1
|
Poojari DP, Umakanth S, Maiya GA, Rao BK, Khurana S, Kumaran D S, Attal R, Brien M. Effect of family-centered care interventions on well-being of caregivers of children with cerebral palsy: a systematic review. F1000Res 2024; 12:790. [PMID: 38911944 PMCID: PMC11193087 DOI: 10.12688/f1000research.133314.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/30/2024] [Indexed: 06/25/2024] Open
Abstract
Background Caring for a child with long-term functional limitations can have a negative impact on the physical and psychological well-being of the caregiver. Family-centered care (FCC) interventions have the potential to empower caregivers and contribute to their well-being. This systematic review aimed to synthesize existing evidence on the effectiveness of FCC interventions in improving the well-being of caregivers of children with cerebral palsy (CP), and identify the key components of such interventions that are most commonly practiced and deemed effective. Methods This review systematically searched seven databases for randomized controlled trials that evaluated the effectiveness of any FCC intervention on the well-being of caregivers of children with or at risk of CP. We used the Cochrane RoB 2.0 tool to assess risk of bias and Critical Appraisal Skills Programme (CASP) checklist for critical appraisal. Due to high heterogeneity of studies, narrative synthesis was used to summarize the data. Results The review consists of 11 studies which were categorized into five sections based on the components of FCC intervention provided in each individual study: 1. Information provision, and Enabling and partnership (n= 5); 2. Information provision, and Respectful and supportive care (n= 1); 3. Enabling and partnership (n= 2); 4. Enabling and partnership, and Respectful and supportive care (n= 2); 5. Information provision, Enabling and partnership and Respectful and supportive care (n= 1). Risk of bias was low in four studies, unclear in two studies, and high in five studies. Conclusion FCC interventions were found to be effective in improving caregivers' satisfaction with attainment of child and caregiver goals. Evidence from multiple studies does not strongly support the effectiveness of FCC interventions on caregiver's mental health, parenting and personal outcomes. Limited evidence precludes a conclusion on the effectiveness of the components of FCC on well-being of caregivers of children with CP.
Collapse
Affiliation(s)
- Deepalaxmi Paresh Poojari
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shashikiran Umakanth
- Department of Medicine, Dr TMA Pai Hospital, Udupi, Manipal Academy of Higher Education, Manipal, Karnataka, 576101, India
| | - G. Arun Maiya
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Bhamini Krishna Rao
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Sonia Khurana
- Department of Physical therapy, College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Senthil Kumaran D
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Radhika Attal
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Marie Brien
- Enabling Inclusion Program, Amar Seva Sangam, Ayikudi, Tamil Nadu, India
| |
Collapse
|
2
|
Featherston R, Barlow J, Song Y, Haysom Z, Loy B, Tufford L, Shlonsky A. Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents. Cochrane Database Syst Rev 2024; 1:CD012445. [PMID: 38197473 PMCID: PMC10777456 DOI: 10.1002/14651858.cd012445.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
BACKGROUND Emotional and behavioural difficulties (EBD) in children are common, characterised by externalising or internalising behaviours that can be highly stable over time. EBD are an important cause of functional disability in childhood, and predictive of poorer psychosocial, academic, and occupational functioning into adolescence and adulthood. The prevalence, stability, and long-term consequences of EBD highlight the importance of intervening in childhood when behavioural patterns are more easily modified. Multiple factors contribute to the aetiology of EBD in children, and parenting plays an important role. The relationship between parenting and EBD has been described as bidirectional, with parents and children shaping one another's behaviour. One consequence of bidirectionality is that parents with insufficient parenting skills may become involved in increasingly negative behaviours when dealing with non-compliance in children. This can have a cyclical effect, exacerbating child behavioural difficulties and further increasing parental distress. Behavioural or skills-based parenting training can be highly effective in addressing EBD in children. However, emotional dysregulation may intercept some parents' ability to implement parenting skills, and there is recognition that skills-based interventions may benefit from adjunct components that better target parental emotional responses. Mindful parenting interventions have demonstrated some efficacy in improving child outcomes via improvements in parental emotion regulation, and there is potential for mindfulness training to enhance the effectiveness of standard parent training programmes. OBJECTIVES To assess the effectiveness of mindfulness-enhanced parent training programmes on the psychosocial functioning of children (aged 0 to 18 years) and their parents. SEARCH METHODS We searched the following databases up to April 2023: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL Plus, PsycINFO, Sociological Abstracts, Social Sciences Citation Index, Conference Proceedings Citation Index - Social Science & Humanities, AMED, ERIC, ProQuest Dissertations & Theses, Cochrane Database of Systematic Reviews, Campbell Collaboration Library of Systematic Reviews, as well as the following trials registers: ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP). We also contacted organisations/experts in the field. SELECTION CRITERIA We included randomised and quasi-randomised trials. Participants were parents or caregivers of children under the age of 18. The intervention was mindfulness-enhanced parent training programmes compared with a no-intervention, waitlist, or attentional control, or a parent training programme with no mindfulness component. The intervention must have combined mindfulness parent training with behavioural or skills-based parent training. We defined parent training programmes in terms of the delivery of a standardised and manualised intervention over a specified and limited period, on a one-to-one or group-basis, with a well-defined mindfulness component. The mindfulness component must have included mindfulness training (breath, visualisation, listening, or other sensory focus) and an explicit focus on present-focused attention and non-judgemental acceptance. DATA COLLECTION AND ANALYSIS We followed standard Cochrane procedures. MAIN RESULTS Eleven studies met our inclusion criteria, including one ongoing study. The studies compared a mindfulness-enhanced parent training programme with a no-treatment, waitlist, or attentional control (2 studies); a parent training programme with no mindfulness component (5 studies); both a no-treatment, waitlist, or attentional control and a parent training programme with no mindfulness component (4 studies). We assessed all studies as being at an unclear or high risk of bias across multiple domains. We pooled child and parent outcome data from 2118 participants to produce effect estimates. No study explicitly reported on self-compassion, and no adverse effects were reported in any of the studies. Mindfulness-enhanced parent training programmes compared to a no-treatment, waitlist, or attentional control Very low certainty evidence suggests there may be a small to moderate postintervention improvement in child emotional and behavioural adjustment (standardised mean difference (SMD) -0.46, 95% confidence interval (CI) -0.96 to 0.03; P = 0.06, I2 = 62%; 3 studies, 270 participants); a small improvement in parenting skills (SMD 0.22, 95% CI 0.06 to 0.39; P = 0.008, I2 = 0%; 3 studies, 587 participants); and a moderate decrease in parental depression or anxiety (SMD -0.50, 95% CI -0.96 to -0.04; P = 0.03; 1 study, 75 participants). There may also be a moderate to large decrease in parenting stress (SMD -0.79, 95% CI -1.80 to 0.23; P = 0.13, I2 = 82%; 2 studies, 112 participants) and a small improvement in parent mindfulness (SMD 0.21, 95% CI -0.14 to 0.56; P = 0.24, I2 = 69%; 3 studies, 515 participants), but we were not able to exclude little to no effect for these outcomes. Mindfulness-enhanced parent training programmes compared to parent training with no mindfulness component Very low certainty evidence suggests there may be little to no difference postintervention in child emotional and behavioural adjustment (SMD -0.09, 95% CI -0.58 to 0.40; P = 0.71, I2 = 64%; 5 studies, 203 participants); parenting skills (SMD 0.13, 95% CI -0.16 to 0.42; P = 0.37, I2 = 16%; 3 studies, 319 participants); and parent mindfulness (SMD 0.11, 95% CI -0.19 to 0.41; P = 0.48, I2 = 44%; 4 studies, 412 participants). There may be a slight decrease in parental depression or anxiety (SMD -0.24, 95% CI -0.83 to 0.34; P = 0.41; 1 study, 45 participants; very low certainty evidence), though we cannot exclude little to no effect, and a moderate decrease in parenting stress (SMD -0.51, 95% CI -0.84 to -0.18; P = 0.002, I2 = 2%; 3 studies, 150 participants; low certainty evidence). AUTHORS' CONCLUSIONS Mindfulness-enhanced parenting training may improve some parent and child outcomes, with no studies reporting adverse effects. Evidence for the added value of mindfulness training to skills-based parenting training programmes is suggestive at present, with moderate reductions in parenting stress. Given the very low to low certainty evidence reviewed here, these estimates will likely change as more high-quality studies are produced.
