Parental Stress, Health and Disabilities. A Training Programme in Psychological Flexibility During COVID 19
Phase: NA
Conditions: Parent-Child Relations, Parental Stress
Sponsor: Universidad Europea de Madrid

 
 
 
 
 
 
 
Parental stress and disability. A psychological flexibility training  
programme  
ID: CIPI/21/091  
Document date: 15th November 2021  
IP: Francisco Montesinos, Ph.D.  
Study Protocol and Statistical Analysis Plan  
 
 
 

Study Protocol:  
• Objective: To study the efficacy of a group treatment based on 
Acceptance and Commitment Therapy on parental stress in relatives 
of people with intellectual disabilities. 
• Design: Randomized clinical trial 
• Methods.  
 
After being informed about the study, all patients giving written 
informed consent will be assessed to determine eligibility for study 
entry. Parents who meet eligibility requirements will be assessed 
through a standardized questionnaires, self-report instruments and 
randomized assigned to a waiting list or treatment.  
 
Participants assigned to treatment arm will receive psychological 
intervention consistent in a 3-session group ACT-based treatment in 
the in a room of the collaborating NGO by a psychologist trained in 
third-generation therapies and experienced in working with families  
Standardized questionnaires were administered before the 
intervention (pre-treatment), one week after its completion (post-
treatment), and three months later (follow-up). Participants 
completed daily self-monitoring from one week before the 
intervention (forming the BL) until one week after the intervention, 
obtaining 4 measures. In addition, participants filled in their 
workbooks in each session 
 
 
21 participants
11 Treatment
10 Waiting List+intervention 5 
month later

Intervention protocol. 
Session 1. Introducing ACT therapy. Promoting creative hopelessness: an 
experiential exercise to assess the effectiveness of stress coping repertoires 
through “Man in the hole” metaphor (Hayes et al., 2014). Training in self 
as context through the “Observer exercise” (Hayes et al., 2014). 
Homework: implementing committed actions and self-report. 
Session 2. Training in values and commitment action through experiential 
exercises: 1) What kind of mother or father do I want to be? 2) What can I 
do this week to move towards the kind of parent I want to be? 3) Clarifying 
values about family/parenting; assessing the importance and value 
orientation on a scale of 0 to 10. Training in self as context through the 
“Observer exercise” (Hayes et al., 2014). Training in acceptance, defusion 
and contact with the present moment through experiential exercises: 1) 
Emotion Mindfulness through physicalization (Harris, 2019) 2) “Joe the 
Bum” metaphor (Hayes et al., 2014) and 3) “Passengers on the Bus” 
metaphor (Hayes et al., 2014). Homework: implementing committed 
actions and self-report. Homework: What can I do this week to move 
towards the kind of parent I want to be? Practicing Mindful breathing 
exercise (audio recording) and self-report. 
Session 3. Training in values and commitment action through experiential 
exercises: 1) Identifying valuable actions in the presence of internal and 
external barriers.  2) Experiential exercise: “When...Then”. 3) “The choice 
point” (Harris, 2019) 4) Our values as parents. Sharing the values on which 
I articulate my actions. Training in self as context through the “Observer 
exercise” (Hayes et al., 2014). Training in acceptance, defusion and contact 
with the present moment through experiential exercises: 1) Mindful 
breathing exercise (audio re-cording) 2) “Passengers on the Bus” metaphor 
(Hayes et al., 2014). Homework: implementing committed actions and self-
report. Provision of support and supplementary materials. 
Statistical Analysis Plan (SAP):  
The results will be analysed through non-parametric techniques 
(comparisons of pre, post and follow-up group means). An analysis of 
variance will be performed to determine the specific weight of each 
independent variable, as well as the possible interaction between them. The 
statistical approach of Jacobson and Truax (1991) will be used to estimate 
the clinical significance of the effect. Finally, the change in self-monitoring 
will be analysed through repeated measures ANOVA.