The Effectiveness of Acceptance and Commitment-based Treatment on Children's Anxiety and the Parenting Stress of Mothers
Subject Areas : Woman and familyKowsar Tardast 1 , Abbas Amanelahi 2 , GholamReza Rajabi 3 , Khaled Aslani 4 , Khadijeh Shiralinia 5
1 - Ph.D student of counseling, Shahid Chamran University, Ahvaz, Iran.
2 - * Associate professor, Shahid Chamran University, Ahvaz, Iran
a.amanelahi@scu.ac.ir
3 - Associate professor, Shahid Chamran University, Ahvaz, Iran
4 - Associate professor, Shahid Chamran University, Ahvaz, Iran
5 - Assistant professor, Shahid Chamran University, Ahvaz, Iran
Keywords: anxiety, key words are: parenting stress, acceptance and commitment-based treatment,
Abstract :
The purpose of the present study was to Complete this sentence about the purpose of the study ….The research population included 7 to 12-year-old ahvaz children with symptoms of anxiety. Three Anxious by the age of 7… 7 to 12 years old and their mothers were selected using purposeful sampling. Non-congruent multiple baseline experimental single case study was used as the method of the present study. The efficacy of Acceptance and Commitment based Therapy Protocol was carried out in three phases of intervention (Baseline, 12 session treatment and 1 month follow-up) by using the Spence Children's Anxiety Scale- Parent form and Parenting Stress index– short form delete. Data were analyzed with visuals inspection, improvement percentage and reliable change index (RCI) strategies. The results presented the positive effect of acceptance-and-commitment-based parenting education on treatment's targets. Moreover, this training was able to reduce not only the children's anxiety but the parenting stress of mothers as well.Conflict of interest: According to the authors, the present article did not have any conflict of interest.C
Abidin, R. (1995). Parenting Stress Index (PSI) manual (3rd edition). Pediatric Psychology Press.
Brown, F. J., & Hooper, S. (2009). Acceptance and Commitment Therapy (ACT) with a learning disabled young person experiencing anxious and obsessive thoughts. Journa of
Caspi, A., Moffitt, T., Newman, D., & Silva, P. (1996). Behavioral observations at age 3 years predict adult psychiatric disorders: longitudinal evidence from a birth cohort. Archives Of General Psychiatry, 53,1033–1039.
Coyne, L. W., McHugh, L., & Martinez, E. R. (2011). Acceptance and commitment therapy (ACT): Advances and applications with children, adolescents, and families. Child and Adolescent Psychiatric Clinics of North America, 20, 379–399.
Davis, A. (2015). Parental Stress and Child Behavior Problems in Families of Children with Autism. A Thesis submitted in partial satisfaction of the requirements for the degree Doctor of Philosophy in Clinical Psychology.
Davies, P., & Martin, M. (2014). Children’s Coping and Adjustment in High-Conflict Homes: The Reformulation of Emotional Security Theory. Child Development Perspectives, 8, 242-249.
Deater-Deckard, K. (1998). Parenting stress and child adjustment: Some old hypotheses and new questions. Clinical Psychology: Science and Practice, 5, 314-332.
Ehrenreich, J. T., Micco, J. A., Fisher, P. H., & Warner, C. M. (2009). Assessment of relevant parenting factors in families of anxious children: The family assessment clinician-rated interview (FACI). Child Psychiatry and Human Development, 40, 331–342.
Fadaei, Z., Dehghani, M., Tahmasian, K., Farhadei, M. Investigating reliability, validity and factor structure of parenting stress- short form in mother`s of 7-12 year-old children. Journal of Research in Behavioural Sciences. 2010: 8 (2): 81-91.(in Persian)
Fletcher, L., & Hayes, S. C. (2005). Relational frame theory, acceptance and commitment therapy, and a functional analytic definition of mindfulness. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 23, 315–336.
Farahani, H., Abedi, A., aghamohamadi, S., kazemi, Z. Single-case designs in Behavioral and Medical Sciences Research (3rd edition). 2013: Tehran. Psychology and Art Publications. (in Persian)
Gal, M., Borg, W., & Gal, J. Quantitative and qualitative research methods in Educational Sciences and Psychology. Tehran. Shahid Beheshti University and Samat Publications 1995.
