Acceptance and Commitment Therapy for Parents of Children With ASD: Effects on Cognitive Fusion, Stigma, and Mindfulness

NCT07582627 | Completed DMC

• 2 other identifiers: JU-CON-2026-001JU-NUR-ACT-2026
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this intervention is to evaluate whether Acceptance and Commitment Therapy (ACT) can improve psychological well-being among parents of children with Autism Spectrum Disorder (ASD) in Saudi Arabia. The study focuses on parents aged 18 years and older who are caring for children diagnosed with ASD. The main questions it aims to answer are:

• Does ACT reduce affiliate stigma among parents of children with ASD?
• Does ACT reduce cognitive fusion among parents of children with ASD?
• Does ACT improve mindfulness levels among parents of children with ASD?
• Does ACT reduce mental health problems (depression, anxiety, and stress) among parents of children with ASD?
• Does ACT influence perceived social support among parents of children with ASD? Participants will take part in an ACT-based intervention program and complete questionnaires before and after the intervention. Specifically, participants will:
• Attend structured ACT sessions delivered online over five weeks.
• Complete questionnaires measuring affiliate stigma, cognitive fusion, and mindfulness before the intervention.
• Complete the same questionnaires after the intervention to assess changes.

Conditions

Autism Spectrum Disorder (ASD)

Keywords

Acceptance and Commitment Therapy; Autism Spectrum Disorder; Caregivers; Parents; Psychological Flexibility; Mindfulness; Cognitive Fusion; Stigma; Caregiver Burden; Depression; Anxiety; Stress

Outcome Measures

Primary Outcomes (5)

• Cognitive Fusion

  Cognitive fusion will be assessed using the Cognitive Fusion Questionnaire (CFQ), a 7-item self-report scale rated on a 7-point Likert scale. Higher total scores indicate greater cognitive fusion and lower psychological flexibility.

  - Baseline (Week 0) - Post-intervention (Week 5)

• Affiliate Stigma

  Affiliate stigma will be measured using the Affiliate Stigma Scale (ASS), a 22-item self-report instrument assessing affective, cognitive, and behavioral domains. Each item is rated on a 4-point Likert scale, with higher scores indicating greater levels of stigma experienced by parents of children with Autism Spectrum Disorder.

  - Baseline (Week 0) - Post-intervention (Week 5)

• Mindfulness

  Mindfulness will be measured using the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R), a 10-item self-report scale assessing attention, awareness, and acceptance. Higher scores indicate greater levels of mindfulness.

  - Baseline (Week 0) - Post-intervention (Week 5)

• Depression, Anxiety, and Stress

  Psychological distress will be measured using the 21-item Depression, Anxiety, and Stress Scale (DASS-21). It assesses emotional states across three subscales, with higher scores indicating greater distress.

  - Baseline (Week 0) - Post-intervention (Week 5)

• Perceived Social Support

  Perceived social support will be assessed using the 12-item Multidimensional Scale of Perceived Social Support (MSPSS), measuring support from family, friends, and significant others. Higher scores indicate greater perceived support.

  - Baseline (Week 0) - Post-intervention (Week 5)

Study Arms (1)

Acceptance and Commitment Therapy (ACT) Group

EXPERIMENTAL

Participants in this arm received a structured Acceptance and Commitment Therapy (ACT) intervention delivered online. The program consisted of multiple sessions conducted weekly, focusing on mindfulness, acceptance, cognitive fusion, and value-based action. The intervention aimed to reduce cognitive fusion and affiliate stigma while improving mindfulness among parents of children with Autism Spectrum Disorder. Participants completed outcome measures before and after the intervention to assess changes.

