Effects of Community-Based Acceptance and Commitment Therapy on Quality of Life and Mental Health Outcomes for Mothers of Children With Autism Spectrum Disorder: A Pilot RCT in China

Acceptance and Commitment Therapy (ACT) has shown promise in improving psychological flexibility and reducing distress among parents of children with autism; however, evidence among Chinese mother remains limited. This study examined the feasibility, acceptability and preliminary efficacy of a community-based ACT intervention.

42 participants were randomly assigned to ACT group received a 5-week ACT training (Mage=40.81, SDage=7.31) or control group received a 5-week Psychoeducation program (Mage=42.43, SDage=11.57). All participants completed post-intervention assessments; the ACT group also had a one-month follow-up with daily Loving-Kindness reminders. Feasibility was assessed through recruitment, compliance and attrition rates; acceptability was evaluated via qualitative interviews.

Compared with the control group, the ACT group showed significant improvements in quality of life in the social (p =.021) and environment (p =.032) domains of quality of life after the intervention. The ACT group also showed sustained improvements in quality of life (physical, psychological, and social domains) at onemonth follow-up. Improvements in mental health (depression: p = .04; anxiety: p = .019; stress: p = .011) and psychological flexibility (experiential avoidance: p = .008; cognitive fusion: p = .011) were observed from baseline to follow-up.

The ACT intervention demonstrated good feasibility and acceptability for Chinese mothers of children with autism, with preliminary findings indicating positive meffects on quality of life, mental health and psychological flexibility. As a scalable, lowintensity intervention deliverable in community settings, its benefits persisted when supplemented with follow-up reminders, indicating the need for larger, longer studies to compare strategies for sustaining long term effects.