Collapse
Affiliation(s)
- Rebecca Featherston
- Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine Nursing & Health Sciences, Monash University, Caulfield, Australia
| | - Jane Barlow
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Yunshan Song
- Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine Nursing & Health Sciences, Monash University, Caulfield, Australia
| | - Zoe Haysom
- Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine Nursing & Health Sciences, Monash University, Caulfield, Australia
| | - Brenda Loy
- Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine Nursing & Health Sciences, Monash University, Caulfield, Australia
| | - Lea Tufford
- School of Nursing and Allied Health Professions, Laurentian University, Ontario, Canada
| | - Aron Shlonsky
- Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine Nursing & Health Sciences, Monash University, Caulfield, Australia
| |
Collapse
|
3
|
Oldham M, Dinu L, Loebenberg G, Field M, Hickman M, Michie S, Brown J, Garnett C. Methodological Insights on Recruitment and Retention From a Remote Randomized Controlled Trial Examining the Effectiveness of an Alcohol Reduction App: Descriptive Analysis Study. JMIR Form Res 2024; 8:e51839. [PMID: 38180802 PMCID: PMC10799283 DOI: 10.2196/51839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/07/2023] [Accepted: 11/24/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Randomized controlled trials (RCTs) with no in-person contact (ie, remote) between researchers and participants offer savings in terms of cost and time but present unique challenges. OBJECTIVE The goal of this study is to examine the differences between different forms of remote recruitment (eg, National Health Service [NHS] website, social media, and radio advertising) in the proportion of participants recruited, demographic diversity, follow-up rates, and cost. We also examine the cost per participant of sequential methods of follow-up (emails, phone calls, postal surveys, and postcards). Finally, our experience with broader issues around study advertising and participant deception is discussed. METHODS We conducted a descriptive analysis of 5602 increasing-and-higher-risk drinkers (Alcohol Use Disorders Identification Test score ≥8), taking part in a 2-arm, parallel group, remote RCT with a 1:1 allocation, comparing the intervention (Drink Less app) with usual digital care (NHS alcohol advice web page). Participants were recruited between July 2020 and March 2022 and compensated with gift vouchers of up to £36 (a currency exchange rate of £1=US $1.26988 is applicable) for completing follow-up surveys, with 4 stages of follow-up: email reminders, phone calls, postal survey, and postcard. RESULTS The three main recruitment methods were advertisements on (1) social media (2483/5602, 44.32%), (2) the NHS website (1961/5602, 35.01%), and (3) radio and newspapers (745/5602, 13.3%), with the remaining methods of recruitment accounting 7.37% (413/5602) of the sample. The overall recruitment cost per participant varied from £0 to £11.01. Costs were greater when recruiting participants who were men (£0-£28.85), from an ethnic minority group (£0-£303.81), and more disadvantaged (£0-£49.12). Targeted approaches were useful for recruiting more men but less useful in achieving diversity in ethnicity and socioeconomic status. Follow-up at 6 months was 79.58% (4458/5602). Of those who responded, 92.4% (4119/4458) responded by email. Each additional stage of follow-up resulted in an additional 2-3 percentage points of the overall sample being followed up, although phone calls, postal surveys, and postcards were more resource intensive than email reminders. CONCLUSIONS For remote RCTs, researchers could benefit from using a range of recruitment methods and cost-targeted approaches to achieve demographic diversity. Automated emails with substantial financial incentives for prompt completion can achieve good follow-up rates, and sequential, offline follow-up options, such as phone calls and postal surveys, can further increase follow-up rates but are comparatively expensive. We also make broader recommendations focused on striking the right balance when designing remote RCTs. Careful planning, ongoing maintenance, and dynamic decision-making are required throughout a trial to balance the competing demands of participation among those eligible, deceptive participation among those who are not eligible, and ensuring no postrandomization bias is introduced by data-checking protocols.
Collapse
Affiliation(s)
- Melissa Oldham
- University College London, London, London, United Kingdom
| | - Larisa Dinu
- University College London, London, London, United Kingdom
| | | | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, United Kingdom
| | - Jamie Brown
- University College London, London, London, United Kingdom
| | - Claire Garnett
- University College London, London, London, United Kingdom
| |
Collapse
|
4
|
Gur A, Reich A. Psychological flexibility of parents of children with disabilities: A systematic literature review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 136:104490. [PMID: 36966545 DOI: 10.1016/j.ridd.2023.104490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 02/27/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE Psychological flexibility, a popular concept in clinical psychology, is still evolving in the context of studying parents of children with disabilities. This study systematically reviewed the literature on the psychological flexibility of parents of children with disabilities to identify contributions of the literature and make recommendations for practice and future study. MATERIALS AND METHODS The systematic review was conducted according to the PRISMA guidelines and identified studies on the psychological flexibility of parents of children with disabilities using five electronic databases: PsychNet, PubMed, ERIC, Social Services Abstracts, and EBSCO. Twenty-six articles met the criteria and were included. A thematic analysis was conducted to extract major themes. RESULTS Three major themes emerged from the data: (1) psychological flexibility is associated with various aspects of mental health; (2) psychological flexibility is associated with parental functioning in caring for children with a disability; (3) acceptance and commitment therapy (ACT) based interventions effectively enhance the psychological flexibility of parents of children with disabilities. CONCLUSIONS The study concludes that psychological flexibility is extremely relevant to disability studies and should be further explored in relation to different parental well-being and functioning aspects. Professionals are encouraged to incorporate principles of acceptance and commitment therapy into their work with parents of children with disabilities.
Collapse
Affiliation(s)
- Ayelet Gur
- Social Work Department, Tel-Hai College, Upper Galilee, Israel.
| | - Ari Reich
- Faculty of Education, Bar Ilan University, Ramat Gan, Israel
| |
Collapse
|
5
|
Okajima J, Okajima I. Psychometric Properties of the Japanese Version of the Parental Acceptance and Action Questionnaire in Parents with Infants and Toddlers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095674. [PMID: 37174194 PMCID: PMC10178238 DOI: 10.3390/ijerph20095674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/23/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023]
Abstract
We aimed to examine the reliability and validity of the Parental Acceptance and Action Questionnaire-Japanese version (PAAQ-J). We considered a total of 2000 mothers with infants and toddlers aged 0-3 years and evaluated their scores on the PAAQ-J Acceptance and Action Questionnaire-II (AAQ-II) and Hospital Anxiety and Depression Scale (HADS). We conducted an exploratory factor analysis, creating a PAAQ-J with 12 items and three factors (α = 0.80): Inaction-Behavior, Inaction-Cognition, and Unwillingness, with α of 0.84, 0.72 and 0.68, respectively. The test-retest reliability examination results showed that the interclass correlation coefficient was 0.49, with 95% CI between 0.44 and 0.54. The correlation coefficient of PAAQ-J was 0.57, 0.32, and 0.33 with AAQ-II, and HADS-depression and HADS-anxiety, respectively. PAAQ-J's validity to adequately evaluate an individual's avoidance of experiences regarding childcare and their psychological flexibility was proven. Since the original PAAQ was for 6-18-year-old children with anxiety symptoms, it is necessary to examine its reliability and validity not only for infants and toddlers, but also for parents of older children and adolescents in the future.
Collapse
Affiliation(s)
- Junko Okajima
- Department of Psychology, Rikkyo University, Saitama 352-8558, Japan
- Department of Rehabilitation, University of Tokyo Health Sciences, Tokyo 206-0033, Japan
| | - Isa Okajima
- Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, Tokyo 173-8602, Japan
| |
Collapse
|
6
|
Noritz G, Davidson L, Steingass K. Providing a Primary Care Medical Home for Children and Youth With Cerebral Palsy. Pediatrics 2022; 150:e2022060055. [PMID: 36404756 DOI: 10.1542/peds.2022-060055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cerebral palsy (CP) is the most common motor disorder of childhood, with prevalence estimates ranging from 1.5 to 4 in 1000 live births. This clinical report seeks to provide primary care physicians with guidance to detect children with CP; collaborate with specialists in treating the patient; manage associated medical, developmental, and behavioral problems; and provide general medical care to their patients with CP.
Collapse
Affiliation(s)
- Garey Noritz
- Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio; and
| | - Lynn Davidson
- The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Katherine Steingass
- Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio; and
| |
Collapse
|
7
|
Rakhshani T, Hamid S, Kamyab A, Kashfi SM, Jeihooni AK. The effect of parenting style on anxiety and depression in adolescent girls aged 12–16 years. Heliyon 2022; 8:e11478. [DOI: 10.1016/j.heliyon.2022.e11478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/13/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
|
8
|
Whittingham K, Sheffield J, Mak C, Wright A, Boyd RN. Parenting Acceptance and Commitment Therapy: An RCT of an online course with families of children with CP. Behav Res Ther 2022; 155:104129. [DOI: 10.1016/j.brat.2022.104129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/09/2022] [Accepted: 05/21/2022] [Indexed: 11/02/2022]
|
9
|
Lamond B, Roberts SD, Miller SP, Wade SL, Williams TS. Psychosocial Intervention Outcomes for Children with Congenital and Neonatal Conditions: Systematic Review. J Pediatr Psychol 2022; 47:1003-1018. [PMID: 35472174 DOI: 10.1093/jpepsy/jsac038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/14/2022] Open
Abstract
There has been a historic lack of psychosocially geared treatment studies for congenital and neonatal conditions that impact brain development, despite well-established knowledge that these conditions impact cognitive development, quality of life (QoL), mental health, and academic success. OBJECTIVE The aim of the present study was to systematically investigate the research literature focusing on the effects of interventions in psychosocially geared programs for children with neonatal brain injury on school and psychological outcomes. METHODS Psychosocially geared programs broadly refer to interventions to improve parenting and school functioning, or child behavior, as well as other interventions that have a psychological component but may be more physically oriented, such as goal-directed physiotherapy. A comprehensive search of PubMed, Medline, PsychINFO, and Embase was completed between June and July 2020. The methodological quality of included articles was assessed using the Cochrane Risk of Bias Tool for Randomized Trials (RoB-2). RESULTS AND CONCLUSION Twenty studies met the inclusion criteria and demonstrated adequate risk of bias (i.e., low risk of bias or some concerns). The studies included family (n = 2), parenting (n = 7), and child (n = 10) interventions. There is some evidence supporting the effectiveness of psychosocial interventions for children with neonatal brain injury and their families on academic outcomes, behavior, and QoL, indicated by positive intervention effects in 65% (n = 13) of studies.