Behavioral: Acceptance and Commitment Therapy (ACT)

Interventions

Acceptance and Commitment Therapy (ACT) BEHAVIORAL

Acceptance and Commitment Therapy (ACT) is a structured behavioral intervention designed to enhance psychological flexibility through mindfulness, acceptance, and value-based action. In this study, ACT was delivered online by a trained mental health nurse to parents of children with Autism Spectrum Disorder. The intervention consisted of multiple sessions conducted weekly over several weeks. Sessions included psycho-education about ACT principles, mindfulness exercises, cognitive fusion techniques, and strategies to promote acceptance and value-driven behavior. Participants engaged in interactive discussions, guided activities, and homework assignments. The intervention aimed to reduce cognitive fusion and affiliate stigma while improving mindfulness. Outcome measures were assessed before and after the intervention to evaluate effectiveness.

Acceptance and Commitment Therapy (ACT) Group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Parents or caregivers have children diagnosed with ASD,
• Age from 18 to 65 years old.
• Both sexes
• willing to participate in the study and able to communicate.

You may not qualify if:

• Caregivers with physical and mental disabilities were excluded.

Sponsors & Collaborators

• University of Jazan: lead

Study Sites (1)

Jazan Health Cluster

Jizan, Saudi Arabia

Location

Related Publications (26)

• Yesilkaya, M., & Magallón-Neri, E. (2024). Parental Stress Related to Caring for a Child With Autism Spectrum Disorder and the Benefit of Mindfulness-Based Interventions for Parental Stress: A Systematic Review. Sage Open, 14(2). https://doi.org/10.1177/21582440241235033

  BACKGROUND

• Salami, I., & Alhalal, E. (2024). Affiliate stigma among caregivers of children with autism spectrum disorder in Saudi Arabia. BMC Psychology, 12(1), 145. https://doi.org/10.1186/s40359-024-01545-y

  BACKGROUND

• Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of personality assessment, 52(1), 30-41

  BACKGROUND

• Wong CCY, Mak WWS, Liao KYH. 2016. Self-compassion: a potential buffer against affiliate stigma experienced by parents of children with autism spectrum disorders. Mindfulness 7(6):1385-1395 DOI 10.1007/s12671-016-0580-2.

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• Mak WWS, Kwok YTY. Internalization of stigma for parents of children with autism spectrum disorder in Hong Kong. Soc Sci Med. 2010 Jun;70(12):2045-2051. doi: 10.1016/j.socscimed.2010.02.023. Epub 2010 Mar 12.

  PMID: 20362379 BACKGROUND

• Mak, W. W., & Cheung, R. Y. (2008). Affiliate stigma among caregivers of people with intellectual disability or mental illness. Journal of applied research in intellectual disabilities, 21(6), 532-545.

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  BACKGROUND

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  BACKGROUND

• Lunsky Y, Fung K, Lake J, Steel J, Bryce K. 2017. Evaluation of acceptance and commitment therapy (ACT) for mothers of children and youth with autism spectrum Disorder. Mindfulness 9(4):1110-1116.

  BACKGROUND

• Kinnear SH, Link BG, Ballan MS, Fischbach RL. Understanding the Experience of Stigma for Parents of Children with Autism Spectrum Disorder and the Role Stigma Plays in Families' Lives. J Autism Dev Disord. 2016 Mar;46(3):942-53. doi: 10.1007/s10803-015-2637-9.

  PMID: 26659549 BACKGROUND

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  PMID: 35911024 BACKGROUND

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  PMID: 24411117 BACKGROUND

• Fekih-Romdhane F, Fawaz M, Hallit R, Sawma T, Obeid S, Hallit S. Psychometric properties of an Arabic translation of the multidimensional social support scale (MSPSS) in a community sample of adults. BMC Psychiatry. 2023 Jun 14;23(1):432. doi: 10.1186/s12888-023-04937-z.

  PMID: 37316897 BACKGROUND

• Fung K, Lake J, Steel L, Bryce K, Lunsky Y. ACT Processes in Group Intervention for Mothers of Children with Autism Spectrum Disorder. J Autism Dev Disord. 2018 Aug;48(8):2740-2747. doi: 10.1007/s10803-018-3525-x.

