Abstract
Evidence supports the use of acceptance and commitment therapy (ACT) for well-being and behavior change among parents. This study examined the impact of a brief ACT intervention on positive parenting strategies, psychological flexibility, and distress among parents who have experienced relationship violence.As part of a larger study, 43 parents were recruited from a community outreach center and completed measures of parenting, ACT processes, and distress. Participants were pseudo-randomly assigned to either receive their treatment-as-usual (TAU) or ACT plus TAU. Twenty-five participants received four weekly sessions of ACT plus TAU, and 18 received TAU only. Positive parenting behaviors among parents in the ACT + TAU group improved immediately following treatment compared to the TAU group. Improvements were maintained six weeks following treatment. The hypothesis that psychological flexibility would mediate improvements was not supported.The present study provides initial, preliminary support for the secondary benefits of brief, broad ACT interventions for positive parenting behaviors among parents who have experienced relationship violence. Clinical implications for implementing ACT for parents who have experienced relationship violence and methodological limitations are discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Psychological Association Division 12 Society of Clinical Psychology (APA Div 12 SCP; 2016). Website on research-supported psychological treatments. Retrieved from http://www.div12.org/Psychological-Treatments/treatments.
Appleyard, K., & Osofsky, J. D. (2003). Parenting after trauma: supporting parents and caregivers in the treatment of children impacted by violence. Infant Mental Health Journal, 24(2), 111–125. https://doi.org/10.1002/imhj.10050.
Banyard, V. L., Williams, L. M., & Siegel, J. A. (2003). The impact of complex trauma and depression on parenting: an exploration of mediating risk and protective factors. Child Maltreatment, 8(4), 334–349. https://doi.org/10.1177/1077559503257106.
Basharpoor, S., Shafiei, M., & Daneshvar, S. (2015). The comparison of experiential avoidance, mindfulness and rumination in trauma-exposed individuals with and without posttraumatic stress disorder (PTSD) in an Iranian sample. Archives of Psychiatric Nursing, 29, 279–283. https://doi.org/10.1016/j.apnu.2015.05.004.
Batten, S. V., & Hayes, S. C. (2005). Acceptance and commitment therapy in the treatment of comorbid substance abuse and post-traumatic stress disorder: a case study. Clinical Case Studies. https://doi.org/10.1177/1534650103259689.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory-II (1, pp. 82). San Antonio: Psychological Corporation.
Benzies, K., Keown, L., & Magill-Evans, J. (2009). Immediate and sustained effects of parenting on physical aggression in Canadian children aged 6 years and younger. The Canadian Journal of Psychiatry / La Revue Canadienne De Psychiatrie, 54(1), 55–64.
Berntsen, D., & Rubin, D. C. (2006). The centrality of event scale: A measure of integrating a trauma into one’s identity and its relation to post-traumatic stress disorder symptoms. Behaviour Research and Therapy, 44(2), 219–231.
Blackledge, J. T., & Hayes, S. C. (2006). Using acceptance and commitment training in the support of parents and children diagnosed with autism. Child & Family Behavior Therapy, 28(1), 1–18. https://doi.org/10.1300/J019v28n01_01.
Blanchard, E. B., Jones-Alexander, J., Buckley, T. C., & Forneris, C. A. (1996). Psychometric properties of the PTSD checklist (PCL). Behaviour Research and Therapy, 34(8), 669–673. https://doi.org/10.1016/0005-7967(96)00033-2.
Boals, A., & Murrell, A. R. (2016). I am trauma: experimentally reducing event centrality and PTSD symptoms in a clinical trial. Journal of Loss and Trauma, 21, 471–483. https://doi.org/10.1080/15325024.2015.1117930.
Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., … Zettle, R. D. (2011). Preliminary psychometric properties of the acceptance and action questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42(4), 676–688.
Brassell, A. A., Rosenberg, E., Parent, J., Rough, J. N., Fondacaro, K., & Seehuus, M. (2016). Parent’s psychological flexibility: associations with parenting and child psychosocial well-being. Journal of Contextual Behavioral Science, 5(2), 111–120. https://doi.org/10.1016/j.jcbs.2016.03.001.