Collapse
Affiliation(s)
- Bronwyn Lamond
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Canada.,Department of Applied Psychology and Human Development, The University of Toronto, Canada
| | - Samantha D Roberts
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Canada.,Department of Psychology, York University, Canada
| | - Steven P Miller
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Canada.,BC Children's Hospital & Sunny Hill Health Centre, Canada
| | - Shari L Wade
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, USA
| | - Tricia S Williams
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Canada.,Department of Pediatrics, The University of Toronto, Canada
| |
Collapse
|
10
|
Sundin P, Crespi CM. Power analysis for stepped wedge trials with multiple interventions. Stat Med 2022; 41:1498-1512. [PMID: 35014710 DOI: 10.1002/sim.9301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/02/2021] [Accepted: 12/09/2021] [Indexed: 11/06/2022]
Abstract
Stepped wedge design (SWD) trials are cluster randomized trials that feature staggered, unidirectional cross-over between treatment conditions. Existing literature on power for SWDs focuses primarily on designs with two conditions, typically a control and an intervention condition. However, SWDs with more than one treatment condition are being proposed and conducted. We present a linear mixed model for SWDs with two or more interventions, including both multiarm and factorial designs. We derive standard errors of the intervention effect coefficients, and present power calculation methods. We consider both repeated cross-sectional and cohort designs. Design features, with a focus on treatment allocations, are examined to determine their impact on power.
Collapse
Affiliation(s)
- Phillip Sundin
- Department of Biostatistics, University of California Los Angeles (UCLA), Los Angeles, California, USA
| | - Catherine M Crespi
- Department of Biostatistics, University of California Los Angeles (UCLA), Los Angeles, California, USA
| |
Collapse
|
11
|
Thompson M, Bond FW, Lloyd J, Anslow S, Berry E. Exploring the role of contextual behavioural science variables and education in the prosocial domain of global poverty and human rights. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
12
|
Andrews ML, Garcia YA, Catagnus RM, Gould ER. Effects of Acceptance and Commitment Training Plus Behavior Parent Training on Parental Implementation of Autism Treatment. PSYCHOLOGICAL RECORD 2021; 72:601-617. [PMID: 34866659 PMCID: PMC8628834 DOI: 10.1007/s40732-021-00496-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 11/27/2022]
Abstract
The objective of this study was to examine the effects of acceptance and commitment training (ACT) plus behavior parent training (BPT), when delivered via telehealth, on parental implementation of behavioral strategies, experiential avoidance (EA), and stress. The study also examined the subsequent effects on the parents’ autistic children’s behaviors. A multiple baseline design was implemented across four parent-child dyads who participated in the online training. The findings showed that ACT+BPT resulted in parental implementation reaching and maintaining high levels. The training also decreased EA and stress in three parents. Moreover, the parents’ ratings of their children’s challenging behaviors decreased. However, such a trend was not as clearly depicted by direct measures of the children’s behaviors. A social validity interview revealed parents found ACT beneficial in assisting them to learn and use the BPT strategies. Implications and suggestions for future research are discussed.
Collapse
Affiliation(s)
- Meredith L. Andrews
- Applied Behavior Analysis Online Program, The Chicago School of Professional Psychology, 325 North Wells Street, Chicago, IL USA
| | | | - Robyn M. Catagnus
- Applied Behavior Analysis Online Program, The Chicago School of Professional Psychology, 325 North Wells Street, Chicago, IL USA
| | | |
Collapse
|
13
|
Byrne G, Ghráda ÁN, O'Mahony T, Brennan E. A systematic review of the use of acceptance and commitment therapy in supporting parents. Psychol Psychother 2021; 94 Suppl 2:378-407. [PMID: 32406169 DOI: 10.1111/papt.12282] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 04/03/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Acceptance and commitment therapy (ACT) has accrued a growing evidence-base for a wide variety of psychological difficulties. Given that ACT promotes broad and flexible repertoires of behaviour as well as neutralizing the ubiquitous psychological processes theorized to be responsible for much human suffering, such an approach may hold promise. The use of ACT-informed parenting interventions offers another alternative to solely behavioural approaches but it remains relatively understudied and in need of further exploration. DESIGN The current systematic review, which searched four databases, aimed to collate all ACT interventions that included parental therapeutic components in the treatment of various child presenting difficulties. The review also rated the methodological rigour of the ACT evidence-base for this type of treatment format. RESULTS Twenty-seven individual studies covering a broad spectrum of presenting problems were included, comprising of 1,155 participants. A large proportion of studies were within-group designs with a smaller number using randomized controlled trials. The majority of studies reported improvements on either parent report symptoms regarding child physical or psychological functioning as well as parent-reported measures of stress, depression, and anxiety. Similar improvements were noted on a number of ACT mechanisms of change outcomes, including mindfulness, acceptance, and cognitive fusing. These gains were evident for parents of children with neurodevelopmental disorders, chronic pain, and significant physical health difficulties. Maintenance or further treatment gains were often reported at follow-up. These positive findings are tempered by low levels of methodological rigour common in some of the studies included. CONCLUSIONS Despite these limitations, ACT holds promise as a transdiagnostic intervention that can help with the parenting of children with a range of psychological and physical difficulties. PRACTITIONER POINTS ACT has accrued a relatively strong evidence base for a range of psychological difficulties. Despite some methodological shortcomings, ACT shows promise as an intervention to help parents manage stress and difficulties especially in relation to children with autism, chronic pain, and physical health needs. Further research is required in comparing ACT to more established treatments and helping consolidate initial positive findings.
Collapse
Affiliation(s)
- Gary Byrne
- Health Service Executive, Dublin, Ireland
| | | | | | - Emma Brennan
- School of Psychology, Trinity College, Dublin, Ireland
| |
Collapse
|
14
|
Jin X, Wong CL, Li H, Chen J, Chong YY, Bai Y. Acceptance and Commitment Therapy for psychological and behavioural changes among parents of children with chronic health conditions: A systematic review. J Adv Nurs 2021; 77:3020-3033. [PMID: 33626192 DOI: 10.1111/jan.14798] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/12/2020] [Accepted: 01/25/2021] [Indexed: 12/13/2022]
Abstract
AIMS To systematically identify the application of Acceptance and Commitment Therapy among parents of children with chronic health conditions and determine its effectiveness in parental psychological flexibility, psychological distress and parenting behaviour. DESIGN Systematic review. DATA SOURCES Nine databases (i.e. MEDLINE, PubMed, Embase, Cochrane Library, CINAHL, PsychINFO, Web of Science, China National Knowledge Infrastructure and WanFang Data) were systematically searched from inception to October 2019. REVIEW METHODS Quality of studies was appraised by using the Joanna Briggs Institute critical appraisal checklist. Findings were synthesized narratively. This work was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. RESULTS Eight studies involving 485 parents were included. Results indicated that Acceptance and Commitment Therapy significantly improved parental psychological flexibility and reduced psychological distress compared with usual care and waitlist, but was not significantly different from active treatments. Limited studies have provided very preliminary evidence that Acceptance and Commitment Therapy can significantly improve dysfunctional parenting behaviour than usual care and waitlist. High attrition rate at follow-up made the overall confidence of maintained effect relatively low. CONCLUSION This review provides preliminary evidence that Acceptance and Commitment Therapy is beneficial for improving psychological flexibility, psychological distress and parenting behaviour among parents of children with chronic health conditions. Future studies with rigorous designs and large sample sizes are warranted to verify the evidence and explore its long-term efficacy. IMPACT Acceptance and Commitment Therapy has been increasingly applied to parents of children with chronic health conditions. This review provides positive evidence of its effects on psychological and behavioural outcomes among these parents. This work will help healthcare professionals and researchers with their practice and further research.
Collapse
Affiliation(s)
- Xiaohuan Jin
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Huiyuan Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jieling Chen
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yang Bai
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
15
|
Scott B, Gurwitch RH, Messer EP, Kelley LP, Myers DR, Young JK. Integrated CARE: Adaptation of Child-Adult Relationship Enhancement (CARE) Model for Use in Integrated Behavioral Pediatric Care. Clin Pediatr (Phila) 2021; 60:100-108. [PMID: 32959667 DOI: 10.1177/0009922820959938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The authors adapted the established Child-Adult Relationship Enhancement (CARE) interaction model for use in integrated behavioral health clinics. CARE was modified for delivery in the examination room, during routine primary care visits. Adopting a real-world implementation approach, clinical social workers were trained in the new model-IntegratedCARE-and provided the brief, 3-session treatment to 30 different parent-child dyads. Measurements included the Parental Stress Index-4 Short Form (PSI 4-SF), the Eyberg Childhood Behavior Inventory (ECBI), and the Therapy Attitude Inventory (TAI). There was a statistically significant mean score decrease on the both subscales of the ECBI at pre- and posttreatment. Scores on the TAI indicated that participants were satisfied with the treatment. Attrition rates were somewhat lower than similar studies. Findings indicate the IntegratedCARE model is feasible for sustainable delivery by trained behavioral health professionals in primary care.