  PMID: 29546537 BACKGROUND

• Ebrahim, M. T., & Alothman, A. A. (2022). The reliability and validity of the multidimensional scale of perceived social support (MSPSS) in mothers of children with developmental disabilities in Saudi Arabia. Research in Autism Spectrum Disorders, 92, 101926.

  BACKGROUND

• Chua JYX, Shorey S. The Effect of Mindfulness-Based and Acceptance Commitment Therapy-Based Interventions to Improve the Mental Well-Being Among Parents of Children with Developmental Disabilities: A Systematic Review and Meta-Analysis. J Autism Dev Disord. 2022 Jun;52(6):2770-2783. doi: 10.1007/s10803-021-04893-1. Epub 2021 Jun 28.

  PMID: 34181139 BACKGROUND

• Chan KKS, Lam CB. 2018. Self-stigma among parents of children with autism spectrum disorder. Research in Autism Spectrum Disorders 48:44-52 DOI 10.1016/j.rasd.2018.01.001.

  BACKGROUND

• Chan KKS, Lam CB. 2017. Trait mindfulness attenuates the adverse psychological impact of stigma on parents of children with autism spectrum disorder. Mindfulness 8(4):984-994 DOI 10.1007/s12671-016-0675-9.

  BACKGROUND

• Corti C, Pergolizzi F, Vanzin L, Cargasacchi G, Villa L, Pozzi M, Molteni M. 2018. Acceptance and commitment Therapy-Oriented Parent-Training for parents of children with autism. Journal of Child and Family Studies 27:2887-2900

  BACKGROUND

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• Ali AM, Hori H, Kim Y, Kunugi H. The Depression Anxiety Stress Scale 8-Items Expresses Robust Psychometric Properties as an Ideal Shorter Version of the Depression Anxiety Stress Scale 21 Among Healthy Respondents From Three Continents. Front Psychol. 2022 Mar 24;13:799769. doi: 10.3389/fpsyg.2022.799769. eCollection 2022.

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  PMID: 35248844 BACKGROUND

• Al-Gamal, E., Alhosain, A., Alsunaye, K., Alhujaili, A. D., & Thomas, C. (2019). Levels and predictors of self-stigma among male nursing students in Saudi Arabia. American Journal of Men's Health, 13(5), 1557988319876264.

  BACKGROUND

• Al-Ghabeesh, S. H., Abu El Haija, A. H., & El-Adwan, R. M. (2021). The Relationship between Cognitive Fusion and Psychological Distress among Parents of Children with Autism Spectrum Disorder. International Journal of Pediatrics, 2021.

  BACKGROUND

• Al-Zaidy, A., Alqahtani, A. H., Alhazzani, M., & Alqahtani, A. S. (2020). Prevalence of Autism Spectrum Disorder in Saudi Arabia: A systematic review. Journal of Family Medicine and Primary Care, 9(1), 62-67.

  BACKGROUND

MeSH Terms

Conditions

Autism Spectrum Disorder; Social Stigma; Caregiver Burden; Depression; Anxiety Disorders

Interventions

Acceptance and Commitment Therapy

Condition Hierarchy (Ancestors)

Child Development Disorders, Pervasive; Neurodevelopmental Disorders; Mental Disorders; Social Behavior; Behavior; Stress, Psychological; Behavioral Symptoms

Intervention Hierarchy (Ancestors)

Cognitive Behavioral Therapy; Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Amani A. Kappi, PhD

  University of Jazan

  PRINCIPAL INVESTIGATOR

• Warda H. Al Shahat, PhD

  University of Jazan

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: April 29, 2026
• First Posted: May 13, 2026
• Study Start: January 25, 2026
• Primary Completion: February 26, 2026
• Study Completion: February 26, 2026
• Last Updated: May 13, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

SA (1)