Comparison of the Effectiveness of Acceptance and Commitment Therapy and Cognitive-Behavioral Therapy on Stigma in Mothers of Children with Autism Spectrum Disorder

Authors

    Farokh Lagha Akafi Broujeny Ph.D. Student, Department of Counseling, Ro.C., Islamic Azad University, Tehran, Iran
    Masoumeh Behboodi * Assistant Professor, Department of Counseling, Ro.C., Islamic Azad University, Tehran, Iran Behboodi@riau.ac.ir
    Farideh Dokaneifard Associate Professor, Department of Counseling, Ro.C., Islamic Azad University, Tehran, Iran

Keywords:

Autism spectrum disorder, stigma, cognitive-behavioral therapy, acceptance and commitment therapy

Abstract

Autism spectrum disorder can be considered a neurodevelopmental disorder characterized by communicative deviation or delay, persistent deficits in reciprocal social interactions, restricted patterns of communication, and repetitive behaviors. The present study aimed to compare the effectiveness of acceptance and commitment therapy and cognitive-behavioral therapy on stigma in mothers of children with autism spectrum disorder. This study was a quasi-experimental research with a pretest-posttest design and a control group. Forty-five mothers of children with autism spectrum disorder were selected through convenience sampling and randomly assigned equally to two experimental groups and one control group (15 participants in each group). One experimental group participated in an acceptance and commitment therapy program consisting of eight 90-minute sessions, and the other experimental group participated in a cognitive-behavioral therapy program consisting of eight 90-minute sessions, while members of the control group did not participate in these programs. Participants were assessed using the Internalized Stigma of Parents of Disabled Children Questionnaire (2009). Data were analyzed using univariate and multivariate covariance analysis. The results indicated that acceptance and commitment therapy and cognitive-behavioral therapy had a positive and significant effect on stigma in mothers of children with autism spectrum disorder (P < .01). Furthermore, the findings showed no significant difference between the effectiveness of acceptance and commitment therapy and cognitive-behavioral therapy regarding stigma and its subscales (P < .05). The findings of this study suggest that acceptance and commitment therapy and cognitive-behavioral therapy programs can play an important role in reducing stigma in mothers of children with autism spectrum disorder.

Downloads

Download data is not yet available.

References

1. American Psychiatric A. Diagnostic and Statistical Manual of Mental Disorders. Arlington: Wiley Blackwell; 2013.

2. Taveira MdGMM, Correia DS, Coelho JAP, Miranda CT. Transtornos do espectro autista: visão de discentes dos cursos de medicina e enfermagem de uma universidade pública. Ciênc saúde coletiva. 2023;28(6):1853-62. doi: 10.1590/1413-81232023286.15292022.

3. Patel AD, Arya A, Agarwal V, Gupta PK, Agarwal M. Burden of care and quality of life in caregivers of children andadolescents with autism spectrum disorder. Asian J Psychiatr. 2022;70:103030. doi: 10.1016/j.ajp.2022.103030.

4. Rabiei F, Ehteshamzadeh P, Homaei R, Jayervand H. Effectiveness of Play Therapy Based on Sensory Integration on Communication Skills, Social Interaction, Stereotyped Behaviors, and Motor Development in Boys with Autism Spectrum Disorder. J Child Ment Health. 2024;10(4):93-108. doi: 10.61186/jcmh.10.4.8.

5. Kendall PC, Ney JS, Maxwell CA, Lehrbach KR, Jakubovic RJ, McKnight DS. Adapting CBT for youth anxiety: Flexibility, within fidelity, in different settings. Front Psych. 2023;14. doi: 10.3389/fpsyt.2023.1067047.

6. Bagheri-Sheykhangafshe F, Mohammadi-Sangachin-Doost A, Savabi-Niri V, Mojez N, Bourbour Z. The Efficacy of Cognitive-Behavioral Group Therapy on Psychological Well-being and Resilience of Students with Depressive Syndrome. J Child Ment Health. 2023;10(1):108-24. doi: 10.61186/jcmh.10.1.9.

