A pilot trial investigating the effectiveness of online Triple P plus acceptance and commitment therapy ( ACT ) in addressing parental stress and child behavioural difficulties in a primary care level service

Objective This study aimed to assess the effectiveness of a therapist‐led, online Level 4 Triple P + ACT behavioural management programme (intervention arm) relative to Level 4 Triple P (treatment as usual arm). The intervention comprised 2 specific ACT sessions and Triple P that aimed to provide additive effects for parents of children with behavioural difficulties in a primary care setting. Method Fifty‐five parents were randomized to receive either Level 4 Triple P + ACT or standard Triple P. Results Parents randomized to Triple P + ACT did not evidence decreases in parental stress relative to those in the standard Triple P. Both groups demonstrated reductions in terms of daily hassles. Findings favoured standard Triple P in terms of reductions in child behavioural difficulties although there was evidence of differing rates of externalizing diagnoses among the two groups. Conclusion Findings from this study suggest minimal additive benefit of adding an ACT treatment component to standard Level 4 Triple P for parents of children presenting with behavioural difficulties in a primary care setting in relation to parental stress. The research suggests that standard behavioural management programmes may provide what parents require in primary care. However, ACT components may be effective for certain cohorts of parents who struggle to flexibly adapt behavioural management strategies in helping develop the parent–child relationship. Further research is required to identify which parents may benefit from the addition of ACT treatment components.