Ginsburg, G. S., La Greca, A. M., & Silverman, W. K. (1998). Social anxiety in children with anxiety disorders:Relation with social and emotional functioning. Journal of Abnormal Child Psychology, 26, 175–185.
Ginsburg, G. S., Lambert, S. F., & Drake, K. L. (2004). Attributions of control, anxiety sensitivity, and panic symptoms among adolescents. Cognitive Therapy and Research, 28, 745–763.
Hadian, M., Kazemi, M. S (1396). The effectiveness of acceptance and commitment therapy on generalized anxiety disorder in children with type 1 diabetes. Journal of Ilam University of Medical Sciences. 25(6). 185-198. (in Persian)
Hancock, K. M., Swain, J., Hainsworth, C. J., Dixon, A. L., Koo, S., & Munro, K. (2016). Acceptance and Commitment Therapy versus Cognitive Behavior Therapy for Children With Anxiety: Outcomes of a Randomized Controlled Trial. Journal of Clinical Child & Adolescent Psychology, 00:1–16.
Haskett, M. E., Ahern, L. S., Ward, C. S., & Allaire, J. C. (2006). Factor structure and validity of the Parenting Stress Index-Short Form. Journal of Clinical Child and Adolescent Psychology, 35, 302-312.
Herbert, J. D. (2002). Review of S. C. Hayes, K. D. Strosahl, & K. G. Wilson, Acceptance and Commitment Therapy: An experiential approach to behavior change. Cognitive and Beahvioral Practice, 9, 164-166.
Hirshfeld-Becker, R., Masek, B., Henin, A., Blakely, L. R., Pollock-Wurman, R. A., McQuade, J., DePetrillo, L., Briesch, J., Ollendick, T. H., Rosenbaum, J. F., & Biederman, J. (2010). Cognitive behavioral therapy for 4- to 7-year-old children with anxiety disorders: a randomized clinical trial. Journal of Consulting and Clinical Psychology, 78, 498–510.
Hughes, A. A., Hedtke, K. A., & Kendall, P. C. (2008). Family functioning in families of children with anxiety disorders. Journal of Family Psychology, 22, 325–328.
Imani, M. The effictiveness of Acceptance Based Behavior Therapy and Integrative Behavioral Couple Therapy in reducing distressed couples and General Anxiety Disorder Mahshahr women. PhD Thesis of Counseling 2011. (in Persian)
Ingram, R.E., Hayes., & Scott, W. (2000). Empirically supported treatment: A critical analysis. In. Syder, C.R & Ingram, R.E(Eds). Handbook of psychological change (pp.40-60). New York: John Wiley & sons.
Kazdin, A.E.(1999). The meanings and measurement of clinical significance. Journal of consulting and clinical psychology, 67, 300-307.
Lee, J., Semple, R. J., Rosa, D., & Miller, L. (2008). Mindfulness based cognitive therapy for children: Results of a pilot study. Journal of Cognitive Psychotherapy, 22, 15–28.
McCurry, C.) 2009 (. Parenting Your Anxious Child with Mindfulness and Acceptance. New Harbinger Publications, Inc.
Monga, S., Rosenbloom, B. N., Tanha, A., Owens, M., & Young, A. (2014). Comparison of child–parent and parent-only cognitive- behavioral therapy programs for anxious children aged 5 to 7 years: short- and long-term outcomes. Journal of the American Academy of Child and Adolescent Psychiatry,1-9.
O’Brien, K., Larson, C., & Murrell, A. (2008). Third-wave behavior therapies for children and adolescents: Progress, challenges and future directions. In L. A. G. S. C. Hayes (Ed.), Acceptance and mindfulness treatments for children and adolescents (pp. 15–35). Oakland, CA: New Harbinger and Context Press.
Putnick, D. L., Bornstein, M. H., Hendricks, C., Painter, K. M., Suwalsky, J. T. D., & Collins, W. A. (2010). Stability, continuity, and similarity of parenting stress in European American mothers and fathers across their child's transition to adolescence. Parenting: Science & Practice, 10, 60-77.