7. Md S, Corrigan PW, Reed S, Ohan JL. Vicarious stigma and self-stigma experienced by parents of children with mental health and/or neurodevelopmental disorders. Community Ment Health J. 2021;57:1537-46. doi: 10.1007/s10597-021-00774-0.

8. He D, He L, Yuan Y, Huang L, Xiao Q, Ye X. Stigma and its correlates among patients with Crohn's disease: a cross-sectional study in China. Int J Nurs Sci. 2023;10:318-24. doi: 10.1016/j.ijnss.2023.06.012.

9. Gray DE. Everybody just freezes. Everybody is just embarrassed: felt and enacted stigma among parents of children with high functioning autism. Sociol Health Illn. 2002;24(6):734-49. doi: 10.1111/1467-9566.00316.

10. Werner S, Shulman C. Subjective well-being among family caregivers of individuals with developmental disabilities: the role of affiliate stigma and psychosocial moderating variables. Res Dev Disabil. 2013;34(11):4103-14. doi: 10.1016/j.ridd.2013.08.029.

11. Mak WWS, Kwok YTY. Internalization of stigma for parents of children with autism spectrum disorder in Hong Kong. Soc Sci Med. 2010;70:2045-51. doi: 10.1016/j.socscimed.2010.02.023.

12. Rezaei Dehnavi S, Hemati Alamdarloo G. The Impact of Perceived Stigma on Mental Health of Mothers of Children with Autism Spectrum Disorders. Journal of Family Research. 2015;11(1):123-39.

13. Salleh NS, Abdullah KL, Yoong TL, Jayanath S, Husain M. Parents' experiences of affiliate stigma when caring for a child with autism spectrum disorder (ASD): A meta-synthesis of qualitative studies. J Pediatr Nurs. 2020;55:174-83. doi: 10.1016/j.pedn.2020.09.002.

14. Pisula E, Porebowicz-Dorsmann A. Family functioning, parenting stress and quality of life in mothers and fathers of Polish children with high functioning autism or Asperger syndrome. PLoS ONE. 2017;12(10):e0186536. doi: 10.1371/journal.pone.0186536.

15. Haji naghi tehrani F, Saberi H, Bagheri N. Effectiveness of treatment based on acceptance and commitment on quality of life and cognitive flexibility of mothers of children with autism. IJRN. 2022;9(1):41-51.

16. AghaVirdinejad S, Akbari B, Sadeghi A. Comparison of the Effectiveness of Cognitive-Behavioral Therapies and Acceptance and Commitment on Quality of Life and Mental Well-Being of Mothers of Children with Autism Spectrum Disorder. Community Health Journal. 2022;16(3):14-26.

17. Taati E, Zarbakhsh Bahri MR. Comparison of the Coherence and Defense Mechanisms between Parents of Normal Children and Parents of Children with Autism and Attention Deficit Hyperactivity Disorder. J Child Ment Health. 2019;6(3):15-27. doi: 10.29252/jcmh.6.3.3.

18. McCarthy J, Underwood L, Tsakanikos E, Craig T, Howlin P, Bouras N. EPA-0297 - Predictors of Challenging Behaviour Among Mental Health Service Users with Intellectual Disability and Autism Spectrum Disorders. European Psychiatry. 2014;29(S1):1-. doi: 10.1016/S0924-9338(14)77741-7.

19. Rezaei Dehnavi S, Nouri A, Jafari M, Faramarzi S. Investigating stigma phenomenon among mothers with down syndrome children in Isfahan: a psycho- social approach. Journal of Family Research. 2009;5(19):401-16.

20. Ejei J, Sayadshirazy M, Gholamali-Lavasani M, Kasaei-Esfahani A. Compare the Effectiveness of Group Therapy Based on Acceptance and Commitment and Cognitive-Behavioral Therapy on Reducing Anxiety of Mothers of Autistic Children. Journal of Psychology. 2018;22(1):3-21.

