Comparing the Effects of Cognitive Behavioral Therapy and Acceptance and Commitment Therapy on Quality of Life in the Mothers of Children With Autism

The prevalence of Autism Spectrum Disorder (ASD) is significantly on the rise in children. ASD is characterized by stereotyped behaviors, irritability, destructive behaviors, and serious forms of social interaction. ASD usually develops before the age of 3 years. ASD severely impacts family life; accordingly, the parents of children with ASD encounter numerous challenges. Taking care of these children, even in the best of circumstances, is a challenging activity; sometimes, in addition to caring for children, conditions are imposed on parents that add to their challenges. Multiple demands and restrictions are faced by the parents of children with ASD; thus, these parents are exposed to adverse consequences. Therefore, the present research aimed to compare the effects of Cognitive–Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) on Quality of Life (QoL) in the mothers of children diagnosed with ASD.

This was a quasi–experimental research with a pretest–posttest and a control group design. The statistical population of the study included all the mothers of children with ASD in Kermanshah City, Iran, in 2019. For this purpose, 45 eligible and volunteer mothers were selected based on the inclusion and exclusion criteria of the research. Consequently, they were randomly divided into 3 groups of CBT, ACT, and control (n=15/group). The inclusion criteria of the study included the mothers of children with ASD (diagnosis by a pediatric neurologist), physical ability, an age range of 25 to 50 years, the educational level of above diploma, not receiving any psychological treatment, willingness to attend the therapy sessions, and completing the study questionnaires. The exclusion criteria were absence from >3 sessions in the experimental groups; the existence of severe behavioral problems during the sessions, as well as non–participation and non–cooperation in the research project. The research instrument was the World Health Organization Quality of Life Questionnaire (WHOQOL–BREF) (1996). The interventions were performed in the CBT group (Redfourd, 2007) for eight 90–minute sessions twice a week, and in the ACT group (Kowalkowski, 2012) for eight 90–minute sessions twice a week. The collected data were analyzed using descriptive statistics (including mean & standard deviation) and inferential statistics, including one–way Analysis of Variance (ANOVA), Chi–squared test, Multivariate Analysis of Covariance (MANCOVA), and Bonferroni posthoc test in SPSS. The significance level of all tests was considered 0.05.

The MANCOVA results suggested that after removing the pretest effects, the difference was significant between the study groups (CBT, ACT, & control) in the posttest phase respecting QoL and its components, including physical health, mental health, social relations, and environmental health (p<0.001). According to the Bephroni posthoc test data, there was no significant difference between the effects of CBT and ACT on the QoL of the explored mothers (p=1.000). However, there was a significant difference between the CBT and control groups (p<0.001) as well as between the ACT and control groups (p<0.001) concerning QoL in the examined mothers of children with ASD.

Based on the present study results, CBT and ACT can be useful and effective in improving the QoL of the mothers of children with ASD.