Piacentini, J & Roblek, T. (2002). Recognizing and treating childhood anxiety disorders. Western Journal of Medicine, 176,149–151.
Raphael, J. L., Zhang, Y., Liu, H., & Giardino, A. P. (2009). Parenting stress in U.S. families: Implications for paediatric health care utilization. Child: Care, Health, and Development, 36, 216-224.
Reynolds, C. R., & Richmond, B. O. (1978). What i think and feel: A revised measure of children's manifest anxiety. Journal of Abnormal Child Psychology, 6, (2), 271–280.
Reynolds, C. R., & Richmond, B. O. (1979). Factor structure and construct validity of "What I think and feel": The Revised Children's Manifest Anxiety Scale. Journal of Personality Assessment, 43(3), 281-283.
Roza, A., Hofstra, M., van der Ende, J., Verhulst, F. (2003). Stable prediction of mood and anxiety disorders based on behavioural and emotional problems in childhood: a 14-year follow-up during childhood, adolescence, and young adulthood. American Journal of Psychiatry. 160, 2116–2121.
Semple, R. J. (2005). Mindfulness-Based Cognitive Therapy for Children: A Randomized Group Psychotherapy Trial Developed to Enhance Attention and Reduce Anxiety. Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy under the Executive Committee of The Graduate School of Arts and Sciences.
Semple, R. J., Reid, E. F. G., Miller, L. (2005). Treating Anxiety With Mindfulness: An Open Trial of Mindfulness Training for Anxious Children. Journal of Cognitive Psychotherapy: An International Quarterly.19 (4), 379-392.
Spence, S. H. )1997.( Structure of anxiety symptoms among children: a confirmatory factor-analytic study. Journal of Abnormal Psychology; 106(2): 280.97.
Spence, S. H. )1998 .(A measure of anxiety symptoms among children. Behaviour Research and Therapy; 36(5), 545-66.
Spence, S., Barrett, P., & Turner, C. (2003). Psychometric properties of the spence children's anxiety scale with young adolescents. Journal of anxiety disorders, 17(6), 605-625.
Stellard, P., Velleman, R., Langsford, J., & Baldwin, S. (2111). Coping and psychological distress in children involved in road traffic accidents. British Journal of Clinical Psychology, 41, 197-218.
Swain, J., Hancock, K., Dixon, A., Koo, S., & Bowman, J. (2013, a). Acceptance and Commitment Therapy for anxious children and adolescents: study protocol for a randomized controlled trial. Trials. 1-12.
Taghavi, M., Alishahi, M Validity and reliability Children's Manifest Anxiety Scale. Journal of Psychology 2003: 7 (4): 342-357. (in Persian)
Wang, M., Meng, Q., Liu, L., Liu, G. (2015). Reliability and Validity of the Spence Children’s Anxiety Scale for Parents in Mainland Chinese Children and Adolescents. Child Psychiatry & Human Development .47, 830–839.
_||_Abidin, R. (1995). Parenting Stress Index (PSI) manual (3rd edition). Pediatric Psychology Press.
Brown, F. J., & Hooper, S. (2009). Acceptance and Commitment Therapy (ACT) with a learning disabled young person experiencing anxious and obsessive thoughts. Journa of
Caspi, A., Moffitt, T., Newman, D., & Silva, P. (1996). Behavioral observations at age 3 years predict adult psychiatric disorders: longitudinal evidence from a birth cohort. Archives Of General Psychiatry, 53,1033–1039.
Coyne, L. W., McHugh, L., & Martinez, E. R. (2011). Acceptance and commitment therapy (ACT): Advances and applications with children, adolescents, and families. Child and Adolescent Psychiatric Clinics of North America, 20, 379–399.
Davis, A. (2015). Parental Stress and Child Behavior Problems in Families of Children with Autism. A Thesis submitted in partial satisfaction of the requirements for the degree Doctor of Philosophy in Clinical Psychology.
Davies, P., & Martin, M. (2014). Children’s Coping and Adjustment in High-Conflict Homes: The Reformulation of Emotional Security Theory. Child Development Perspectives, 8, 242-249.
