Effectiveness of an Online Psychological Support Program for Mothers of Children With Autism

Sabri Hergüner181 enrolled

Overview

The aim of this study to evaluate the effectiveness of an online psychological support program for mothers of children diagnosed with Autism Spectrum Disorder (ASD). In this study, investigators aim to assess the impact of the psychological support program on mothers' mental health and parenting stress levels, investigate the factors associated with changes in parenting stress, and examine the effect of reduced parenting stress on children's behavioral problems and the severity of autism.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social communication and interaction, repetitive behaviors, and restricted interests. Since ASD is a developmental disorder that affects language, speech, cognitive, social, and emotional skills, raising a child with ASD can be a challenging experience for parents. Parents of children with ASD generally experience higher levels of stress, anxiety, and depression compared to parents of typically developing children, and their chronic stress levels are also higher compared to parents of children with developmental delays. A longitudinal study has shown that acceptance plays a protective role in parents' adaptation to an autism diagnosis and is associated with lower levels of depression both cross-sectionally and over time. In contrast, caregivers with increasing levels of self-blame and hopelessness toward the diagnosis have been observed to experience worsened mental health and decreased life satisfaction. Acceptance and Commitment Therapy (ACT) is a form of cognitive-behavioral therapy that focuses on acceptance and mindfulness. This therapeutic approach aims to increase psychological flexibility by altering individuals' relationship with events and their function through six flexible hexagonal concepts (acceptance, defusion, present moment contact, context-based self, values, and value-driven behavior). A review study conducted in 2022 demonstrated that ACT interventions for parents of children with ASD can be beneficial. The rationale for this study stems from the need for approaches to improve the mental health of mothers of children diagnosed with ASD, as these mothers experience higher levels of stress, anxiety, and depression. The literature on the effects of ACT-based interventions on parents' psychological well-being is limited. Research on the effectiveness of ACT-based psychological support programs for parents of children with ASD is still in its early stages. Therefore, it is important to evaluate how ACT-based psychological support programs affect the anxiety, stress, and depression levels of parents of children with ASD, the factors related to these effects, and how reductions in parenting stress influence children's behavioral problems and autism severity.

Interventions

Online Acceptance and Commitment Therapy-Based Parent Support ProgramBEHAVIORAL

The sessions are structured around the core ACT skills (contact with the present moment, acceptance, defusion, values, commitment, and contextual self). Each session includes stages of information sharing, exemplification, meditation practice, feedback, and group discussion. The topics and practices are derived from standardized content commonly used in ACT groups. After each session, home exercises related to the weekly topic are provided, and feedback on these exercises is gathered from participants at the beginning of the next session. Audio recordings for the meditation practices are created and sent to participants via email.

Eligibility

Sex: ALLMin age: 2 YearsMax age: 11 Years

Medical Language ↔ Plain English

Inclusion Criteria: * The participant must have at least one child with a clinically confirmed diagnosis of ASD. * The child with autism must be between 2 and 11 years of age. * Parents must be able to speak and read Turkish sufficiently. * Parents must agree not to participate in any other mental health support program during the study. Exclusion Criteria: * Incomplete completion of the scales * The child with autism is not between the ages of 2 and 11 * Parents are participating in another mental health support program.

Outcomes

Primary Outcomes

Changes in Depression, Anxiety, and Stress

The Depression Anxiety Stress Scales-21 (DASS-21) is a 21-item self-report questionnaire assessing symptoms of depression, anxiety, and stress. Each item is rated on a 4-point Likert scale (0-3). Scores for each subscale range from 0 to 42, with higher scores indicating greater symptom severity. The total score ranges from 0 to 126, with higher scores indicating greater overall psychological distress. The scale will be administered at baseline (T1), at the end of the 5-week intervention (T2), and at the 6-week follow-up (T3) in the intervention group. The control group will be assessed at T1 and T2 only. Changes in scores from T1 to T2 will be compared between groups using analysis of covariance (ANCOVA), controlling for baseline values. Within-group changes across T1, T2, and T3 will also be evaluated in the intervention group.