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Kemp, Francesca Georgina (2024) Adapting Compassionate Mind Training into guided self-help for parents of autistic children. DClinPsy thesis, University of Nottingham.

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Abstract

Background: Parents of autistic children (PAC) are at increased risk of psychological distress, including parental stress, shame and self-criticism. Poor parental mental health can adversely affect parent-child interactions and their attachment relationship, in a transactional manner. There is a lack of evidence-based PAC-specific interventions focusing on reducing their psychological distress. Furthermore, PAC experience multiple barriers to accessing direct psychological interventions provided by health services. Compassion Focused Therapy (CFT) is a recommended transdiagnostic intervention for high shame and self-criticism and is potentially applicable for use as preventative guided self-help with PAC. Cross-sectional research has shown that increased PAC self-compassion is associated with increased well-being and reduced psychological distress. There is limited research around the use of CFT with PAC. No PAC-specific CFT self-help resources are available.

Study aims: To explore adaptations needed to use a CFT resource as a guided self-help intervention with PAC, and to define anticipated factors influencing successful intervention implementation during future feasibility testing.

Research questions:

• How can a CFT resource be adapted into a guided self-help intervention for PAC, whilst maintaining theoretical coherence, for further investigation during feasibility testing?

• What are stakeholder views regarding anticipated factors influencing successful implementation of the CFT resource during future feasibility testing?

Methods: Abiding by practice guidelines for intervention adaptation, five iterative phases of stakeholder feedback on an existing CFT resource for parents were facilitated, leading to subsequent intervention refinement. Phases one and two involved focus groups with PAC. Phases three and four involved seeking written commentary and a later focus group with clinical psychologists (CPs) working within children’s autism services. The fifth phase involved seeking written commentary from all participants that had opted into receiving updates about the project and CFT experts. Directed Content Analysis supported extraction of adaptation suggestions during each feedback round. A secondary Framework Analysis was later employed to all focus group data to meet the second research aim.

Results: Compassionate Mind Training for Parents of Autistic Children (CMT-PAC) guided self-help intervention was developed. Seven PAC, four CPs and one CFT expert provided feedback on CMT-PAC which led to adaptations. CFT-trained clinicians deemed the final CMT-PAC maintained theoretical coherence. Two key concepts from the Framework Analysis were recognised in all focus groups: ‘personal and social context of parents’ and ‘barriers and facilitators to engagement’. Stakeholders raised several further research questions to consider when CMT-PAC undergoes feasibility testing.

Discussion: This study is the first to adapt a CFT intervention for PAC in collaboration with multiple stakeholder groups. Stakeholders anticipated CMT-PAC will be valuable for PAC and services, and highlighted key facilitators for successful implementation, including cultivating a therapeutic relationship via modelling compassionate qualities within the text, and promoting flexible intervention engagement. Potential issues requiring further consideration were highlighted, such as whether fears of compassion may reduce engagement in self-directed practices, and queries around feasibility of imagery and body-based CMT exercises due to PAC differences associated with neurodivergence. Future research should involve studies of CMT-PAC to investigate the acceptability, feasibility and effectiveness in cultivating compassion and reducing psychological distress among PAC.

Item Type:	Thesis (University of Nottingham only) (DClinPsy)
Supervisors:	Hudson, Mark Schröder, Thomas Gale, Corinne
Keywords:	Autistic children; Parents; Psychological distress; Compassion Focused Therapy; Self-help intervention; Feasibility testing
Subjects:	W Medicine and related subjects (NLM Classification) > WM Psychiatry
Faculties/Schools:	UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID:	79786
Depositing User:	Kemp, Francesca
Date Deposited:	11 Dec 2024 04:40
Last Modified:	11 Dec 2024 04:40
URI:	https://eprints.nottingham.ac.uk/id/eprint/79786

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