Deater-Deckard, K. (1998). Parenting stress and child adjustment: Some old hypotheses and new questions. Clinical Psychology: Science and Practice, 5, 314-332.
Ehrenreich, J. T., Micco, J. A., Fisher, P. H., & Warner, C. M. (2009). Assessment of relevant parenting factors in families of anxious children: The family assessment clinician-rated interview (FACI). Child Psychiatry and Human Development, 40, 331–342.
Fadaei, Z., Dehghani, M., Tahmasian, K., Farhadei, M. Investigating reliability, validity and factor structure of parenting stress- short form in mother`s of 7-12 year-old children. Journal of Research in Behavioural Sciences. 2010: 8 (2): 81-91.(in Persian)
Fletcher, L., & Hayes, S. C. (2005). Relational frame theory, acceptance and commitment therapy, and a functional analytic definition of mindfulness. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 23, 315–336.
Farahani, H., Abedi, A., aghamohamadi, S., kazemi, Z. Single-case designs in Behavioral and Medical Sciences Research (3rd edition). 2013: Tehran. Psychology and Art Publications. (in Persian)
Gal, M., Borg, W., & Gal, J. Quantitative and qualitative research methods in Educational Sciences and Psychology. Tehran. Shahid Beheshti University and Samat Publications 1995.
Ginsburg, G. S., La Greca, A. M., & Silverman, W. K. (1998). Social anxiety in children with anxiety disorders:Relation with social and emotional functioning. Journal of Abnormal Child Psychology, 26, 175–185.
Ginsburg, G. S., Lambert, S. F., & Drake, K. L. (2004). Attributions of control, anxiety sensitivity, and panic symptoms among adolescents. Cognitive Therapy and Research, 28, 745–763.
Hadian, M., Kazemi, M. S (1396). The effectiveness of acceptance and commitment therapy on generalized anxiety disorder in children with type 1 diabetes. Journal of Ilam University of Medical Sciences. 25(6). 185-198. (in Persian)
Hancock, K. M., Swain, J., Hainsworth, C. J., Dixon, A. L., Koo, S., & Munro, K. (2016). Acceptance and Commitment Therapy versus Cognitive Behavior Therapy for Children With Anxiety: Outcomes of a Randomized Controlled Trial. Journal of Clinical Child & Adolescent Psychology, 00:1–16.
Haskett, M. E., Ahern, L. S., Ward, C. S., & Allaire, J. C. (2006). Factor structure and validity of the Parenting Stress Index-Short Form. Journal of Clinical Child and Adolescent Psychology, 35, 302-312.
Herbert, J. D. (2002). Review of S. C. Hayes, K. D. Strosahl, & K. G. Wilson, Acceptance and Commitment Therapy: An experiential approach to behavior change. Cognitive and Beahvioral Practice, 9, 164-166.
Hirshfeld-Becker, R., Masek, B., Henin, A., Blakely, L. R., Pollock-Wurman, R. A., McQuade, J., DePetrillo, L., Briesch, J., Ollendick, T. H., Rosenbaum, J. F., & Biederman, J. (2010). Cognitive behavioral therapy for 4- to 7-year-old children with anxiety disorders: a randomized clinical trial. Journal of Consulting and Clinical Psychology, 78, 498–510.
Hughes, A. A., Hedtke, K. A., & Kendall, P. C. (2008). Family functioning in families of children with anxiety disorders. Journal of Family Psychology, 22, 325–328.
Imani, M. The effictiveness of Acceptance Based Behavior Therapy and Integrative Behavioral Couple Therapy in reducing distressed couples and General Anxiety Disorder Mahshahr women. PhD Thesis of Counseling 2011. (in Persian)
Ingram, R.E., Hayes., & Scott, W. (2000). Empirically supported treatment: A critical analysis. In. Syder, C.R & Ingram, R.E(Eds). Handbook of psychological change (pp.40-60). New York: John Wiley & sons.
Kazdin, A.E.(1999). The meanings and measurement of clinical significance. Journal of consulting and clinical psychology, 67, 300-307.
