Effect of Interventions Based on Acceptance and Commitment Therapy Administered to Parents of Special Needs Children on Their Levels of Psychological Resilience, Depression, Anxiety, Stress and Caregiver Burden: A Randomised Controlled Trial
Phase: NA
Conditions: Acceptance and Commitment Therapy, Anxiety Depression, Caregiver Burden, Public Health Nurse, Stress, Special Needs Children, Caregiver Burnout
Sponsor: Akdeniz University

Official Title of the study: 
Effect of Interventions Based on Acceptance and Commitment Therapy Administered to 
Parents of Special Needs Children on Their Levels of Psychological Resilience, Depression, 
Anxiety, Stress and Caregiver Burden: A randomised controlled trial 
 
 
ClinicalTrials.gov Identifier: NCT04307706 
Date of the document: 01.04.2019

ACT-based Intervention Study Protocol 
 
Sessions 
Aim 
Time 
Material 
Interventions 
Evaluations 
Preparatory 
Session 
• Meeting and establishing therapeutic 
relationship 
• Getting informed consent 
• Explanation of the purpose of the training 
• Collection of pre-test data 
• Taking the participant's story 
• Formulation through behavioral analysis 
60 
minutes 
-A4 paper 
-Data 
collection 
tools 
(AAQ-II, RSA-21, DASS-
21) 
-The Bull's Eye worksheet 
 
Applying Two 
Mountain metaphors 
 
Case formulation: 
Identifying excesses 
and shortcomings 
 Assessing whether the 
purpose of the training is 
understood 
 Ending the session with 
feedback 
 
I. Session 
Values: Clarifying 
values 
• Determining the interventions goals with the 
client 
• Increasing awareness of her/his values, 
clarifying values, evaluations and trying to 
connect with her/his values. 
60 
minutes 
-A small clipboard 
-A4 paper 
-Colorful pencils 
-The Bull's Eye worksheet 
-Values list / Value cards 
 
Clarifying values  
 
Apply 
the 
magic 
wand metaphor  
 
Breathing 
and 
mindfulness exercises 
 Homework assignment: 
- Noticing what you are doing 
in line with your values 
- Breathing and mindfulness 
exercises 
 Ending the session with 
feedback 
 
II. Session 
 
Values and Creative 
hopelessness 
 
 
Setting the agenda by checking homework 
and summarizing the previous session 
 
Determining emotional control strategies 
 
To increase awareness of emotional control 
agenda 
 
Revealing dysfunctional behavior 
60 
minutes 
 
-Rope or belt  
-A small clipboard 
-A4 paper 
 
Forming 
of 
tried-and-
tested solutions and their 
long-term effects. 
- Creative hopelessness 
intervention 
 Tug of war with a 
monster metaphor 
 Struggling 
in 
quicksand metaphor 
 Homework assignment: 
- Filling the tried-and-tested 
solutions and their long-term 
effects table 
- Keep a diary (until next 
session) 
 Ending the session with 
feedback 
 
 
III. Session 
 
Defusion 
 
Setting the agenda by checking homework 
and summarizing the previous session 
 
To see the real / real nature of the thoughts 
 
To react by considering the functionality of 
the thoughts, not their dictionary meanings 
60 
minutes 
 
 
 
Notebook 
 
 
 
 
The 
leaves 
on 
a 
stream 
 
A master storyteller 
 
Letting it be: 
Singing 
and 
silly 
voices 
 Homework assignment: 
- Practice the leaves on a 
stream exercise 
- Repeating the thought as 
singing and silly voices 
 Ending the session with 
feedback 

 
IV. Session 
 
Acceptance 
and 
Contact with the 
Present Moment 
 
Setting the agenda by checking homework 
and summarizing the previous session 
 
Allowing to experience painful personal 
experiences that serve their values 
 
To increase conscious awareness of the 
client's momentary experiences, to fully 
understand what is happening by bringing 
together 
important 
information 
about 
changing or maintaining behavior. 
60 
minutes 
 
 
 
Notebook 
 The struggle switch 
 Demons on the Boat 
 Mindful walking 
 Time machine 
 Breathing exercise 
 Awareness five things 
 Homework assignment: 
- Recognizing when they 
struggle with their feelings 
and open up to them 
- Doing a work as 'mindful' 
- Mindful-breathing exercise 
for 10 minutes 
 Ending the session with 
feedback 
 
V. Session 
 
Self-as-context, 
Values 
and 
Committed Action: 
Doing what matters 
 
Setting the agenda by checking homework 
and summarizing the previous session 
 
Making a connection with the sense of self, 
independent of the client's thoughts and 
feelings, providing a safe and stable point of 
view for observing and accepting them. 
 
Transforming values into ongoing and 
progressive forms of action  
60 
minutes 
 
 
 
 
Notebook 
 
 The 
sky 
and 
the 
weather metaphor 
 The 
Chessboard 
Metaphor 
 Talking and listening 
 Values and table of 
values 
commited 
action (to be created 
with parents) 
 Homework assignment: 
- 
Self-observation 
during 
mindful-practice 
- Take a step action on values 
- Noting what they did for 
their values in the created table 
 Ending the session with 
feedback 
 
VI. Session 
 
Values 
and 
Committed Action: 
Doing what matters 
 
Setting the agenda by checking homework 
and summarizing the previous session 
 
Transforming values into ongoing and 
progressive forms of action 
 
Enabling clients to reconnect with values the 
moment they move away from their values 
or lose the relationship 
60 
minutes 
 
 
Notebook 
 
 Values and table of 
values 
commited 
action (to be created 
with parents) 
 Homework assignment: 
- Continuing with commited 
oriented actions as determined 
- Collection of post-test data 
- Informing for follow-up 
testing 
 Ending the session with 
feedback