Academic journal article The International Journal of Behavioral Consultation and Therapy

State of the Research & Literature Address: ACT with Children, Adolescents and Parents

Academic journal article The International Journal of Behavioral Consultation and Therapy

State of the Research & Literature Address: ACT with Children, Adolescents and Parents

Article excerpt

To date, Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999) has been has been shown effective with adults who experience a number of conditions, including work- related stress (Bond & Bunce, 2000), professional burnout (Hayes, Bissett et al., 2004), and anxiety with marital distress (Luciano & Gutierrez, 2001). ACT has also been used to effectively treat several common forms of psychopathology among adults, such as as major depressive disorder (Lopez & Arco, 2002), panic disorder (Carrascoso, 2000), and poly-substance abuse (Hayes, Wilson et al., 2002). In addition, ACT has been shown to be an effective treatment of serious mental illness, such as schizophrenia (Bach & Hayes, 2002), and medical disorders--e.g., diabetes (Gregg, 2004). A good deal of time and effort has gone into the summarization of ACT conducted with adults. Several international presentations, an empirical review paper (Hayes, Masuda, Bissett, Luoma, & Guuerrero, 2004), and a meta-analysis (Hayes, Luoma, Bond, Masuda, & Lillis, 2006) have summarized such theoretical and empirical work.

Thus far, there has been little focus on summarizing the state of ACT work conducted with children, adolescents, and their parents. To rectify this need, theoretical papers and empirical research conducted with these populations will be reviewed. Prior to this review, the authors will provide a list of general considerations for using ACT with youth and parents.

Then, a brief introduction to each problem currently addressed by the ACT research community, followed by: published empirical studies, published theoretical papers that pose specific considerations for working with individuals with that problem, and any applicable unpublished works will be presented. The authors' decision to include unpublished work was based upon two factors: (a) many clinicians and researchers have expressed an interest in ACT with youth and parents; however, (b) because the area of study is fairly recent, little published work has come to fruition. After individual problems are addressed, the published research will be briefly summarized. Finally, further questions and recommendations for ACT researchers will be offered.

General Considerations for use of ACT with Youth

ACT can be incorporated into existing treatment protocols for children, adolescents and/or parents. In addition, ACT shows promising results as the primary treatment for these populations; although, the special challenges of working with children need to be kept in mind (Murrell, Coyne & Wilson, 2005). Case conceptualizations of children, like adults, require a functional analysis and assessment of both values and avoidance. However, using multiple sources of information is especially important with young children. In addition to meeting ethical requirements, in order to maintain the integrity of the collaborative spirit of ACT, therapists should obtain fully informed consent from children as well as their parents. An additional concern is developmental propriety. Although children and adolescents are able to benefit from most components of the ACT model, some pieces of the work are more difficult than others. Developing a sense of self-as-context and making contact with the present moment may be too abstract for children--especially young children--to grasp. Murrell et al. suggest concretizing metaphors such as the mud-in-a-glass and the box-of-stuff as well as including many physical activities in efforts to increase effectiveness. These adaptations allow for developmentally appropriate exercises for children and teens of various capabilities. For example, the complicated idea of valuing is made clearer through the vital or poison activity. In this activity, youth are encouraged to sort their attempts at alleviating distress into one of two boxes, one with a heart that represents moving closer towards values and the other with a poison bottle that represents moving away from values. …

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