Background. Caregiver strain is the caregiver’s perception of all the problems they face throughout the caregiving process. Caregivers of children with autism spectrum disorder (ASD) are reported to have higher levels of strain compared to parents of children with ADHD, children with other developmental disorders, children with emotional and behavioral issues, and children with other special needs. The caregiving process also have negative repercussions on the health and quality of life of caregivers of children with ASD. The negative impacts often experienced by caregivers of children with ASD include somatic symptoms, high levels of anxiety, and poor health conditions when compared to the population in general. A recent study found that the strain experienced by caregivers can have debilitating effects to physical and psychological health, as well as have a high potential to disrupt the effectiveness of interventions for the child with ASD. This study aimed to reduce caregiver strain in mothers who have children with autism spectrum disorder (ASD) using acceptance and commitment therapy (ACT). ACT was chosen as it would facilitate caregivers to accept the life long condition of pervasive disorders. Then, the ACT would proceed by empowering the caregivers on the things that they could do as well as commit to those things.

Methods. The research team successfully gathered four participants who were able to complete the intervention sessions all the way through. This study was conducted based on the high caregiver strain experienced by caregivers during the caregiving process. The participant criteria for this study were mothers who were informal caregivers or family caregivers of their biological child who had been diagnosed with ASD. The mother had to live in the same house with the child and haD taken the role of caregiver for at least one year. The mother had to at least possess a high school diploma because ACT was an intervention which used several philosophies, strategies, and techniques which required the users to have adequate verbal comprehension. Participants with at least a high school education were approximated to have the necessary intellectual capacity and verbal ability to understand the content in ACT. Participants had to care for the child for at least 20 hours in a week. Participants also had to have pre-test scores that were more than or equal to 14 on the modified caregiver strain index and/or were experiencing caregiver strain, determined through in-depth interview. The current study was conducted using the one group quasi-experimental, before-after (pretest-posttest) design. The acceptance and commitment therapy (ACT) intervention was individually implemented to four participants. This design was carried out on one group by looking at the conditions before and after the acceptance and commitment therapy intervention. The intervention was preceded by a pre-test and followed by a post-test at the end of the intervention. The sampling technique is non-random or nonprobability sampling. Analyses were drawn from comparing quantitative and qualitative data from the pretest and posttest results.

Results. Quantitative results showed that ACT reduced strain scores measured by the modified caregiver strain index (MCSI). Qualitative results showed that this intervention helped participants to deal with caregiver strain better. Participants reported having more positive feelings, ability to control negative emotions, and capability to deal with unpleasant events in their lives. Participants also reported that they obtained new knowledge and skills on how to deal with strain as a caregiver of a child with ASD.

Conclusions. Based on the results, it can be concluded that acceptance and commitment therapy is effective in managing the strain of being a caregiver of ASD child. It is suggested that more studies are conducted to increase the feasibility of ACT in managing caregiver strain.

Added-values: The study well-documented the applicaiton of ACT in reducing the strain of caregiving child with ASD.

Keywords: Acceptance and Commitment Therapy, caregiver, strain, autism spectrum disorders, psychology

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