta-analytic review. Psychotherapy and Psychosomatics, 78(2), 73–80.

    Article  PubMed  Google Scholar 

  • Rayner, M., Dimovski, A., Muscara, F., Yamada, J., Burke, K., McCarthy, M., Hearps, S. J. C., Anderson, V. A., Coe, A., Hayes, L., Walser, R., & Nicholson, J. M. (2016). Participating From the Comfort of Your Living Room: Feasibility of a Group Videoconferencing Intervention to Reduce Distress in Parents of Children With a Serious Illness or Injury. Child & Family Behavior Therapy, 38(3), 209–224. https://doi.org/10.1080/07317107.2016.1203145

    Article  Google Scholar 

  • Reeves, B. C., & Gaus, W. (2004). Guidelines for Reporting Non-Randomised Studies. Complementary Medicine Research, 11(1), 46–52. https://doi.org/10.1159/000080576

    Article  Google Scholar 

  • Ruiz, F. J., Herrera, A. I. L., Luciano, C., Cangas, A. J., & Beltran, I. (2013). Measuring experiential avoidance and psychological inflexibility: The Spanish version of the Acceptance and Action Questionnaire—II. Psicothema, 25(1), 123–129. https://doi.org/10.7334/psicothema2011.239

    Article  PubMed  Google Scholar 

  • Sairanen, E., Lappalainen, R., Lappalainen, P., Kaipainen, K., Carlstedt, F., Anclair, M., & Hiltunen, A. (2019). Effectiveness of a web-based Acceptance and Commitment Therapy intervention for wellbeing of parents whose children have chronic conditions: A randomized controlled trial. Journal of Contextual Behavioral Science, 13(June 2018), 94–102. https://doi.org/10.1016/j.jcbs.2019.07.004

  • Trigo, M. E., & Martínez, R. J. (2016). Generalized eta squared for multiple comparisons on between-groups designs. Psicothema, 28(3), 340–345. https://doi.org/10.7334/psicothema2015.124

    Article  Google Scholar 

  • Tronieri, J. S., Wadden, T. A., Leonard, S. M., & Berkowitz, R. I. (2019). A pilot study of acceptance-based behavioural weight loss for adolescents with obesity. Behavioural and Cognitive Psychotherapy, 47(6), 686–696. https://doi.org/10.1017/S1352465819000262

    Article  PubMed  PubMed Central  Google Scholar 

  • Vázquez, C., Duque, A., & Hervás, G. (2013). Satisfaction with life scale in a representative sample of Spanish adults: Validation and normative data. Spanish Journal of Psychology, 16(e82), 1–15. https://doi.org/10.1017/sjp.2013.82

    Article  Google Scholar 

  • Whittingham, K., Sanders, M., McKinlay, L., & Boyd, R. N. (2014). Interventions to Reduce Behavioral Problems in Children With Cerebral Palsy: An RCT. Pediatrics, 133(5), e1249–e1257. https://doi.org/10.1542/peds.2013-3620

    Article  PubMed  Google Scholar 

  • Whittingham, K., Sanders, M. R., McKinlay, L., & Boyd, R. N. (2015). Parenting intervention combined with acceptance and commitment therapy: A trial with families of children with cerebral palsy. Journal of Pediatric Psychology, 41, 531–542. https://doi.org/10.1093/jpepsy/jsv118

    Article  PubMed  PubMed Central  Google Scholar 

  • World Health Organization. (2006). Principles for evaluating health risks in children associated with exposure to chemicals. World Health Organization.

  • Williams, K. E., Ciarrochi, J., & Heaven, P. C. L. (2012). Inflexible Parents, Inflexible Kids: A 6-Year Longitudinal Study of Parenting Style and the Development of Psychological Flexibility in Adolescents. Journal of Youth and Adolescence, 41(8), 1053–1066. https://doi.org/10.1007/s10964-012-9744-0

    Article  PubMed  Google Scholar 

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Funding

This work is supported by the Spanish Ministry of Science and Innovation (Project refer- ence/AEI/10.13039/501100011033) awarded to I.G. JMFC acknowledges funding from Juan de la Cierva program (Spain) under Contract No. FJC2021-047648-I.

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Flujas-Contreras, J.M., García-Palacios, A., Castilla, D. et al. Internet-based versus face-to-face Acceptance and Commitment Therapy for parental psychological flexibility. Curr Psychol 43, 9854–9866 (2024). https://doi.org/10.1007/s12144-023-05052-8

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