Brockman, C., Snyder, J., Gewirtz, A., Gird, S. R., Quattlebaum, J., Schmidt, N.,…Degarmo, D. (2016). Relationship of service members’ deployment trauma, PTSD symptoms, and experiential avoidance to postdeployment family reengagement. Journal of Family Psychology, 30(1), 52–62. https://doi.org/10.1037/fam0000152.
Bryan, C. J., Ray-Sannerud, B., & Heron, E. A. (2015). Psychological flexibility as a dimension of resilience for posttraumatic stress, depression, and risk for suicidal ideation among Air Force personnel. Journal of Contextual Behavioral Science, 4(4), 263–268. https://doi.org/10.1016/j.jcbs.2015.10.002.
Burke, K., & Moore, S. (2015). Development of the parental psychological flexibility questionnaire. Child Psychiatry and Human Development, 46, 548–557. https://doi.org/10.1007/s10578-014-0495-x.
Burke, K., Muscara, F., McCarthy, M., Dimovski, A., Hearps, S., Anderson, V., & Walser, R. (2014). Adapting acceptance and commitment therapy for parents of children with life-threatening illness: pilot study. Families, Systems, & Health, 32(1), 122–127. https://doi.org/10.1037/fsh0000012.
Burrows, C. J. (2013). Acceptance and commitment therapy with survivors of adult sexual assault: a case study. Clinical Case Studies. https://doi.org/10.1177/1534650113479652.
Butler, J., & Ciarrochi, J. (2007). Psychological acceptance and quality of life in the elderly. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care, & Rehabilitation, 16, 607–615. https://doi.org/10.1007/s11136-006-9149-1.
Casselman, R. B., & Pemberton, J. R. (2015). ACT-based parenting group for veterans with PTSD: development and preliminary outcomes. The American Journal of Family Therapy, 43(1), 57–66. https://doi.org/10.1080/01926187.2014.939003.
Cheron, D. M., Ehrenreich, J. T., & Pincus, D. B. (2009). Assessment of parental experiential avoidance in a clinical sample of children with anxiety diosrders. Child Psychiatry and Human Development, 40, 383–403. https://doi.org/10.1007/s10578-009-0135-z.
Coles, R. L. (2009). Just doing what they gotta do: single black custodial fathers coping with the stresses and reaping the rewards of parenting. Journal of Family Issues, 30(10), 1311 1338. https://doi.org/10.1177/0192513X09339290.
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(2), 379–399. https://doi.org/10.1016/j.chc.2011.01.010.
Coyne, L. W., & Murrell, A. R. (2009). The joy of parenting: An acceptance & commitment therapy guide to effective parenting in the early years. Oakland: New Harbinger Publications.
Danzig, A. P., Dyson, M. W., Olino, T. M., Laptook, R. S., & Klein, D. N. (2015). Positive parenting interacts with child temperament and negative parenting to predict children’s socially appropriate behavior. Journal of Social And Clinical Psychology, 34(5), 411–435.
Dwairy, M. (2010). Parental acceptance-rejection: a fourth cross-cultural research on parenting and psychological adjustment of children. Journal of Child and Family Studies, 19, 30–35. https://doi.org/10.1007/s10826-009-9338-y.
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319–345. https://doi.org/10.1016/S0005-7967(99)00123-0.
Engle, J. L., & Follette, V. (2012). Acceptance and commitment therapy for trauma-related problems. In R. A. McMackin, E. Newman, J. M. Fogler, T. M. Keane (Eds.), Trauma therapy in context: The science and craft of evidence-based practice (pp. 353–372). Washington, DC: American Psychological Association. https://doi.org/10.1037/13746-017.
Field, T. M. (1995). Psychologically depressed parents. In M. H. Bornstein (Ed.), Handbook of parenting, 4, 85–99. Hillsdale: Lawrence Erlbaum Associates, Inc.
Fledderus, M., Oude Voshaar, M. A., ten Klooster, P. M., & Bohlmeijer, E. T. (2012). Further evaluation of the psychometric properties of the acceptance and action questionnaire-II. Psychological assessment, 24(4), 925.