Collapse
|
16
|
Vyas SS, Ford MK, Tam EWY, Westmacott R, Sananes R, Beck R, Williams TS. Intervention experiences among children with congenital and neonatal conditions impacting brain development: patterns of service utilization, barriers and future directions. Clin Neuropsychol 2021; 35:1009-1029. [DOI: 10.1080/13854046.2020.1871516] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Shruti S. Vyas
- Division of Neurology, Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Meghan K. Ford
- Division of Neurology, Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Emily W. Y. Tam
- Department of Pediatrics, The University of Toronto, Toronto, ON, Canada
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Robyn Westmacott
- Division of Neurology, Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Pediatrics, The University of Toronto, Toronto, ON, Canada
| | - Renee Sananes
- Department of Pediatrics, The University of Toronto, Toronto, ON, Canada
- Division of Cardiology, Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Ranit Beck
- Division of Neonatology, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Tricia S. Williams
- Division of Neurology, Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Pediatrics, The University of Toronto, Toronto, ON, Canada
| |
Collapse
|
17
|
Whittingham K, Sheffield J, Mak C, Dickinson C, Boyd RN. Early Parenting Acceptance and Commitment Therapy 'Early PACT' for parents of infants with cerebral palsy: a study protocol of a randomised controlled trial. BMJ Open 2020; 10:e037033. [PMID: 33039994 PMCID: PMC7552872 DOI: 10.1136/bmjopen-2020-037033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION New international clinical practice guidelines exist for identifying infants at high risk of cerebral palsy (CP) earlier: between 12 to 24 weeks corrected age, significantly earlier than previous diagnosis windows in Australia at 19 months. The earlier detection of infants at high risk of CP creates an opportunity for earlier intervention. The quality of the parent-infant relationship impacts various child outcomes, and is leveraged in other forms of intervention. This paper presents the protocol of a randomised controlled trial of an online parent support programme, Early Parenting Acceptance and Commitment Therapy (Early PACT) for families of infants identified as at high risk of CP. We predict that participating in the Early PACT programme will be associated with improvements in the parent-infant relationship, in parent mental health and well-being as well as infant behaviour and quality of life. METHODS AND ANALYSIS This study aims to recruit 60 parents of infants (0 to 2 years old corrected age) diagnosed with CP or identified as at high risk of having CP. Participants will be randomly allocated to one of two groups: Early PACT or waitlist control (1:1). Early PACT is an online parent support programme grounded in Acceptance and Commitment Therapy (ACT). It is delivered as a course on an open source course management system called edX. Early PACT is designed to support parental adjustment and parent-infant relationship around the time of early diagnosis. Assessments will be conducted at baseline, following completion of Early PACT and at 6-month follow-up (retention). The primary outcome will be the quality of parent-child interactions as measured by the Emotional Availability Scale. Standard analysis methods for randomised controlled trial will be used to make comparisons between the two groups (Early PACT and waitlist control). Retention of effects will be examined at 6-month follow-up. ETHICS AND DISSEMINATION This study is approved through appropriate Australian and New Zealand ethics committees (see in text) with parents providing written informed consent. Findings from this trial will be disseminated through peer-reviewed journal publications and conference presentations. TRIAL REGISTRATION DETAILS This trial has been prospectively registered on 12 June 2018 to present (ongoing) with the Australian New Zealand Clinical Trials Registry (ACTRN12618000986279); https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=3 74 896.
Collapse
Affiliation(s)
- Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre (CHRC), Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Jeanie Sheffield
- School of Psychology, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Catherine Mak
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre (CHRC), Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Corrine Dickinson
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre (CHRC), Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre (CHRC), Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
18
|
Burek B, Ford MK, Hooper M, Green R, Kohut SA, Andrade BF, Ravi M, Sananes R, Desrocher M, Miller SP, Wade SL, Williams TS. Transdiagnostic feasibility trial of internet-based parenting intervention to reduce child behavioural difficulties associated with congenital and neonatal neurodevelopmental risk: introducing I-InTERACT-North. Clin Neuropsychol 2020; 35:1030-1052. [DOI: 10.1080/13854046.2020.1829071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Brittany Burek
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Toronto, Canada
- Department of Applied Psychology and Human Development, The University of Toronto, Toronto, Canada
| | - Meghan K. Ford
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Marie Hooper
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Toronto, Canada
- Department of Psychology, York University, Toronto, Canada
| | - Rivka Green
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Toronto, Canada
- Department of Psychology, York University, Toronto, Canada
| | - Sara Ahola Kohut
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Brendan F. Andrade
- Margaret and Wallace McCain Centre for Child Youth and Family Mental Health, Child Youth and Emerging Adult Program, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, The University of Toronto, Toronto, Canada
| | - Monidipa Ravi
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Toronto, Canada
- Department of Psychiatry, The University of Toronto, Toronto, Canada
| | - Renee Sananes
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Mary Desrocher
- Department of Psychology, York University, Toronto, Canada
| | - Steven P. Miller
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Toronto, Canada
- Department of Pediatrics, The University of Toronto, Toronto, Canada
| | - Shari L. Wade
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Tricia S. Williams
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Toronto, Canada
- Department of Pediatrics, The University of Toronto, Toronto, Canada
- Department of Psychiatry, The University of Toronto, Toronto, Canada
| |
Collapse
|
19
|
Daks JS, Peltz JS, Rogge RD. Psychological flexibility and inflexibility as sources of resiliency and risk during a pandemic: Modeling the cascade of COVID-19 stress on family systems with a contextual behavioral science lens. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020; 18:16-27. [PMID: 32834972 PMCID: PMC7428754 DOI: 10.1016/j.jcbs.2020.08.003] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The coronavirus disease (COVID-19) pandemic and the historic economic shutdown and stay-at-home efforts to slow its spread have radically impacted the lives of families across the world, completely disrupting routines and challenging them to adjust to new health risks as well as to new work and family demands. The current study applied a contextual behavioral science lens to the spillover hypothesis of Family Systems Theory to develop a multi-stage mechanistic model for how COVID-19 stress could impact family and child functioning and how parents' psychological flexibility could shape those processes. METHODS A total of 742 coparents (71% female; 84% Caucasian, 85% married, M = 41 years old) of children (ages 5-18, M = 9.4 years old, 50% male) completed an online survey from March 27th to the end of April 2020. RESULTS Path analyses highlighted robust links from parent inflexibility to all components of the model, predicting: greater COVID-19 stress, greater coparenting discord and family discord, greater caustic parenting, and greater parent and child distress. Parent flexibility was associated with greater family cohesion, lower family discord and greater use of constructive parenting strategies (inductive, democratic/autonomy supportive, positive). Results further suggested that COVID-19 stressors predicted greater family and coparent discord, which in turn predicted greater use of caustic parenting (reactive, inconsistent, aggressive), which in turn predicted greater child and parent distress. CONCLUSIONS The current results highlight parental flexibility and inflexibility as key points of intervention for helping families navigate the current global health crisis, highlighting the crucial role they play in the lives of families.
Collapse
|
20
|
Moore DA, Nunns M, Shaw L, Rogers M, Walker E, Ford T, Garside R, Ukoumunne O, Titman P, Shafran R, Heyman I, Anderson R, Dickens C, Viner R, Bennett S, Logan S, Lockhart F, Thompson Coon J. Interventions to improve the mental health of children and young people with long-term physical conditions: linked evidence syntheses. Health Technol Assess 2020; 23:1-164. [PMID: 31122334 DOI: 10.3310/hta23220] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Although mental health difficulties can severely complicate the lives of children and young people (CYP) with long-term physical conditions (LTCs), there is a lack of evidence about the effectiveness of interventions to treat them. OBJECTIVES To evaluate the clinical effectiveness and cost-effectiveness of interventions aiming to improve the mental health of CYP with LTCs (review 1) and explore the factors that may enhance or limit their delivery (review 2). DATA SOURCES For review 1, 13 electronic databases were searched, including MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Science Citation Index. For review 2, MEDLINE, PsycINFO and CINAHL were searched. Supplementary searches, author contact and grey literature searches were also conducted. REVIEW METHODS The first systematic review sought randomised controlled trials (RCTs) and economic evaluations of interventions to improve elevated symptoms of mental ill health in CYP with LTCs. Effect sizes for each outcome were calculated post intervention (Cohen's d). When appropriate, random-effects meta-analyses produced pooled effect sizes (d). Review 2 located primary qualitative studies exploring experiences of CYP with LTCs, their families and/or practitioners, regarding interventions aiming to improve the mental health and well-being of CYP with LTCs. Synthesis followed the principles of metaethnography. An overarching synthesis integrated the findings from review 1 and review 2 using a deductive approach. End-user involvement, including topic experts and CYP with LTCs and their parents, was a feature throughout the project. RESULTS Review 1 synthesised 25 RCTs evaluating 11 types of intervention, sampling 12 different LTCs. Tentative evidence from seven studies suggests that cognitive-behavioural therapy interventions could improve the mental health of CYP with certain LTCs. Intervention-LTC dyads were diverse, with few opportunities to meta-analyse. No economic evaluations were located. Review 2 synthesised 57 studies evaluating 21 types of intervention. Most studies were of individuals with cancer, a human immunodeficiency virus (HIV) infection or mixed LTCs. Interventions often aimed to improve broader mental health and well-being, rather than symptoms of mental health disorder. The metaethnography identified five main constructs, described in an explanatory line of argument model of the experience of interventions. Nine overarching synthesis categories emerged from the integrated evidence, raising implications for future research. LIMITATIONS Review 1 conclusions were limited by the lack of evidence about intervention effectiveness. No relevant economic evaluations were located. There were no UK studies included in review 1, limiting the applicability of findings. The mental health status of participants in review 2 was usually unknown, limiting comparability with review 1. The different evidence identified by the two systematic reviews challenged the overarching synthesis. CONCLUSIONS There is a relatively small amount of comparable evidence for the effectiveness of interventions for the mental health of CYP with LTCs. Qualitative evidence provided insight into the experiences that intervention deliverers and recipients valued. Future research should evaluate potentially effective intervention components in high-quality RCTs integrating process evaluations. End-user involvement enriched the project. STUDY REGISTRATION This study is registered as PROSPERO CRD42011001716. FUNDING The National Institute for Health Research (NIHR) Health Technology Assessment programme and the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula.
