Health Service Executive, Dublin, Ireland.
School of Psychology, Trinity College, Dublin, Ireland.
Psychol Psychother. 2021 Apr;94 Suppl 2:378-407. doi: 10.1111/papt.12282. Epub 2020 May 13.
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.
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.
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.
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.
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.
接受和承诺疗法（ACT）在治疗各种心理困扰方面积累了越来越多的证据。鉴于 ACT 促进了广泛而灵活的行为 repertoire，以及中和了普遍存在的被认为是导致人类痛苦的心理过程，这种方法可能具有潜力。基于 ACT 的育儿干预措施的使用为仅采用行为方法提供了另一种选择，但它仍然相对研究不足，需要进一步探索。
本系统评价搜索了四个数据库，旨在汇集所有包含父母治疗成分的 ACT 干预措施，这些干预措施用于治疗各种儿童出现的困难。该综述还评估了这种治疗格式的 ACT 证据基础的方法学严谨性。
共有 27 项涵盖广泛表现问题的独立研究被纳入，涉及 1155 名参与者。很大一部分研究是组内设计，少数采用随机对照试验。大多数研究报告了儿童身体或心理功能方面的父母报告症状以及父母报告的压力、抑郁和焦虑方面的改善。在许多 ACT 变化机制的结果上也注意到了类似的改善，包括正念、接受和认知融合。这些收益在神经发育障碍、慢性疼痛和严重身体健康问题的儿童的父母中得到了体现。在随访时，通常会报告维持或进一步的治疗收益。尽管存在这些局限性，但 ACT 作为一种跨诊断干预措施具有潜力，可以帮助父母应对各种心理和身体困难。
ACT 在一系列心理困扰方面积累了相对较强的证据基础。尽管存在一些方法学上的缺陷，但 ACT 显示出作为一种干预措施的潜力，可以帮助父母管理压力和困难，尤其是与自闭症、慢性疼痛和身体需要的孩子。需要进一步研究将 ACT 与更成熟的治疗方法进行比较，并帮助巩固最初的积极发现。