Forgatch, M. S., Patterson, G. R., & DeGarmo, D. S. (2005). Evaluating fidelity: predictive validity for a measure of competent adherence to the Oregon model of parent management training. Behavior Therapy, 36, 3–13.
Frick, P. J. (1991). The Alabama parenting questionnaire. Unpublished rating scale, University of Alabama.
Froehlich, J., & Morgan, P. (2015). The significant work of parenting. Work: Journal of Prevention, Assessment & Rehabilitation, 50(3), 411–412.
Grant, K., Bautovich, A., McMahon, C., Reilly, N., Leader, L., & Austin, M. (2012). Parental care and control during childhood: associations with maternal perinatal mood disturbance and parenting stress. Archives of Women’s Mental Health, 15(4), 297–305. https://doi.org/10.1007/s00737-012-0292-0.
Gross, C. L., & Marcussen, K. (2016). Postpartum depression in mothers and fathers: the role of parenting efficacy expectations during the transition to parenthood. Sex Roles. https://doi.org/10.1007/s11199-016-0629-7.
Guedeney, A. (2000). Infant depression and withdrawal: clinical assessment. WAIMH Handbook of Infant Mental Health, 4, 455–484.
Gustafsson, H. C., & Cox, M. J. (2012). Relations among intimate partner violence, maternal depressive symptoms, and maternal parenting behaviors. Journal of Marriage and Family, 74(5), 1005–1020. https://doi.org/10.1111/j.1741-3737.2012.01010.x.
Hawes, D. J., & Dadds, M. R. (2006). Assessing parenting practices through parent-report and direct observation during parent-training. Journal of Child and Family Studies, 15(5), 554–567.
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1–25. https://doi.org/10.1016/j.brat.2005.06.006.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd edn.). New York: Guilford Press.
Hogue, A., Henderson, C. E., Dauber, S., Barajas, P. C., Fried, A., & Liddle, H. A. (2008). Treatment adherence, competence, and outcome in individual and family therapy for adolescent behavior problems. Journal of Consulting and Clinical Psychology, 76, 544–555. https://doi.org/10.1037/0022-006X.76.4.544.
Huh, D., Tristan, J., Wade, E., & Stice, E. (2006). Does problem behavior elicit poor parenting?: A prospective study of adolescent girls. Journal of Adolescent Research, 21, 185–204. https://doi.org/10.1177/0743558405285462.
Juul, S. H., Hendrix, C., Robinson, B., Stowe, Z. N., Newport, D. J., Brennan, P. A., & Johnson, K. C. (2016). Maternal early-life trauma and affective parenting style: the mediating role of HPA-axis function. Archives of Women’s Mental Health, 19, 17–23. https://doi.org/10.1007/s00737-015-0528-x.
Kashdan, T. B., Morina, N., & Priebe, S. (2009). Post-traumatic stress disorder, social anxiety disorder, and depression in survivors of the Kosovo War: experiential avoidance as a contributor to distress and quality of life. Journal of Anxiety Disorders, 23, 185–196. https://doi.org/10.1016/j.janxdis.2008.06.006.
Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30(7), 865–878. https://doi.org/10.1016/j.cpr.2010.03.001.
Levendosky, A. A., & Graham-Bermann, S. A. (2001). Parenting in battered women: The effects of domestic violence on women and children. Journal of Family Violence, 16, 171–192. https://doi.org/10.1023/A:1011111003373.
Lovejoy, M. C., Graczyk, P. A., O’Hare, E., & Neuman, G. (2000). Maternal depression and parenting behavior: a meta-analytic review. Clinical Psychology Review, 20, 561–592. https://doi.org/10.1016/S0272-7358(98)00100-7.
Madigan, S., Wade, M., Plamondon, A., & Jenkins, J. (2015). Maternal abuse history, postpartum depression, and parenting: links with preschoolers’ internalizing problems. Infant Mental Health Journal, 36, 146–155. https://doi.org/10.1002/imhj.21496.