Collapse
Affiliation(s)
- Darren A Moore
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Michael Nunns
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Liz Shaw
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Morwenna Rogers
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Erin Walker
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Tamsin Ford
- Child Mental Health Group, University of Exeter Medical School, Exeter, UK
| | - Ruth Garside
- The European Centre for Environment and Human Health, University of Exeter Medical School, Exeter, UK
| | - Obi Ukoumunne
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Penny Titman
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Roz Shafran
- University College London Institute of Child Health, London, UK
| | - Isobel Heyman
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Rob Anderson
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Chris Dickens
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Russell Viner
- University College London Institute of Child Health, London, UK
| | - Sophie Bennett
- University College London Institute of Child Health, London, UK
| | - Stuart Logan
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Fiona Lockhart
- Biomedical Research Centre Patient & Public Involvement Group, University College London Hospitals, London, UK
| | - Jo Thompson Coon
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| |
Collapse
|
21
|
Whittingham K, McGlade A, Kulasinghe K, Mitchell AE, Heussler H, Boyd RN. ENACT (ENvironmental enrichment for infants; parenting with Acceptance and Commitment Therapy): a randomised controlled trial of an innovative intervention for infants at risk of autism spectrum disorder. BMJ Open 2020; 10:e034315. [PMID: 32819928 PMCID: PMC7440709 DOI: 10.1136/bmjopen-2019-034315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 05/04/2020] [Accepted: 06/08/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition with impacts on behaviour, cognition, communication, social interaction and family mental health. This paper reports the protocol of a randomised controlled trial (RCT) of a very early intervention, ENACT (ENvironmental enrichment for infants; parenting with Acceptance and Commitment Therapy), for families of infants at risk of ASD. METHODS AND ANALYSIS We aim to recruit 66 mothers of infants at risk of ASD (ie, infants with a sibling or parent diagnosed with ASD) to this RCT. Families will be randomly assigned to care-as-usual or ENACT. ENACT is a very early intervention, leveraging parent-child interactions to improve early social reciprocity, while supporting parental mental health and the parent-child relationship through Acceptance and Commitment Therapy. Intervention content is delivered online (approximately 8 hours) and supported by more than 7 consultations with a clinician. Parents will perform the social reciprocity intervention with their child (30 min per day). Assessments at four time points (baseline, 3 months, 6 months, and 12 months corrected age) will assess parent-infant interaction, parental mental health, infant development and early ASD markers. Analysis will be by intention to treat using general linear models for RCTs. ETHICS AND DISSEMINATION This protocol has been approved by the Children's Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC/19/QCHQ/50131) and the University of Queensland Human Research Ethics Committee (2019000558). If efficacy is demonstrated, the intervention has the potential for wide and accessible dissemination. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12618002046280).
Collapse
Affiliation(s)
- Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Andrea McGlade
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Kavindri Kulasinghe
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Amy E Mitchell
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Honey Heussler
- Mater Medical Research Institute, South Brisbane, Queensland, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
22
|
Han A, Yuen HK, Jenkins J. Acceptance and commitment therapy for family caregivers: A systematic review and meta-analysis. J Health Psychol 2020; 26:82-102. [PMID: 32659142 DOI: 10.1177/1359105320941217] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Acceptance and commitment therapy is an emerging evidenced-based practice, but no systematic review regarding the effects of ACT on family caregivers has been conducted. This article examined the effects of ACT on family caregivers by conducting meta-analysis with a random effects model. Twenty-four articles were identified from four electronic databases searched up to 30 March 2020. Meta-analyses found moderate effects of ACT on depressive symptoms and quality of life, small effects on anxiety, and small to moderate effects on stress. Further ACT studies should be conducted to measure effects on different outcomes for various family caregiver populations.
Collapse
Affiliation(s)
- Areum Han
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hon K Yuen
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeremy Jenkins
- Telehealth Private Practice: jeremyjenkins.icouch.me, Montana, USA
| |
Collapse
|
23
|
Fang S, Ding D. The efficacy of group-based acceptance and commitment therapy on psychological capital and school engagement: A pilot study among Chinese adolescents. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.04.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
24
|
Meuret AE, Tunnell N, Roque A. Anxiety Disorders and Medical Comorbidity: Treatment Implications. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:237-261. [PMID: 32002933 DOI: 10.1007/978-981-32-9705-0_15] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Anxiety disorders are debilitating psychological disorders characterized by a wide range of cognitive and somatic symptoms. Anxiety sufferers have a higher lifetime prevalence of various medical problems. Chronic medical conditions furthermore increase the likelihood of psychiatric disorders and overall dysfunction. Lifetime rates of cardiovascular, respiratory, gastrointestinal, and other medical problems are disproportionately high in anxiety and panic/fear sufferers. The heightened comorbidity is not surprising as many symptoms of anxiety and panic/fear mimic symptoms of medical conditions. Panic disorder specifically is strongly linked to medical conditions due to its salient somatic symptoms, such as dyspnea, dizziness, numbness, chest pain, and heart palpitations, all of which can signal danger and deterioration for chronic disease sufferers. This chapter identifies shared correlates of medical illness and anxiety disorders and evidence for misinterpretation of symptoms as medically relevant and offers an analysis of implications for treatment of both types of conditions. We will concentrate on medical conditions with high associations for anxiety and panic by aspects of symptomatology, specifically neurological disorders (fibromyalgia, epilepsy, cerebral palsy), diabetes, gastrointestinal illness (irritable bowel syndrome, gastroesophageal reflux disease), and cardiovascular and respiratory illnesses (asthma).
Collapse
Affiliation(s)
- Alicia E Meuret
- Department of Psychology, Southern Methodist University, Dallas, TX, USA.
| | - Natalie Tunnell
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
| | - Andres Roque
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
| |
Collapse
|
25
|
Fang S, Ding D. A meta-analysis of the efficacy of acceptance and commitment therapy for children. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.01.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
26
|
Douglas PS. Pre-emptive Intervention for Autism Spectrum Disorder: Theoretical Foundations and Clinical Translation. Front Integr Neurosci 2019; 13:66. [PMID: 31798425 PMCID: PMC6877903 DOI: 10.3389/fnint.2019.00066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 11/04/2019] [Indexed: 12/28/2022] Open
Abstract
Autism spectrum disorders (ASD) are an emergent public health problem, placing significant burden upon the individual, family and health system. ASD are polygenetic spectrum disorders of neural connectome development, in which one or more feedback loops amplify small genetic, structural, or functional variations in the very early development of motor and sensory-motor pathways. These perturbations trigger a 'butterfly effect' of unpredictable cascades of structural and functional imbalances in the global neuronal workspace, resulting in atypical behaviors, social communication, and cognition long-term. The first 100 days post-term are critically neuroplastic and comprise an injury-sensitive developmental window, characterized by a neural biomarker, the persistence of the cortical subplate, and a behavioral biomarker, the crying diathesis. By the time potential diagnostic signs are identified, from 6 months of age, ASD neuropathy is already entrenched. The International Society for Autism Research Special Interest Group has called for pre-emptive intervention, based upon rigorous theoretical frames, and real world translation and evaluation. This paper responds to that call. It synthesizes heterogenous evidence concerning ASD etiologies from both psychosocial and biological research literatures with complexity science and evolutionary biology, to propose a theoretical framework for pre-emptive intervention. This paper hypothesizes that environmental factors resulting from a mismatch between environment of evolutionary adaptedness and culture initiate or perpetuate early motor and sensory-motor lesions, triggering a butterfly effect of multi-directional cascades of atypical developmental in the complex adaptive system of the parent and ASD-susceptible infant. Chronic sympathetic nervous system/hypothalamic-pituitary-adrenal axis hyperarousal and disrupted parent-infant biobehavioral synchrony are the key biologic and behavioral mechanisms perpetuating these atypical developmental cascades. A clinical translation of this evidence is proposed, for application antenatally and in the first 6 months of life, as pre-emptive intervention for ASD.
Collapse
Affiliation(s)
- Pamela S Douglas
- Transforming Maternity Care Collaborative, Griffith University, Brisbane, QLD, Australia.,Discipline of General Practice, The University of Queensland, Brisbane, QLD, Australia
| |
Collapse
|
27
|
Ruane A, Carr A, Moffat V, Finn T, Murphy A, O'Brien O, Groarke H, O'Dwyer R. A randomised controlled trial of the Group Stepping Stones Triple P training programme for parents of children with developmental disabilities. Clin Child Psychol Psychiatry 2019; 24:728-753. [PMID: 30764646 DOI: 10.1177/1359104519827622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The central aim of this study was to examine the effectiveness of Group Stepping Stones Triple P (GSSTP) in an Irish context for families of children with both developmental disabilities and internalising and externalising behavioural problems. Parents of 84 children (mean age = 5.73; SD = 2.06) with developmental disabilities and co-occurring behaviour problems attending Irish public health services were randomly assigned to a 9-week GSSTP group or a waiting list control (WLC) group. All parents completed self-report measures before (Time 1) and after (Time 2) the programme and parents in the GSSTP group were assessed at 3- to 5-month follow-up (Time 3). At Time 2, clinical improvement and reliable change rates on the primary dependent variables (summary scales of the Developmental Behaviour Checklist and Strengths and Difficulties Questionnaire) were significantly higher in the GSSTP group than in the WLC group. At Time 2, mean scores of the GSSTP group showed significant, small to medium improvements relative to the WLC group on parent-reported child behaviour problems, parenting skills and confidence, and parental adjustment. Most of these improvements were maintained at 3- to 5-month follow-up. These results indicate that GSSTP is a promising intervention for improving child behaviour and parenting outcomes in a mixed-disability group in an Irish context.