Lee, J., Semple, R. J., Rosa, D., & Miller, L. (2008). Mindfulness based cognitive therapy for children: Results of a pilot study. Journal of Cognitive Psychotherapy, 22, 15–28.
McCurry, C.) 2009 (. Parenting Your Anxious Child with Mindfulness and Acceptance. New Harbinger Publications, Inc.
Monga, S., Rosenbloom, B. N., Tanha, A., Owens, M., & Young, A. (2014). Comparison of child–parent and parent-only cognitive- behavioral therapy programs for anxious children aged 5 to 7 years: short- and long-term outcomes. Journal of the American Academy of Child and Adolescent Psychiatry,1-9.
O’Brien, K., Larson, C., & Murrell, A. (2008). Third-wave behavior therapies for children and adolescents: Progress, challenges and future directions. In L. A. G. S. C. Hayes (Ed.), Acceptance and mindfulness treatments for children and adolescents (pp. 15–35). Oakland, CA: New Harbinger and Context Press.
Putnick, D. L., Bornstein, M. H., Hendricks, C., Painter, K. M., Suwalsky, J. T. D., & Collins, W. A. (2010). Stability, continuity, and similarity of parenting stress in European American mothers and fathers across their child's transition to adolescence. Parenting: Science & Practice, 10, 60-77.
Piacentini, J & Roblek, T. (2002). Recognizing and treating childhood anxiety disorders. Western Journal of Medicine, 176,149–151.
Raphael, J. L., Zhang, Y., Liu, H., & Giardino, A. P. (2009). Parenting stress in U.S. families: Implications for paediatric health care utilization. Child: Care, Health, and Development, 36, 216-224.
Reynolds, C. R., & Richmond, B. O. (1978). What i think and feel: A revised measure of children's manifest anxiety. Journal of Abnormal Child Psychology, 6, (2), 271–280.
Reynolds, C. R., & Richmond, B. O. (1979). Factor structure and construct validity of "What I think and feel": The Revised Children's Manifest Anxiety Scale. Journal of Personality Assessment, 43(3), 281-283.
Roza, A., Hofstra, M., van der Ende, J., Verhulst, F. (2003). Stable prediction of mood and anxiety disorders based on behavioural and emotional problems in childhood: a 14-year follow-up during childhood, adolescence, and young adulthood. American Journal of Psychiatry. 160, 2116–2121.
Semple, R. J. (2005). Mindfulness-Based Cognitive Therapy for Children: A Randomized Group Psychotherapy Trial Developed to Enhance Attention and Reduce Anxiety. Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy under the Executive Committee of The Graduate School of Arts and Sciences.
Semple, R. J., Reid, E. F. G., Miller, L. (2005). Treating Anxiety With Mindfulness: An Open Trial of Mindfulness Training for Anxious Children. Journal of Cognitive Psychotherapy: An International Quarterly.19 (4), 379-392.
Spence, S. H. )1997.( Structure of anxiety symptoms among children: a confirmatory factor-analytic study. Journal of Abnormal Psychology; 106(2): 280.97.
Spence, S. H. )1998 .(A measure of anxiety symptoms among children. Behaviour Research and Therapy; 36(5), 545-66.
Spence, S., Barrett, P., & Turner, C. (2003). Psychometric properties of the spence children's anxiety scale with young adolescents. Journal of anxiety disorders, 17(6), 605-625.
Stellard, P., Velleman, R., Langsford, J., & Baldwin, S. (2111). Coping and psychological distress in children involved in road traffic accidents. British Journal of Clinical Psychology, 41, 197-218.
Swain, J., Hancock, K., Dixon, A., Koo, S., & Bowman, J. (2013, a). Acceptance and Commitment Therapy for anxious children and adolescents: study protocol for a randomized controlled trial. Trials. 1-12.
Taghavi, M., Alishahi, M Validity and reliability Children's Manifest Anxiety Scale. Journal of Psychology 2003: 7 (4): 342-357. (in Persian)
Wang, M., Meng, Q., Liu, L., Liu, G. (2015). Reliability and Validity of the Spence Children’s Anxiety Scale for Parents in Mainland Chinese Children and Adolescents. Child Psychiatry & Human Development .47, 830–839.