Acceptance and Commitment Therapy

The Clinician's Guide for Supporting Parents

Koa Whittingham, Lisa Coyne

• Publisher: Academic Press
• Year: 2019
• ISBN:
  9780128146705
• Topic: Psychology
• Subtopic: Clinical Psychology
• Index: Psychology

Acceptance and Commitment Therapy: The Clinician's Guide for Supporting Parents constitutes a principles-based guide for clinicians to support parents across various stages of child and adolescent development. It uses Acceptance and Commitment Therapy (ACT) as an axis to integrate evolution science, behaviour analysis, attachment theory, emotion-focused and compassion-focused therapies into a cohesive framework. From this integrated framework, the authors explore practice through presenting specific techniques, experiential exercises, and clinical case studies.

• Explores the integration of ACT with established parenting approaches
• Includes a new model - the parent-child hexaflex - and explores each component of this model in depth with clinical techniques and a case study
• Emphasizes how to foster a strong therapeutic relationship and case conceptualization from an acceptance and commitment therapy perspective
• Covers the full spectrum of child development from infancy to adolescence
• Touches upon diverse clinical presentations including: child anxiety, neurodevelopmental disorders, and child disruptive behavior problems, with special emphasis on infant sleep
• Addresses how best to support parents with mental health concerns, such as postnatal depression
• Is relevant for both novices and clinicians, students in psychology, social work and educational professionals supporting parents

Chapter 1

Introduction

Abstract

Acceptance and commitment therapy as well as the wider literature of relational frame theory and the complimentary approach of compassion-focused therapy can be used to support parents, the parent–child relationship, as well as children and adolescents. An evolutionary, developmental, and contextual behavioral approach to supporting parents can incorporate both the relational–emotional and the behavioral literature without contradiction. Applying this framework, we can see how psychological flexibility in parents supports the kinds of parent–child interactions that, in turn, support the development of psychological flexibility in children.

Keywords

Acceptance and commitment therapy; parenting; child development; compassion; psychological flexibility; evolution; future

Chapter Outline

• References 5

Parental care is intimately associated with the complex and intricate coevolutionary relationships that exist among the core features of humanity: a large brain, flexible social cooperation, language, symbolic thought, and intersubjectivity (Hrdy, 2011). Humans are flexible cooperative breeders. That is, our children are not raised just by their biological mother; rather, fathers, grandparents, aunts and uncles, older siblings, and nonfamilial caregivers all may be involved in raising a child. Systems of care organize around children in a flexible and opportunistic way, sensitive to context, and we too, as clinicians supporting parents and children, are part of this flexible and cooperative network in its modern form.

Acceptance and commitment therapy (ACT), the wider literature of relational frame theory (RFT), and the complimentary approach of compassion-focused therapy (CFT), are approaches emblematic of contextual behavioral science. These approaches have clear implications for parenting and the parent–child relationship, from finding meaning in parenting, to supporting the child’s emergence into the symbolic world, to responsive and attuned parenting, to supporting the child’s burgeoning perspective-taking abilities, to compassionate parenting. ACT, RFT, and CFT can be used to support parents in their enjoyment of and persistence in parenting well - in a flexible, workable, and compassionate way - even when psychologically difficult. Further, it can be used to understand and predict what kinds of parenting behavior might contribute to the development of psychologically flexible and prosocial children with broad and flexible behavioral repertoires. The research supporting these links is still in its infancy—there is much work still to be done—but the theoretical links are clear and consistent with existing research in areas such as attachment theory, metaemotion theory, theory of mind, and parental mind-mindedness.

Nurturing psychological flexibility.

When ACT, RFT, and CFT are integrated with existing literature across the relational–emotional, behavioral, and developmental areas a model begins to emerge: a model of how parental psychological flexibility can support parental interaction that, in turn, supports the development of a psychologically flexible child. If the therapy of ACT is a way of intervening—a kind of medicine when psychological health has been compromised—then flexible parenting is a way of growing psychologically flexible people organically, through ordinary day-to-day interactions. This relationship between parental psychological flexibility, parental behavior, and the growth of a psychologically flexible child is illustrated in the following diagram:

Applying the ACT/RFT lens to parenting leads us to emphasize the resilience of a flexible experiential approach to parenting with the parent discovering workable parenting solutions. This flexible, workable parenting style can be understood as an evolutionary approach (Hayes & Sanford, 2015; Hayes, Sanford, & Chin, 2017). It is parenting using the principles of evolution: variation, selection, and the retention of adaptive traits. Parents flexibly vary their behavior, experimenting with different approaches (variation), since some behaviors work and some do not (selection). The behaviors that work are selected and retained, that is, the parent uses them again (retention). If selected behaviors stop working parents again experiment, reintroducing variation into their parenting. Thus, parenting evolves over time, and evolves with the development of the child.

