Skip to main content
SpringerLink
Log in
Book cover

Child and Adolescent Resilience Within Medical Contexts pp 193–207Cite as

Acceptance and Commitment Therapy (ACT) to Foster Resilience in Pediatric Chronic Illness

  • Chapter
  • First Online:

Abstract

Children with chronic illness face numerous stressors related to their condition such as coping with illness-related procedures, managing tremendous illness burden, dealing with aversive physical symptoms, and attempting to minimize the impact of their illness on their quality of life. Despite these challenges, children with chronic illnesses and their families demonstrate resilience in that the majority are able to demonstrate relatively typical levels of emotional and behavioral functioning. Psychological flexibility is a psychological construct that reflects many of the factors associated with resilience and positive coping, such as active engagement in the stressors, emotion regulation, and maintenance of developmentally expected activities. Acceptance and Commitment Therapy (ACT) has been shown to promote psychological flexibility in chronic illness populations. This chapter highlights the overlap between psychological flexibility and resilience, and identifies the application of Acceptance and Commitment Therapy to promoting those factors thought to be critical for resilience. Relevant literature is reviewed, and case vignettes are used to highlight key clinical features of ACT.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   89.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Ayllon, T., & Azrin, N. (1968). Reinforcer sampling: A technique for increasing the behavior of mental patients. Journal of Applied Behavior Analysis, 1(1), 13–20.

    Article  PubMed  PubMed Central  Google Scholar 

  • Azrin, N., & Foxx, R. (1971). A rapid method of toilet training the institutionalized retarded. Journal of Applied Behavior Analysis, 4(2), 89–99.

    Article  PubMed  PubMed Central  Google Scholar 

  • Burke, K., Muscara, F., McCarthy, M., Dimovski, A., Hearps, S., Anderson, V., & Walser, R. (2014). Adapting acceptance and commitment therapy for parents of children with life-threatening Illness: Pilot study. Families Systems & Health, 32(1), 122–127. doi:10.1037/Fsh0000012.

    Google Scholar 

  • Casier, A., Goubert, L., Gebhardt, W. A., Baets, F. D., Aken, S. V., Matthys, D., & Crombez, G. (2013). Acceptance, well-being and goals in adolescents with chronic illness: A daily process analysis. Psychology & Health, 28(11), 1337–1351. doi:10.1080/08870446.2013.809083.

    Google Scholar 

  • Clark, C. (2016). Imaginal coping: Resilience through a play of tropes. In C. DeMichelis & M. Ferrari (Eds.), Child and adolescent resilience within medical contexts: Integrating research and practice. New York, NY: Springer.

    Google Scholar 

  • Coatsworth, J. D., Duncan, L. G., Greenberg, M. T., & Nix, R. L. (2010). Changing parent’s mindfulness, child management skills and relationship quality with their youth: Results from a randomized pilot intervention trial. Journal of Child and Family Studies, 19(2), 203–217. doi:10.1007/s10826-009-9304-8.

    Article  PubMed  Google Scholar 

  • Compas, B. E., Jaser, S. S., Dunn, M. J., & Rodriguez, E. M. (2012). Coping with chronic Illness in childhood and adolescence. Annual Review of Clinical Psychology, 8, 455–480. doi:10.1146/annurev-clinpsy-032511-143108.

    Article  PubMed  Google Scholar 

  • Coyne, L. W., McHugh, L., & Martinez, E. R. (2011). Acceptance and commitment therapy (ACT): Advances and applications with children, adolescents, and families. Child and Adolescent Psychiatric Clinics of North America, 20(2), 379–399. doi:10.1016/j.chc.2011.01.010.

    Article  PubMed  Google Scholar 

  • Cullen, C. (2008). Acceptance and commitment therapy (ACT): A third wave behaviour therapy. Behavioural and Cognitive Psychotherapy, 36, 667–673.

    Article  Google Scholar 

  • Duncan, L. G., Coatsworth, J. D., & Greenberg, M. T. (2009). A model of mindful parenting: Implications for parent-child relationships and prevention research. Clinical Child and Family Psychology Review, 12(3), 255–270. doi:10.1007/s10567-009-0046-3.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ernst, M. M., Johnson, M. C., & Stark, L. J. (2010). Developmental and psychosocial issues in cystic fibrosis. Child and Adolescent Psychiatric Clinics of North America, 19(2), 263–283. doi:10.1016/j.chc.2010.01.004.

    Article  PubMed  PubMed Central  Google Scholar 

  • Goldstein, R. D. (2016). Resilience in the care of children with palliative care needs. In C. DeMichelis & M. Ferrari (Eds.), Child and adolescent resilience within medical contexts: Integrating research and practice. New York, NY: Springer.

