Guo Ying, He Haoran, Lan Jiajun
Capital University of Physical Education and Sports, Beijing, 100191, China.
Child Adolesc Psychiatry Ment Health. 2025 Jul 21;19(1):80. doi: 10.1186/s13034-025-00944-y.
Through a meta-analysis, this study evaluated the effectiveness of Acceptance and Commitment Therapy (ACT) in reducing stress among parents of children with special needs. This study aimed to quantify the intervention effect and identify moderating variables, such as cultural differences and intervention parameters, to provide evidence for clinical practice.
Systematic searches were conducted across the PsycINFO, PubMed, Web of Science, and Cochrane Library databases. The inclusion criteria were as follows: (1) peer-reviewed English publications; (2) randomized controlled trials; (3) the use of ACT as the core intervention; (4) study participants being parents of children with special needs; and (5) reporting standardized effect sizes for stress symptoms. A total of 10 studies (n = 700) met the inclusion criteria. A random effects model was employed for the meta-analysis, and subgroup analyses were performed based on geographic distribution, intervention duration, intervention parameters, and types of children's illnesses (neurodevelopmental disorders, chronic diseases, and critical conditions).
ACT significantly reduced stress symptoms among parents of special children, with a standardized mean difference (SMD =- 0.42, 95% CI- 0.72 to- 0.12, P = 0.0068). Subgroup analyses and meta-regression indicated a notable non-linear dose-response relationship concerning the intervention parameters. Key factors contributing to the heterogeneity of intervention outcomes included the frequency of the intervention, duration per session, overall intervention period, modalities employed, types of parental groups, and categories of children's illnesses.
ACT demonstrated moderate efficacy in alleviating stress among parents of exceptional children. The most significant stress reduction was observed when interventions were conducted for a minimum of 120 min per session, at least twice weekly, and over a total duration exceeding 8 weeks, particularly when ACT was integrated with other interventions for parents of children suffering from chronic and critical illnesses. Additionally, the effectiveness of the intervention in mixed-gender parent groups was significantly greater than in groups where mothers constituted over 90% of participants (P < 0.05). Implementing high-intensity ACT courses for populations experiencing acute stress is recommended to facilitate the rapid alleviation of stress symptoms. Concurrently, mobile health-assisted, low-density, long-term interventions are suggested for individuals dealing with chronic stress. Future research should investigate the efficacy disparities in predominantly mother-led groups and strive to develop gender-adapted ACT protocols.
通过一项荟萃分析，本研究评估了接纳与承诺疗法（ACT）在减轻特殊需求儿童家长压力方面的有效性。本研究旨在量化干预效果，并确定调节变量，如文化差异和干预参数，为临床实践提供依据。
在PsycINFO、PubMed、科学网和考克兰图书馆数据库中进行了系统检索。纳入标准如下：（1）同行评审的英文出版物；（2）随机对照试验；（3）使用ACT作为核心干预措施；（4）研究参与者为特殊需求儿童的家长；（5）报告压力症状的标准化效应量。共有10项研究（n = 700）符合纳入标准。荟萃分析采用随机效应模型，并根据地理分布、干预持续时间、干预参数和儿童疾病类型（神经发育障碍、慢性病和危重症）进行亚组分析。
ACT显著减轻了特殊儿童家长的压力症状，标准化平均差（SMD = -0.42，95%CI -0.72至-0.12，P = 0.0068）。亚组分析和荟萃回归表明，干预参数存在显著的非线性剂量反应关系。导致干预结果异质性的关键因素包括干预频率、每次疗程时长、总体干预周期、采用的方式、家长群体类型和儿童疾病类别。
ACT在减轻特殊儿童家长的压力方面显示出中等疗效。当每次干预至少持续120分钟、每周至少两次且总时长超过8周时，观察到压力减轻最为显著，尤其是当ACT与针对患有慢性病和危重症儿童的家长的其他干预措施相结合时。此外，混合性别家长群体中干预的有效性显著高于母亲占参与者90%以上的群体（P < 0.05）。建议为经历急性压力的人群实施高强度ACT课程，以促进压力症状的快速缓解。同时，建议为应对慢性压力的个体提供移动健康辅助的低密度长期干预。未来的研究应调查主要由母亲主导的群体中的疗效差异，并努力制定适合性别的ACT方案。
