Study of Acceptance and Commitment Therapy for Parents in the NICU.

OBJECTIVES

This study evaluated the feasibility and proof of concept of a structured 4-week acceptance and commitment therapy (ACT) protocol for parents of infants admitted to a Level III neonatal intensive care unit (NICU). This investigation emphasized successful protocol implementation, treatment adherence, and preliminary individual-level clinical outcomes.

METHODS

Participants included volunteer, English-speaking parents aged > 18 years, whose infants were < 35 weeks gestational age and admitted to the NICU with an anticipated stay > 28 days. Senior psychiatric residents delivered the ACT protocol in 4-weekly sessions addressing: (1) values versus goals, (2) avoidance behaviors, (3) acceptance, present-moment awareness, and observing self, and (4) values and committed action. Pre- and post-intervention assessments measured acceptance and action, parental bonding, confidence, post-traumatic stress disorder (PTSD), resiliency, and depression. Feasibility was evaluated through treatment adherence and the proportion of participants demonstrating clinically meaningful change on validated measures.

RESULTS

Of 24 enrolled parents, 20 (83%) completed all four sessions, demonstrating strong treatment adherence. Post-intervention, parents demonstrated significant improvements in acceptance and action, parental bonding, and confidence. A borderline significant reduction in PTSD symptoms was observed, while measures of resiliency and depression showed no change. Clinically meaningful individual-level change was observed across multiple outcomes.

CONCLUSIONS

This proof-of-concept study demonstrates the feasibility of delivering a structured ACT protocol at the NICU bedside and provides preliminary individual-level evidence of clinical benefit for parents. Further research with larger samples is needed to confirm these findings and explore long-term outcomes.