Collapse
Affiliation(s)
- Ailbhe Ruane
- School of Psychology, University College Dublin, Ireland.,Health Service Executive, Ireland
| | - Alan Carr
- School of Psychology, University College Dublin, Ireland
| | | | | | | | | | | | | |
Collapse
|
28
|
Abstract
Prepotent response inhibition and temporal perception abilities were explored in a sample of individuals with cerebral palsy relative to typically developing peers. The extent to which inhibitory control difficulties might affect temporal processing was also investigated. For this purpose, two inhibitory control tasks and two duration estimation tasks were given to the groups of cerebral palsy and typically developing children. Results showed inhibition and temporal perception problems in the group with cerebral palsy. A relationship was found between inhibition and temporal estimation performances, which indicates that inhibitory control contributes, at least partially, to acquisition of the temporal processing ability.
Collapse
Affiliation(s)
- Mercedes Cabezas
- BOBATH Foundation.,National Distance Education University (UNED)
| | | |
Collapse
|
29
|
Hahs AD, Dixon MR, Paliliunas D. Randomized controlled trial of a brief acceptance and commitment training for parents of individuals diagnosed with autism spectrum disorders. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2018.03.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
30
|
Ruane AI, Carr A. Systematic Review and Meta-analysis of Stepping Stones Triple P for Parents of Children with Disabilities. FAMILY PROCESS 2019. [PMID: 29520764 DOI: 10.1111/famp.12352] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The aim of this systematic review and meta-analysis was to examine the effectiveness of Stepping Stones Triple P (SSTP) parent training programs on child behavior problems and parenting outcomes in families of children with developmental disabilities. Sixteen suitable studies including data from over 900 families were identified in a search for English language published and unpublished controlled outcome studies. SSTP has five levels on a graded continuum of increasing intensity targeting families with differing degrees of treatment need from low intensity media-based parenting information campaigns at level 1, through brief interventions at levels 2 and 3, to more intensive parent training and family therapy interventions at levels 4 and 5. Analyses were conducted on the combination of all levels of SSTP and separately for each level. For combined levels, significant overall effect sizes were found for parent-reported child problems (d = 0.46), researcher observed child behavior (d = 0.51), parenting style (d = 0.70), parenting satisfaction/self-efficacy (d = 0.44), parental adjustment (d = 0.27), and coparental relationship (d = 0.26), but not researcher-observed parent behavior. Strong support was found for level 4 SSTP as an effective intervention for improving child and parent outcomes in families of children with disabilities who have clinically significant problems. Less intensive SSTP interventions for cases with circumscribed difficulties yielded fewer significant treatment effects, and there were relatively few studies of such interventions.
Collapse
Affiliation(s)
- AIlbhe Ruane
- Clinical Psychology, School of Psychology, University College Dublin, Dublin 4, Ireland
| | - Alan Carr
- Clinical Psychology, School of Psychology, University College Dublin, Dublin 4, Ireland
| |
Collapse
|
31
|
Chong YY, Mak YW, Leung SP, Lam SY, Loke AY. Acceptance and Commitment Therapy for Parental Management of Childhood Asthma: An RCT. Pediatrics 2019; 143:peds.2018-1723. [PMID: 30659063 DOI: 10.1542/peds.2018-1723] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2018] [Indexed: 11/24/2022] Open
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 follow-ups (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 = -5.45; CI -7.71 to -3.30; P = .014), less anxiety (mean difference = -2.20; CI -3.66 to -0.73; P = .003), and stress (mean difference = -2.50; CI -4.54 to -0.47; P = .016). CONCLUSIONS Integrating ACT into parental asthma education was effective at decreasing parental anxiety and stress and reducing the asthma-related emergency department visits of children at 6 months postintervention.
Collapse
Affiliation(s)
- Yuen-Yu Chong
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; and
| | - Yim-Wah Mak
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; and
| | - Sui-Ping Leung
- Department of Pediatrics and Adolescent Medicine, Tuen Mun Hospital, Hong Kong, China
| | - Shu-Yan Lam
- Department of Pediatrics and Adolescent Medicine, Tuen Mun Hospital, Hong Kong, China
| | - Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; and
| |
Collapse
|
32
|
Gould ER, Tarbox J, Coyne L. Evaluating the effects of Acceptance and Commitment Training on the overt behavior of parents of children with autism. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2018. [DOI: 10.1016/j.jcbs.2017.06.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
33
|
Barfoot J, Meredith P, Ziviani J, Whittingham K. Parent-child interactions and children with cerebral palsy: An exploratory study investigating emotional availability, functional ability, and parent distress. Child Care Health Dev 2017; 43:812-822. [PMID: 28737004 DOI: 10.1111/cch.12493] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 06/21/2017] [Accepted: 06/22/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Emotionally available parent-child relationships are supportive of child health and development. When a child has cerebral palsy, a range of child and parent factors can potentially impact the parent-child relationship; however, little research has specifically addressed this question. The aim of this study is to investigate links between parent-child emotional availability and both child functional abilities and parent distress in a sample of parents and children with cerebral palsy. METHODS Twenty-three mothers (mean age 37.3+/-5.7 years) and their children (mean age 4.9+/-3.3 years) with cerebral palsy completed a 20 min videoed parent-child interaction, scored using the Emotional Availability Scales. Parents also completed the Depression Anxiety Stress Scale, the Paediatric Evaluation of Disability Inventory, and the Strengths and Difficulties Questionnaire. Correlational analyses were conducted, and qualitative observations were made. RESULTS Parent-child dyads in which the parent reported depressive symptoms scored poorer on all aspects of parent-child emotional availability. Where parents reported experiencing anxiety or stress, increased parent hostility and decreased child responsiveness was found. There was no relationship between child functional abilities and either parent distress or parent-child emotional availability. Parent sensitivity, structuring, and nonintrusiveness were negatively associated with child peer problems. Both child responsiveness and child involvement were negatively associated with hyperactivity/inattention. Observations of video footage suggested that parent implementation of therapy strategies impacted negatively on parent-child emotional availability for some dyads. CONCLUSION Findings from this study are consistent with the wider literature showing a link between parental depression and the parent-child relationship and extend this link to the cerebral palsy population. The importance of routine screening for parental mental health problems in early childhood intervention is highlighted by these findings. In addition, this study emphasizes the need to better understand how therapists support parents to implement therapeutic strategies to minimize negative impact on the developing parent-child relationship.
Collapse
Affiliation(s)
- J Barfoot
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - P Meredith
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - J Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia.,Children's Health Queensland, South Brisbane, QLD, Australia
| | - K Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, St Lucia, QLD, Australia.,School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| |
Collapse
|
34
|
Hinton S, Sheffield J, Sanders MR, Sofronoff K. A randomized controlled trial of a telehealth parenting intervention: A mixed-disability trial. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 65:74-85. [PMID: 28458049 DOI: 10.1016/j.ridd.2017.04.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 03/31/2017] [Accepted: 04/05/2017] [Indexed: 05/12/2023]
Abstract
BACKGROUND The quality of parenting a child receives has a major impact on development, wellbeing and future life opportunities. AIMS This study examined the efficacy of Triple P Online - Disability (TPOL-D) a telehealth intervention for parents of children with a disability. METHODS Ninety-eight parents and carers of children aged 2-12 years diagnosed with a range of developmental, intellectual and physical disabilities were randomly assigned to either the intervention (51) or treatment-as-usual (47) control group. RESULTS At post-intervention parents receiving the TPOL-D intervention demonstrated significant improvements in parenting practices and parenting self-efficacy, however a significant change in parent-reported child behavioral and emotional problems was not detected. At 3-month follow up intervention gains were maintained and/or enhanced. A significant decrease in parent-reported child behavioral and emotional problems was also detected at this time. CONCLUSIONS The results indicate that TPOL-D is a promising telehealth intervention for a mixed-disability group.
Collapse
Affiliation(s)
- Sharon Hinton
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
| | - Jeanie Sheffield
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
| | - Matthew R Sanders
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
| | - Kate Sofronoff
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
| |
Collapse
|
35
|
Mon MM, Liabsuetrakul T, Htut KM. Effectiveness of Mindfulness Intervention on Psychological Behaviors Among Adolescents With Parental HIV Infection: A Group-Randomized Controlled Trial. Asia Pac J Public Health 2017; 28:765-775. [PMID: 27920241 DOI: 10.1177/1010539516675698] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aims to identify the effectiveness of mindfulness intervention on the psychological behaviors of adolescents with parental HIV infection and its associated factors in Myanmar. A total of 80 adolescents from 2 intervention townships and 80 adolescents from 2 control townships were enrolled in a group randomized controlled trial with assessments at baseline and 6 months follow-up. The mindfulness intervention involved monthly group sessions for 3 consecutive months led by an experienced mindfulness trainer. Three domains of psychological behaviors-namely, emotional, conduct, and social behaviors-were assessed at baseline and compared after 6 months. Multilevel regression analysis was used to determine the effectiveness of the intervention and associated factors for psychological behaviors. The intervention significantly improved emotional and conduct behaviors at 6 months (P < .001) but had no effect on social behavior. The significant effect of the intervention existed after adjusting for gender, family type, child age, and orphan status.