One key potential contribution of ACT, RFT, and CFT to parenting research and intervention is the ability to integrate an at times fractured scientific literature and scientific and clinical community. The field of parenting science and intervention is often split into two worldviews: the relational–emotional (including attachment theory) and the behavioral. However, an evolutionary, contextual paradigm is wide enough to contain both. Within this book we have done the best we can to move toward a united parenting science and intervention approach grounded within an evolutionary, contextual paradigm. The ACT, RFT, and CFT communities are uniquely posed to bring about this change, with an emphasis on an evolutionary approach, strong background in basic behavioral science, grounding within attachment literature (CFT), and basic concepts that easily relate to core components of the relational–emotional literature including shared psychological contact, perspective taking, and compassion.

In this book you will find theory, research, practical hands-on knowledge, experiential exercises, metaphors, and clinical case studies. You will find information for beginners—for novices in acceptance and commitment therapy as well as for novices in parenting intervention—and you will also find in-depth discussion for seasoned ACT therapists and academics.

This book is divided into the following three sections:

1. 1. Theoretical and scientific background.
2. 2. The bedrock of clinical practice.
3. 3. ACT processes.

The first section is the theoretical and scientific background. The first chapter briefly introduces all of the key theoretical frames used in this book through considering the evolution of parental care and parenting in the modern world. It also includes our parent–child hexaflex. All of the usual ACT components (as well as compassion) are present, but each in a more expansive and developmentally attuned way. The other two theoretical and scientific chapters are Connect: The Parent–Child Relationship and Shape: Building a Flexible Repertoire. They cover the emotional–relational and the contextual behavioral literature on parenting, respectively.

The second section, The Bedrock of Clincial Practice, covers the therapeutic relationship and case conceptualization, especially how to conduct a functional analysis and a formulation from an ACT perspective. This includes the application of functional analytic psychotherapy to the therapeutic relationship and the parent–child relationship.

The third section covers the ACT processes, with a chapter for each process within our parent–child hexaflex, and a final chapter on integrating ACT with other interventions. This is where we get practical, with experiential exercises and metaphors (including original exercises and metaphors) as well as case studies.

This book also covers the full spectrum of child development: from infancy through adolescence, along with a diversity of clinical presentations from anxiety to neurodevelopmental disorders, to conduct problems, and to postnatal depression and perinatal loss.

Navigate this book to suit your needs.

References

1. Hayes SC, Sanford BT. Modern psychotherapy as a multidimensional multilevel evolutionary process. Current Opinion in Psychology. 2015;2:16–20.

2. Hayes SC, Sanford BT, Chin FT. Carrying the baton: Evolution science and a contextual behavioral analysis of language and cognition. Journal of Contextual Behavioral Science. 2017;6(3):314–328.

3. Hrdy SB. Mothers and Others Cambridge: Harvand University Press; 2011.

Section 1

Theoretical and scientific background

Outline

• Chapter 2 Parenting
• Chapter 3 Connect: the parent–child relationship
• Chapter 4 Shape: building a flexible repertoire

Chapter 2

Parenting

Abstract

This book is grounded in evolutionary theory, and we integrate attachment theory, behavioral theory, and relational frame theory (RFT) as well as related evidence-based approaches. We begin with an overview of the evolution of humanity and parental care, asking: What is good parenting? We review the core theoretical frameworks for this book including RFT, acceptance and commitment therapy (ACT), compassion-focused therapy, and the developmental ACT model of DNA-V. The benefits of a flexible, workable parenting style that support the child’s developing as a psychologically flexible human being are discussed.

Keywords

Acceptance and commitment therapy; parenting; child development; evolution; parental care; acceptance; compassion

Chapter Outline

• Parenting (and child development) in an evolutionary context 9
• The four streams of evolution 10
• The evolution of parental care 13
• The evolution of human parental care 16
• Unique features of contemporary parenting 20
• What is good parenting? 25
  • The theoretical frames 27
• Acceptance and commitment therapy 29
• Compassion-focused ACT 33
• DNA-V 34
• Chapter summary 35
• References 36

I cried two times when my daughter was born. First for joy, when after 27 hours of labor the little feral being we’d made came yowling into the world, and the second for sorrow, holding the earth’s newest human and looking out the window with her at the rows of cars in the hospital parking lot, the strip mall across the street, the box stores and drive-throughs and drainage ditches and asphalt and waste fields that had once been oak groves. A world of extinction and catastrophe, a world in which harmony with nature had long been foreclosed.

Roy Scranton, “Raising My Child in a Doomed World,” New York Times, Ju...