Peer-reviewed article
Videoconferencing acceptance and commitment therapy for parents of children with special health care needs: A randomised controlled trial.
Yuen Yu Chong, Jacky Kin Fung Chan, Pui Tik Yau, Tim Man Ho Li, Kenneth P Fung et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This randomised controlled trial tested whether parents of children with special health care needs in Hong Kong could benefit from a brief videoconferencing therapy programme delivered by trained paraprofessionals. The intervention, Focused Acceptance and Commitment Therapy, was delivered over 4-6 weeks alongside standard parenting advice. Compared to parents receiving standard parenting advice alone, those who received the therapy showed improvements in parenting stress, depression, and anxiety symptoms, with benefits lasting six months after the intervention ended.
Key points
- At 6 months, the therapy intervention reduced parenting stress by 4.88 points on the Parental Stress Scale compared to standard advice alone
- Depressive symptoms decreased by 4.35 points and anxiety symptoms by 4.89 points in the intervention group
- Psychological flexibility improved by 3.61 points in the intervention group
- 254 parents participated (92.9% mothers), with children averaging 6 years old
- The paraprofessional-delivered model offers a scalable approach that can be integrated into routine paediatric and community care pathways
Limitations
The study does not measure direct child outcomes or whether parental wellbeing improvements translate to improved child health or development. The sample is predominantly mothers from Hong Kong non-governmental organisation centres, which may limit generalisability to other populations and settings.
Abstract
BACKGROUND: Parents of children with special health care needs endure substantial psychological distress, a challenge frequently encountered in nursing practice. While nurses are ideally positioned to identify and support these families, they require access to effective, scalable interventions that can be integrated into care pathways. This study investigated a task-shifting model, testing whether a brief, videoconferencing-delivered Focused Acceptance and Commitment Therapy programme is effective when delivered by trained paraprofessionals. OBJECTIVE: To determine the efficacy of a paraprofessional-led, videoconferencing-delivered Focused Acceptance and Commitment Therapy plus standard parenting advice versus standard parenting advice alone for reducing parenting stress and improving mental health outcomes among parents of children with special health care needs. DESIGN: Assessor-blinded, multicentre randomised controlled trial with repeated measures. METHODS: The trial was conducted at six non-governmental organisation centres in Hong Kong. Eligible parents were randomised 1:1 to (i) Focused Acceptance and Commitment Therapy plus standard parenting advice or (ii) standard parenting advice alone. Standard parenting advice (usual care for both groups) comprised six weekly e-learning modules on positive parenting plus a videoconferencing review session at week 6. The intervention group additionally received 4-6 weekly, 45-60-minute individual Focused Acceptance and Commitment Therapy sessions delivered by trained paraprofessionals via videoconferencing. The primary outcome was parenting stress (Parental Stress Scale). Secondary outcomes were depressive symptoms, anxiety symptoms, and psychological flexibility. Outcomes were assessed at baseline (T0), postintervention (6 weeks post-baseline; T1), and 6 months postintervention (30 weeks post-baseline; T2). Analyses followed the intention-to-treat principle. RESULTS: Among 254 parents (mean [SD] age, 39.0 [6.7] years; child age, 6.0 [2.3] years; 92.9% mothers), at T2, Focused Acceptance and Commitment Therapy plus standard parenting advice reduced parenting stress more than standard parenting advice alone (adjusted means difference, [aMD]; -4.88; 95% CI, -7.15 to -2.62; Cohen d, -0.30; 95% CI, -0.57 to -0.03). Depressive symptoms (aMD, -4.35; 95% CI, -5.43 to -3.27; Cohen d, -0.64; 95% CI, -0.91 to -0.37) and anxiety symptoms (aMD, -4.89; 95% CI, -6.00 to -3.78; Cohen d, -0.87; 95% CI, -1.14 to -0.59) decreased, while psychological flexibility improved (aMD, 3.61, 95% CI, 2.36 to 4.85; Cohen d, 0.67; 95% CI, 0.39 to 0.94). CONCLUSIONS: A brief, paraprofessional-led Focused Acceptance and Commitment Therapy programme delivered via videoconferencing is effective and scalable for reducing parenting stress and improving caregiver mental health. These findings support a task-shifting model where nurses coordinate paraprofessional-delivered support to integrate evidence-based care into routine paediatric and community pathways. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT06262646 (Registration date: February 01, 2024; Start of recruitment: February 02, 2024).
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Focused Acceptance and Commitment Therapy delivered via videoconferencing by trained paraprofessionals (4-6 weekly sessions of 45-60 minutes) plus standard parenting advice (six e-learning modules on positive parenting plus a week-6 review session)
- Population
- 254 parents (mean age 39 years; 92.9% mothers) of children with special health care needs in Hong Kong, recruited through six non-governmental organisation centres
Key finding
Parenting stress reduced by 4.88 points (95% CI -7.15 to -2.62; Cohen d -0.30) at 6-month follow-up
Chong et al. · PubMed (US National Library of Medicine) · 14 Apr 2026