Collapse
Affiliation(s)
- Myo-Myo Mon
- Department of Medical Research, Yangon, Myanmar .,Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Tippawan Liabsuetrakul
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | | |
Collapse
|
36
|
Lyons VH, Li L, Hughes JP, Rowhani-Rahbar A. Proposed variations of the stepped-wedge design can be used to accommodate multiple interventions. J Clin Epidemiol 2017; 86:160-167. [PMID: 28412466 DOI: 10.1016/j.jclinepi.2017.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 03/14/2017] [Accepted: 04/04/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Stepped-wedge design (SWD) cluster-randomized trials have traditionally been used for evaluating a single intervention. We aimed to explore design variants suitable for evaluating multiple interventions in an SWD trial. STUDY DESIGN AND SETTING We identified four specific variants of the traditional SWD that would allow two interventions to be conducted within a single cluster-randomized trial: concurrent, replacement, supplementation, and factorial SWDs. These variants were chosen to flexibly accommodate study characteristics that limit a one-size-fits-all approach for multiple interventions. RESULTS In the concurrent SWD, each cluster receives only one intervention, unlike the other variants. The replacement SWD supports two interventions that will not or cannot be used at the same time. The supplementation SWD is appropriate when the second intervention requires the presence of the first intervention, and the factorial SWD supports the evaluation of intervention interactions. The precision for estimating intervention effects varies across the four variants. CONCLUSION Selection of the appropriate design variant should be driven by the research question while considering the trade-off between the number of steps, number of clusters, restrictions for concurrent implementation of the interventions, lingering effects of each intervention, and precision of the intervention effect estimates.
Collapse
Affiliation(s)
- Vivian H Lyons
- Department of Epidemiology, School of Public Health, University of Washington, Box 357236, Seattle, WA 98195-7236, USA; Harborview Injury Prevention & Research Center, 401 Broadway Avenue, 4th Floor, Seattle, WA 98122, USA.
| | - Lingyu Li
- Department of Biostatistics, School of Public Health, University of Washington, Box 357232, Seattle, WA 98195-7232, USA
| | - James P Hughes
- Department of Biostatistics, School of Public Health, University of Washington, Box 357232, Seattle, WA 98195-7232, USA
| | - Ali Rowhani-Rahbar
- Department of Epidemiology, School of Public Health, University of Washington, Box 357236, Seattle, WA 98195-7236, USA; Harborview Injury Prevention & Research Center, 401 Broadway Avenue, 4th Floor, Seattle, WA 98122, USA
| |
Collapse
|
37
|
Pediatric Rehabilitation Services for Children With Cerebral Palsy: What Can Existing Data Sources Tell Us? Pediatr Phys Ther 2017; 29:179-186. [PMID: 28350778 DOI: 10.1097/pep.0000000000000377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Knowledge about associated service utilization patterns and positive outcomes in children with cerebral palsy (CP) of varying levels of severity is a national priority. Families, clinicians, program directors, and policy makers need this information for clinical decision-making and service planning. Existing data sources in the United States that contain information about children with CP, their health, function, well being, and utilization of health services may add to our existing knowledge. We provide a summary of fourteen national, state, and local sources' data: where the data come from, challenges and/or specific considerations when using or accessing information, and specific data elements included. Currently available sources of data can provide meaningful information for policy, practice, and program development. We propose questions for future inquiry and suggest elements that may be useful for when developing data sources specific to physical therapy and individuals with CP. A physical therapy specific registry is warranted.
Collapse
|
38
|
Kanstrup M, Wicksell RK, Kemani M, Wiwe Lipsker C, Lekander M, Holmström L. 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-BASEL 2016; 3:children3040030. [PMID: 27854323 PMCID: PMC5184805 DOI: 10.3390/children3040030] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 10/31/2016] [Accepted: 11/07/2016] [Indexed: 11/16/2022]
Abstract
Pediatric chronic pain is common and can result in substantial long-term disability. Previous studies on acceptance and commitment therapy (ACT) have shown promising results in improving functioning in affected children, but more research is still urgently needed. In the current clinical pilot study, we evaluated an ACT-based interdisciplinary outpatient intervention (14 sessions), including a parent support program (four sessions). Adolescents were referred to the clinic if they experienced disabling chronic pain. They were then randomized, along with their parents, to receive group (n = 12) or individual (n = 18) treatment. Adolescent pain interference, pain reactivity, depression, functional disability, pain intensity and psychological flexibility, along with parent anxiety, depression, pain reactivity and psychological flexibility were assessed using self-reported questionnaires. There were no significant differences in outcomes between individual and group treatment. Analyses illustrated significant (p < 0.01) improvements (medium to large effects) in pain interference, depression, pain reactivity and psychological flexibility post-treatment. Additionally, analyses showed significant (p < 0.01) improvements (large effects) in parent pain reactivity and psychological flexibility post-treatment. On all significant outcomes, clinically-significant changes were observed for 21%–63% of the adolescents across the different outcome measures and in 54%–76% of the parents. These results support previous findings and thus warrant the need for larger, randomized clinical trials evaluating the relative utility of individual and group treatment and the effects of parental interventions.
Collapse
Affiliation(s)
- Marie Kanstrup
- Functional Area Medical Psychology, Functional Unit Behavioral Medicine, Karolinska University Hospital Solna, P8:01, 171 76 Stockholm, Sweden.
- Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77 Stockholm, Sweden.
| | - Rikard K Wicksell
- Functional Area Medical Psychology, Functional Unit Behavioral Medicine, Karolinska University Hospital Solna, P8:01, 171 76 Stockholm, Sweden.
- Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77 Stockholm, Sweden.
| | - Mike Kemani
- Functional Area Medical Psychology, Functional Unit Behavioral Medicine, Karolinska University Hospital Solna, P8:01, 171 76 Stockholm, Sweden.
- Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77 Stockholm, Sweden.
| | - Camilla Wiwe Lipsker
- Functional Area Medical Psychology, Functional Unit Behavioral Medicine, Karolinska University Hospital Solna, P8:01, 171 76 Stockholm, Sweden.
- Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77 Stockholm, Sweden.
| | - Mats Lekander
- Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77 Stockholm, Sweden.
- Stress Research Institute, Stockholm University, 106 91 Stockholm, Sweden.
| | - Linda Holmström
- Functional Area Medical Psychology, Functional Unit Behavioral Medicine, Karolinska University Hospital Solna, P8:01, 171 76 Stockholm, Sweden.
- Department of Women's and Children's health, Karolinska Institutet, H2:00, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden.
| |
Collapse
|
39
|
Whittingham K, Sheffield J, Boyd RN. Parenting acceptance and commitment therapy: a randomised controlled trial of an innovative online course for families of children with cerebral palsy. BMJ Open 2016; 6:e012807. [PMID: 27798022 PMCID: PMC5073654 DOI: 10.1136/bmjopen-2016-012807] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Cerebral palsy (CP) impacts on the entire family in a manner that is long-term, complex and multifactorial. In addition, the quality of the parent-child relationship impacts on many and varied child outcomes, making the provision of easily accessible and evidence-based support to parents of children with CP a priority. This paper reports the protocol of a randomised controlled trial of an innovative and translatable online intervention, parenting acceptance and commitment therapy (PACT), for families of children with CP. We predict that participating in the PACT programme will be associated with improvements in the parent-child relationship, in child functioning and in adjustment and quality of life for both parent and child. METHODS AND ANALYSIS We aim to recruit 66 parents of children (2-10 years old) diagnosed with CP to this study. Families will be randomly assigned to two groups: wait-list control and PACT. PACT is a parenting intervention grounded in acceptance and commitment therapy (ACT) and developed into an online course 'PARENT101 Parenting with Purpose' using the edX platform. All participants will be offered PACT before completion of the study. Assessments will take place at baseline, following completion of PACT and at 6-month follow-up (retention) and will focus on the parent-child relationship, parent and child adjustment and parent and child quality of life. Analysis will follow standard methods for randomised controlled trials using general linear models, specifically analysis of variance or analysis of covariance. ETHICS AND DISSEMINATION Ethics approvals have been obtained through the Children's Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC/15/QRCH/115) and The University of Queensland (2015001743). If efficacy is demonstrated, then the PARENT101 course has the potential to be disseminated widely in an accessible manner and at minimal cost. Further, the PACT framework may provide a blueprint for similar online courses with parents in a full range of contexts. TRIAL REGISTRATION NUMBER ACTRN12616000351415; Pre-results.
Collapse
Affiliation(s)
- Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Jeanie Sheffield
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
40
|
Pickering JA, Sanders MR. Reducing Child Maltreatment by Making Parenting Programs Available to All Parents: A Case Example Using the Triple P-Positive Parenting Program. TRAUMA, VIOLENCE & ABUSE 2016; 17:398-407. [PMID: 27580665 DOI: 10.1177/1524838016658876] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Preventing the maltreatment of children is a major public health challenge. Using the Triple P-Positive Parenting program as an example, this article makes the case that strengthening parenting and family relationships at a population level is a potentially powerful means of taking on this challenge. We focus on the value of making parenting programs available to all parents in the community. We conclude by examining the key ingredients required to make a population-level parenting approach to reducing child maltreatment work.