McKee, L., Roland, E., Coffelt, N., Olson, A., Forehand, R., Massari, C.,… Zens, M. S. (2007). Harsh discipline and child problem behaviors: the roles of positive parenting and gender. Journal of Family Violence, 22, 187–196. https://doi.org/10.1007/s10896-007-9070-6.
McKinney, C., Morse, M., & Pastuszak, J. (2016). Effective and ineffective parenting: associations with psychological adjustment in emerging adults. Journal Of Family Issues, 37, 1203–1225. https://doi.org/10.1177/0192513X14537480.
Miron, L. R., Sherrill, A. M., & Orcutt, H. K. (2015). Fear of self-compassion and psychological inflexibility interact to predict PTSD symptom severity. Journal of Contextual Behavioral Science, 4(1), 37–41. https://doi.org/10.1016/j.jcbs.2014.10.003.
Morrill, M. I., Hawrilenko, M., & Cόrdova, J. V. (2016). A longitudinal examination of positive parenting following an acceptance-based couple intervention. Journal of Family Psychology, 30(1), 104.
Moyer, D. N., & Sandoz, E. K. (2015). The role of psychological flexibility in the relationship between parent and adolescent distress. Journal of Child and Family Studies, 24, 1406–1418. https://doi.org/10.1007/s10826-014-9947-y.
Murrell, A. R., & Scherbarth, A. J. (2006). State of the research & literature address: ACT with children, adolescents and parents. International Journal of Behavioral Consultation and Therapy, 2, 531–543. https://doi.org/10.1037/h0101005.
Nelson, S. K., Kushlev, K., & Lyubomirsky, S. (2014). The pains and pleasures of parenting: when, why, and how is parenthood associated with more or less well being? Psychological Bulletin, 140, 846–895. https://doi.org/10.1037/a0035444.
Newland, R. P., & Crnic, K. A. (2011). Mother–child affect and emotion socialization processes across the late preschool period: predictions of emerging behaviour problems. Infant and Child Development, 20(6), 371–388. https://doi.org/10.1002/icd.729.
Nomaguchi, K. M., & Milkie, M. A. (2003). Costs and rewards of children: the effects of becoming a parent on adults’ lives. Journal of Marriage and Family, 65, 356–374. https://doi.org/10.1111/j.1741-3737.2003.00356.x.
Orsillo, S. M., & Batten, S. V. (2005). Acceptance and commitment therapy in the treatment of posttraumatic stress disorder. Behavior Modification, 29, 95–129. https://doi.org/10.1177/0145445504270876.
Oxford, M., Cavell, T. A., & Hughes, J. N. (2003). Callous/unemotional traits moderate the relation between ineffective parenting and child externalizing problems: a partial replication and extension. Journal of Clinical Child & Adolescent Psychology, 32(4), 577–585.
Polusny, M. A., Ries, B. J., Meis, L. A., Degarmo, D., Mccormick-Deaton, C. M., Thuras, P., & Erbes, C. R. (2011). Effects of parents’experiential avoidance and PTSD on adolescent disaster-related posttraumatic stress symptomatology. Journal of Family Psychology, 25(2), 220–229. https://doi.org/10.1037/a0022945.
Ruggiero, K. J., Del Ben, K., Scotti, J. R., & Rabalais, A. E. (2003). Psychometric properties of the PTSD checklist–civilian version. Journal of Traumatic Stress, 16(5), 495–502. https://doi.org/10.1023/A:1025714729117.
Schmalz, J. E., & Murrell, A. R. (2010). Measuring experiential avoidance in adults: the avoidance and fusion questionnaire. International Journal of Behavior Consultation and Therapy, 6, 198–213.
Schofield, T. J., Conger, R. D., & Neppl, T. K. (2014). Positive parenting, beliefs about parental efficacy, and active coping: three sources of intergenerational resilience. Journal Of Family Psychology, 28, 973–978. https://doi.org/10.1037/fam0000024.
Shea, S. E., & Coyne, L. W. (2011). Maternal dysphoric mood, stress, and parenting practices in mothers of Head Start preschoolers: the role of experiential avoidance. Child & Family Behavior Therapy, 33, 231–247. https://doi.org/10.1080/07317107.2011.596004.
