Improve the Well-Being of Children with Special Health Care Needs and Their Parents with Mindfulness
By John M. de Castro, Ph.D.
“mindfulness-based parenting program can be an effective intervention for reducing the stress experienced by parents of children with special needs.” – Elizabeth J. Shaffer
There is a tremendous demand for caregiving in the US. It is estimated that over 65 million (29% of the adult population) provides care to someone who is ill, disabled, or aged, averaging 20 hours per week spent caring for their loved ones. Children with special health care needs include a variety of conditions from psychological such as anxiety disorders or depression to chronic conditions such as asthma or diabetes or chronic pain, to developmental issues such as autism. They place considerable burdens on their caregivers. Mindfulness practice for caregivers has been shown to help them cope with the physical and psychological demands of caregiving.
A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.
There has been accumulating research on the application of Acceptance and Commitment Therapy (ACT) for the treatment of children with special health care needs and their caregivers and there is a need to review and summarize the findings. In today’s Research News article “Acceptance and Commitment Therapy for Children with Special Health Care Needs and Their Parents: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8345967/ ) Parmar and colleagues review, summarize, and perform a meta-analysis of the published research studies on the effectiveness of Acceptance and Commitment Therapy (ACT) for the treatment of children with special health care needs and their caregivers.
They identified 10 published research studies. They report that the published research finds that Acceptance and Commitment Therapy (ACT) produces significant reductions in depression and perceived stress, and increases in psychological flexibility in the children. On the other hand, the parents did not show similar improvements except for a small improvement in psychological flexibility.
The published research, then, suggests that Acceptance and Commitment Therapy (ACT) is effective for children with special health care needs in reducing mental distress and increasing their flexibility in dealing with it. ACT also produce small improvements in their caregivers. This suggests that ACT should be recommended to increase mindfulness in children with special health care needs to improve their psychological well-being.
CMCS – Center for Mindfulness and Contemplative Studies
“cultivating a more mindful way of parenting is associated with reduced stress, anxiety, and depression. Parents experienced increased mindful awareness and improved psychological well-being, and they were more accepting of their children. Their children also had fewer behavior problems and enhanced positive interaction with their parents.” – Manika Petcharat
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Parmar, A., Esser, K., Barreira, L., Miller, D., Morinis, L., Chong, Y. Y., Smith, W., Major, N., Church, P., Cohen, E., & Orkin, J. (2021). Acceptance and Commitment Therapy for Children with Special Health Care Needs and Their Parents: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 18(15), 8205. https://doi.org/10.3390/ijerph18158205
Context: Acceptance and Commitment Therapy (ACT) is an emerging treatment for improving psychological well-being. Objective: To summarize research evaluating the effects of ACT on psychological well-being in children with special health care needs (SHCN) and their parents. Data Sources: An electronic literature search was conducted in PubMed, Web of Science, Ovid/EMBASE and PsycINFO (January 2000–April 2021). Study Selection: Included were studies that assessed ACT in children with SHCN (ages 0–17y) and/or parents of children with SHCN and had a comparator group. Data Extraction: Descriptive data were synthesized and presented in a tabular format, and data on relevant outcomes (e.g., depressive symptoms, stress, avoidance and fusion) were used in the meta-analyses to explore the effectiveness of ACT (administered independently with no other psychological therapy) compared to no treatment. Results: Ten studies were identified (child (7) and parent (3)). In children with SHCN, ACT was more effective than no treatment at helping depressive symptoms (standardized mean difference [SMD] = −4.27, 95% CI: −5.20, −3.34; p < 0.001) and avoidance and fusion (SMD = −1.64, 95% CI: −3.24, −0.03; p = 0.05), but not stress. In parents of children with SHCN, ACT may help psychological inflexibility (SMD = −0.77, 95% CI: −1.07, −0.47; p < 0.01). Limitations: There was considerable statistical heterogeneity in three of the six meta-analyses. Conclusions: There is some evidence that ACT may help with depressive symptoms in children with SHCN and psychological inflexibility in their parents. Research on the efficacy of ACT for a variety of children with SHCN and their parents is especially limited, and future research is needed.