Collapse
Affiliation(s)
- John A Pickering
- Parenting and Family Support Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Matthew R Sanders
- Parenting and Family Support Centre, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
41
|
Williams LK, McCarthy MC, Burke K, Anderson V, Rinehart N. Addressing behavioral impacts of childhood leukemia: A feasibility pilot randomized controlled trial of a group videoconferencing parenting intervention. Eur J Oncol Nurs 2016; 24:61-69. [PMID: 27697278 DOI: 10.1016/j.ejon.2016.08.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 06/23/2016] [Accepted: 08/18/2016] [Indexed: 11/15/2022]
Abstract
PURPOSE Child emotional and behavioral problems constitute significant sequelae of acute lymphoblastic leukemia (ALL) treatment. The aims of this study were to a) examine the feasibility, acceptability and satisfaction of a parenting intervention amongst parents of children with ALL and b) explore whether participation in a parenting intervention shows promise for improvements in child behavior. METHODS 12 parents with a child aged between 2 and 8 years receiving maintenance phase treatment for ALL participated in a phase 2 randomized controlled trial comparing eight weeks of group online participation in Triple P: Positive Parenting Program with no intervention. RESULTS The number of eligible parents who completed the intervention was low (31.6%). Main reasons for non-consent or dropout were program time commitment too high or content not relevant. For parents who completed the intervention, satisfaction and acceptability was high. Parents reported the intervention as highly relevant and topical, feasible, helpful and a positive experience. Results indicated a non-significant trend towards improved total child behavioral and emotional difficulties following the intervention. Qualitative results indicated that intervention group parents reported improvements in parenting skills and competence, and decreased child behavioral problems. CONCLUSIONS These pilot data highlight the difficulties of engaging and retaining parents in an 8-week parenting intervention in this context. For parents who completed the intervention, results indicated high feasibility, acceptability and satisfaction. Suggestions for further research and intervention modifications are provided to enhance uptake and strengthen efforts to assist parents in addressing child behavioral and emotional challenges during ALL treatment.
Collapse
Affiliation(s)
- Lauren K Williams
- Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria, 3052, Australia; School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia.
| | - Maria C McCarthy
- Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria, 3052, Australia; Royal Children's Hospital, Flemington Road, Parkville, Victoria, 3052, Australia
| | - Kylie Burke
- Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria, 3052, Australia; Parenting and Family Support Centre, School of Psychology, The University of Queensland, St Lucia, Queensland, 4072, Australia
| | - Vicki Anderson
- Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria, 3052, Australia; Royal Children's Hospital, Flemington Road, Parkville, Victoria, 3052, Australia; Department of Pediatrics, University of Melbourne, Flemington Road, Parkville, Victoria, 3052, Australia; School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia
| | - Nicole Rinehart
- Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria, 3052, Australia; School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia
| |
Collapse
|
42
|
Brassell AA, Rosenberg E, Parent J, Rough JN, Fondacaro K, Seehuus M. Parent's psychological flexibility: Associations with parenting and child psychosocial well-being. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2016. [DOI: 10.1016/j.jcbs.2016.03.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
43
|
Changing problematic parent–child interaction in child anxiety disorders: The promise of Acceptance and Commitment Therapy (ACT). JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2016. [DOI: 10.1016/j.jcbs.2015.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
44
|
Hobart-Porter L, Wade S, Minich N, Kirkwood M, Stancin T, Taylor HG. Determinants of Effective Caregiver Communication After Adolescent Traumatic Brain Injury. PM R 2015; 7:836-844. [PMID: 25687111 PMCID: PMC5437845 DOI: 10.1016/j.pmrj.2015.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 01/31/2015] [Accepted: 02/10/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To characterize the effects of caregiver mental health and coping strategies on interactions with an injured adolescent acutely after traumatic brain injury (TBI). DESIGN Multi-site, cross-sectional study. SETTING Outpatient setting of 3 tertiary pediatric hospitals and 2 tertiary general medical centers. PARTICIPANTS Adolescents (N = 125) aged 12-17 years, 1-6 months after being hospitalized with complicated mild to severe TBI. METHODS Data were collected as part of a multi-site clinical trial of family problem-solving therapy after TBI. Multiple regression analyses were used to examine the relationship of caregiver and environmental characteristics to the dimensions of effective communication, warmth, and negativity during caregiver-adolescent problem-solving discussions. MAIN OUTCOMES MEASURES Adolescent and caregiver interactions, as measured by the Iowa Family Interaction Rating Scales. RESULTS Caregivers who utilized problem-focused coping strategies were rated as having higher levels of effective communication (P < .01), as were those with higher socioeconomic status (P < .01). Problem-focused coping style and higher socioeconomic status were also associated lower levels of negative interactions (P < .01 and P < .05, respectively). Female gender of the adolescent and fewer children in the home were associated with increased parental warmth during the interaction (P < .01 and P < .05, respectively). Neither adolescent TBI severity nor caregiver depression significantly influenced caregiver-teen interactions. CONCLUSIONS Problem-focused coping strategies are associated with higher levels of effective communication and lower levels of caregiver negativity during the initial months after adolescent TBI, suggesting that effective caregiver coping may facilitate better caregiver-adolescent interactions after TBI.
Collapse
Affiliation(s)
| | - Shari Wade
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Nori Minich
- Case Western Reserve University, Cleveland, OH
| | | | | | | |
Collapse
|
45
|
Brown FL, Whittingham K, Boyd RN, McKinlay L, Sofronoff K. Does Stepping Stones Triple P plus Acceptance and Commitment Therapy improve parent, couple, and family adjustment following paediatric acquired brain injury? A randomised controlled trial. Behav Res Ther 2015; 73:58-66. [PMID: 26255172 DOI: 10.1016/j.brat.2015.07.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 05/28/2015] [Accepted: 07/13/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the efficacy of a behavioural family intervention, Stepping Stones Triple P (SSTP), combined with an Acceptance and Commitment Therapy (ACT) workshop in improving parent, family and couple outcomes following paediatric acquired brain injury (ABI). PARTICIPANTS AND SETTING Fifty-nine parents (90% mothers) of children (mean age 7 years; 35 males, 24 females) with ABI. INTERVENTION Participants were randomly assigned to a treatment (10-week group SSTP and ACT program) or a care-as-usual (CAU) control condition (10 weeks). Those in the CAU condition received the treatment after the waitlist period. OUTCOMES Self-report measures of parent psychological distress, parent psychological flexibility, parenting confidence, family functioning, and couple relationship, assessed at: pre-intervention, post-intervention, and 6-months post-intervention. RESULTS Post-intervention, the treatment group showed significant, small to medium improvements relative to the CAU group (at the p < .05 level) on parent psychological distress, parent psychological flexibility, parent confidence in managing behaviours, family adjustment,and number of disagreements between parents. Most improvements were maintained at 6-months. CONCLUSIONS Parent skills training and ACT may be efficacious in improving parent, family, and couple outcomes in families of children with an ABI.
Collapse
Affiliation(s)
- Felicity L Brown
- The School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Australia; Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Australia; Queensland Children's Medical Research Institute, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Australia.
| | - Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Australia; The School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Australia
| | - Lynne McKinlay
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Australia; Queensland Paediatric Rehabilitation Service, Royal Children's Hospital, Brisbane, Australia
| | - Kate Sofronoff
- The School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Australia
| |
Collapse
|
46
|
|
47
|
|
48
|
Wicksell RK, Kanstrup M, Kemani MK, Holmström L, Olsson GL. Acceptance and Commitment Therapy for children and adolescents with physical health concerns. Curr Opin Psychol 2015. [DOI: 10.1016/j.copsyc.2014.12.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
49
|
Woodman AC, Mawdsley HP, Hauser-Cram P. Parenting stress and child behavior problems within families of children with developmental disabilities: Transactional relations across 15 years. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 36C:264-276. [PMID: 25462487 PMCID: PMC4425632 DOI: 10.1016/j.ridd.2014.10.011] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 10/06/2014] [Indexed: 05/21/2023]
Abstract
Parents of children with developmental disabilities (DD) are at increased risk of experiencing psychological stress compared to other parents. Children's high levels of internalizing and externalizing problems have been found to contribute to this elevated level of stress. Few studies have considered the reverse direction of effects, however, in families where a child has a DD. The present study investigated transactional relations between child behavior problems and maternal stress within 176 families raising a child with early diagnosed DD. There was evidence of both child-driven and parent-driven effects over the 15-year study period, spanning from early childhood (age 3) to adolescence (age 18), consistent with transactional models of development. Parent-child transactions were found to vary across different life phases and with different domains of behavior problems.
Collapse
Affiliation(s)
- Ashley C Woodman
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Tobin Hall 509, 135 Hicks Way, Amherst, MA 01003, USA.
| | - Helena P Mawdsley
- College of Education, University of Florida, 618 SW 12th Street, Norman Hall, Gainesville, FL, 32601, USA.
| | - Penny Hauser-Cram
- Lynch School of Education, Boston College, 140 Commonwealth Avenue, Campion Hall, Room 239B, Newton, MA 02467, USA.
| |
Collapse
|
50
|
Brown FL, Whittingham K, Sofronoff K. Parental Experiential Avoidance as a Potential Mechanism of Change in a Parenting Intervention for Parents of Children With Pediatric Acquired Brain Injury. J Pediatr Psychol 2014; 40:464-74. [DOI: 10.1093/jpepsy/jsu109] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 11/21/2014] [Indexed: 11/14/2022] Open
|