21. Fata L, Mutabi F. The way and custom of therapy in cognitive-behavioral theory. Tehran: Danje; 2022.

22. Leahy RL, Holland SJ. Treatment plans and interventions for depression and anxiety disorders. New York: Guilfor; 2000.

23. Driscoll K, Schonberg M, Stark MF, Carter AS, Hirshfeld-Becker D. Family-centered cognitive behavioral therapy for anxiety in very young children with autism spectrum disorder. J Autism Dev Disord. 2020;50(11):1-16. doi: 10.1007/s10803-020-04446-y.

24. Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: The process and practice of mindful change. NewYork: Guilford press; 2011.

25. Harris R. ACT made simple: An easy-to-read primer on acceptance and commitment therapy. Oakland: New Harbinger Publications; 2019.

26. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: model, pro-cesses and outcomes. Behav Res Ther. 2006;44(1):1-25. doi: 10.1016/j.brat.2005.06.006.

27. Towey-Swift KD, Lauvrud C, Whittington R. Acceptance and commitment therapy (ACT) for professional staff burnout: a systematic review and narrative synthesis of controlled trials. J Ment Health. 2022;32(2):452-64. doi: 10.1080/09638237.2021.2022628.

28. Fung K, Lake J, Steel L, Bryce K, Lunsky Y. ACT Processes in Group Intervention for Mothers of Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders. 2018;48(8):2740-7. doi: 10.1007/s10803-018-3525-x.

29. Juvin J, Sadeg S, Julien-Sweerts S. A systematic review: Acceptance and Commitment Therapy for the parents of children and adolescents with Autism Spectrum Disorder. J Autism Dev Disord. 2022;52:124-41. doi: 10.1007/s10803-021-04923-y.

30. Esmaeelpanah Amlashi Z, Hosseinkhanzadeh AA, Akbari B, Moghtader L. Comparison of the Effectiveness of Cognitive Behavioral Training with Acceptance and Commitment Therapy on the Self-esteem of Mothers of Children with Autism Spectrum Disorder. J Child Ment Health. 2022;9(2):50-64. doi: 10.52547/jcmh.9.2.5.

31. ArianaKia E, Moradi A, Hatami M. The Effectivness of Combined of Brief Behavioral Activation Therapy and Mindfulness-based Cognitive Therapy in Patients with Major Depressive Disorder. Journal of Clinical Psychology. 2014;6(1):15-27.

32. Kim S, Richardson A, Werner P, Anstey KJ. Dementia stigma reduction (DESeRvE) through education and virtual contact in the general public: A multi-arm factorial randomised controlled trial. Dementia. 2021;20(6):2152-69. doi: 10.1177/1471301220987374.

33. Kowalkowski JD. The impact of a group-based acceptance and commitment therapy intervention on parents of children diagnosed with an autism spectrum disorder. Ypsilanti: Eastern Michigan University; 2012.

34. Esmaeelpanah Amlashi Z, Hosseinkhanzadeh AA, Akbari B, Moghtader L. Comparison of the Effectiveness of Cognitive Behavioral Training with Acceptance and Commitment Therapy on the Self-esteem of Mothers of Children with Autism Spectrum Disorder. J Child Ment Health. 2022;9(2):4. doi: 10.52547/jcmh.9.2.5.

Downloads

Published

2025-08-01

Submitted

2025-04-04

Revised

2025-07-20

Accepted

2025-07-27

How to Cite

Lagha Akafi Broujeny , F. ., Behboodi, M., & Dokaneifard , F. (2025). Comparison of the Effectiveness of Acceptance and Commitment Therapy and Cognitive-Behavioral Therapy on Stigma in Mothers of Children with Autism Spectrum Disorder. Mental Health and Lifestyle Journal, 3(3), 1-13. https://www.mhljournal.com/index.php/mhlj/article/view/77

Similar Articles

21-30 of 49

You may also start an advanced similarity search for this article.