The impact of an Acceptance and Commitment Therapy (ACT) intervention on parent behavior towards children with Autism

by Lisa Truong

Parents of children with autism or other developmental delays often face difficult challenges and negative private thoughts, which in turn inhibits parents’ abilities to implement effective interventions for their children. The parents’ behaviors are influenced by rule-governed behavior as opposed to contingency shaped behavior. Contingency-shaped behavior is controlled by being exposed to environmental contingencies, while rule-governed behavior (RGB) is an effect of our ability to derive rules from other experiences. Our ability to learn from other experiences and the verbal behavior of others and then apply it to other situations is thought to be an essential human ability that explains many of our higher thinking capabilities. However, RGB can result in over-extension of rules to situations in which they do not apply. One particular category of RBGs, called plys (or “pliance”) is the over-extension of socially derived rules for behavior. For example, a child told by a parent that they should always wear a jacket when they go outside may derive a rule driven by social contingencies rather than the appropriate response to the environment. If the child then tends to put on their jacket based on the rule, without regard for whether it is hot or cold outside, then this child is acting in pliance. This is likely to occur, in part, because one of the known properties of RGB is a reduction in sensitivity to environmental contingencies and contingency-shaped behavior. In a sense, the stronger RGB, the more in tune an individual is with rules rather than the environment. This tends to result in behavior that becomes increasingly narrow and inflexible.

Parents may also act in rule-governed ways when it comes to responding to their child’s behavior. An example would be how a parent would respond to their child crying in public. Rather than ignoring the child’s inappropriate behavior, parents tend to act according to societal expectations. Further, parents may experience accompanying aversive emotional states (e.g., anxiety and embarrassment) and seek to avoid these emotions by parenting in such a way that ends their child’s problematic behavior more quickly in the short-run but extends the life of the behavior through reinforcement. This can lead parents struggling to deal with their own private events to effectively follow behavior plans.

Acceptance and Commitment Therapy (ACT) is a contemporary behavior analytic approach to addressing these private events. The goal of ACT is to increase response flexibility so that clients can better track and engage in behaviors that lead them toward valued living. The ability to act in such ways is often referred to as “psychological flexibility.” Recent research has shown that parenting-specific psychological flexibility leads to more adaptive parenting behaviors and lower levels of child problem behaviors.

The main goal of ACT for parents of children on the autism spectrum is to increase adaptive parenting behaviors in the service of the parents’ values. Parents are asked to identify specific overt behaviors (e.g., playing with their child for at least 15 minutes each day) which would move them towards their own parenting values. A 2017 study (Gould, Tarbox, & Coyne) indicated that a six-week ACT protocol produced an increase in value-directed, overt behaviors in parents with children with autism. These increases in value-directed behavior were maintained at follow-up.

Sources

Gould, E. R., Tarbox, J., & Coyne, L. (2018). Evaluating the effects of Acceptance and Commitment Therapy on overt behavior of parents of children with autism. Journal of Contextual Behavioral Science, 7, 81-88.