Smout, M. F., Hayes, L., Atkins, P. W., Klausen, J., & Duguid, J. E. (2012). The empirically supported status of acceptance and commitment therapy: an update. Clinical Psychologist, 16, 97–109. https://doi.org/10.1111/j.1742-9552.2012.00051.x.
Steer, R. A., Ball, R., & Ranieri, W. F. (1997). Further evidence for the construct validity of the beck depression inventory-II with psychiatric outpatients. Psychological Reports, 80(2), 443–446. https://doi.org/10.2466/pr0.1997.80.2.443.
Tiwari, S., Podell, J. C., Martin, E. D., Mychailyszyn, M. P., Furr, J. M., & Kendall, P. C. (2008). Experiential avoidance in the parenting of anxious youth: theory, research, and future directions. Cognition and Emotion, 22, 480–496. https://doi.org/10.1080/02699930801886599.
Tull, M. T., Jakupcak, M., Paulson, A., & Gratz, K. L. (2007). The role of emotional inexpressivity and experiential avoidance in the relationship between posttraumatic stress disorder symptom severity and aggressive behavior among men exposed to interpersonal violence. Anxiety, Stress, & Coping: An International Journal, 20, 337–351. https://doi.org/10.1080/10615800701379249.
Twohig, M. P. (2009). Acceptance and commitment therapy for treatment-resistant posttraumatic stress disorder:a case study. Cognitive and Behavioral Practice, 16, 243–252. https://doi.org/10.1016/j.cbpra.2008.10.002.
Twohig, M. P., Hayes, S. C., Plumb, J. C., Pruitt, L. D., Collins, A. B., Hazlett-Stevens, H., & Woidneck, M. R. (2010). A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 78(5), 705–716.
Varela, R. E., Vernberg, E. M., Sanchez-Sosa, J. J., Riveros, A., Mitchell, M., & Mashunkashey, J. (2004). Parenting style of mexican, Mexican American, and Caucasian-non-hispanic families:social context and cultural influences. Journal of Family Psychology, 18(4), 651–657. https://doi.org/10.1037/0893-3200.18.4.651.
Weinberg, M. K., & Tronick, E. Z. (1998). The impact of maternal psychiatric illness on infant development. Journal of Clinical Psychiatry, 59(2), 53–61.
Whittingham, K., Sanders, M., McKinlay, L., & Boyd, R. N. (2014). Interventions to reduce behavioral problems in children with cerebral palsy: an RCT. Pediatrics, 133, 1249–1257. https://doi.org/10.1542/peds.2013-3620.
Wilson, K. G., Sandoz, E. K., Kitchens, J., & Roberts, M. E. (2010). The Valued living questionnaire: defining and measuring valued action within a behavioral framework. The Psychological Record, 60, 249–272.
Woidneck, M. R., Morrison, K. L., & Twohig, M. P. (2014). Acceptance and commitment therapy for the treatment of posttraumatic stress among adolescents. Behavior Modification, 38, 451–476. https://doi.org/10.1177/0145445513510527.
Yu, J., Cheah, C. L., & Calvin, G. (2016). Acculturation, psychological adjustment, and parenting styles of Chinese immigrant mothers in the United States. Cultural Diversity And Ethnic Minority Psychology, 22(4), 504–516. https://doi.org/10.1037/cdp0000091.
Yu, S., Assor, A., & Liu, X. (2015). Perception of parents as demonstrating the inherent merit of their values: relations with self-congruence and subjective well-being. International Journal of Psychology, 50(1), 70–74. https://doi.org/10.1002/ijop.12074.
Acknowledgements
This research was supported in part by a grant from the Hogg Foundation for Mental Health.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Moyer, D.N., Page, A.R., McMakin, D.Q. et al. The Impact of Acceptance and Commitment Therapy on Positive Parenting Strategies Among Parents Who Have Experienced Relationship Violence. J Fam Viol 33, 269–279 (2018). https://doi.org/10.1007/s10896-018-9956-5
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10896-018-9956-5