    Google Scholar 

  • Greco, L. A., Heffner, M., Poe, S., Ritchie, S., Polak, M., & Lynch, S. K. (2005). Maternal adjustment following preterm birth: Contributions of experiential avoidance. Behavior Therapy, 36(2), 177–184. doi:10.1016/S0005-7894(05)80066-8.

    Article  Google Scholar 

  • Greco, L. A., Lambert, W., & Baer, R. A. (2008). Psychological inflexibility in childhood and adolescence: Development and evaluation of the avoidance and fusion questionnaire for youth. Psychological Assessment, 20(2), 93–102. doi:10.1037/1040-3590.20.2.93.

    Article  PubMed  Google Scholar 

  • Gregg, J. A., Callaghan, G. M., Hayes, S. C., & Glenn-Lawson, J. L. (2007). Improving diabetes self-management through acceptance, mindfulness, and values: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 75(2), 336–343.

    Article  PubMed  Google Scholar 

  • Hawkes, A. L., Chambers, S. K., Pakenham, K. I., Patrao, T. A., Baade, P. D., Lynch, B. M., … Courneya, K. S. (2013). Effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes in survivors of colorectal cancer: A randomized controlled trial. Journal of Clinical Oncology, 31(18), 2313–2321. doi:10.1200/Jco.2012.45.5873.

    Google Scholar 

  • Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35, 639–665.

    Article  Google Scholar 

  • Hayes, S. C., Barnes-Holmes, D., & Roche, B. (Eds.). (2001). Relational frame theory: A post-Skinnerian account of human language and cognition. New York, NY: Plenum Press.

    Google Scholar 

  • Hayes, S. C., & Strosahl, K. D. (2004). A practical guide to acceptance and commitment therapy. New York, NY: Springer.

    Book  Google Scholar 

  • Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York, NY: Guilford.

    Google Scholar 

  • Hayes, S. C., Villatte, M., Levin, M., & Hildebrandt, M. (2011). Open, aware, and active: Contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annual Review of Clinical Psychology, 7, 141–168. doi:10.1146/annurev-clinpsy-032210-104449.

    Article  PubMed  Google Scholar 

  • Herrman, H., Stewart, D. E., Diaz-Granados, N., Berger, E. L., Jackson, B., & Yuen, T. (2011). What is resilience? Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie, 56(5), 258–265.

    PubMed  Google Scholar 

  • Hilliard, M. E., Harris, M. A., & Weissberg-Benchell, J. (2012). Diabetes resilience: A model of risk and protection in type 1 diabetes. Current Diabetes Reports, 12(6), 739–748. doi:10.1007/s11892-012-0314-3.

    Article  PubMed  Google Scholar 

  • Hoehn, J., Foxen-Craft, E., Pinder, W., & Dahlquist, L. M. (2016). The role of parents in promoting children’s adjustment to chronic illness. In C. DeMichelis & M. Ferrari (Eds.), Child and adolescent resilience within medical contexts: Integrating research and practice. New York, NY: Springer.

    Google Scholar 

  • Hysing, M., Elgen, I., Gillberg, C., & Lundervold, A. J. (2009). Emotional and behavioural problems in subgroups of children with chronic illness: Results from a large-scale population study. Child: Care, Health and Development, 35(4), 527–533. doi:10.1111/j.1365-2214.2009.00967.x.

    Google Scholar 

  • Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30(7), 865–878. doi:10.1016/j.cpr.2010.03.001.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lundgren, T., Dahl, J., Yardi, N., & Melin, L. (2008). Acceptance and commitment therapy and yoga for drug-refractory epilepsy: A randomized controlled trial. Epilepsy & Behavior, 13(1), 102–108. doi:10.1016/j.yebeh.2008.02.009.

    Article  Google Scholar 

  • Luyckx, K., Goossens, E., Van Damme, C., Moons, P., & i-DETACH investigators. (2011). Identity formation in adolescents with congenital cardiac disease: A forgotten issue in the transition to adulthood. Cardiology in the Young, 21(4), 411–420. doi:10.1017/S1047951111000187.

    Article  PubMed  Google Scholar 

  • Luyckx, K., Rassart, J., Aujoulat, I., Goubert, L., & Weets, I. (2014). Self-esteem and illness self-concept in emerging adults with Type 1 diabetes: Long-term associations with problem areas in diabetes. Journal of Health Psychology. doi:10.1177/1359105314531467.

    Google Scholar 

  • Masten, A. S. (2011). Resilience in children threatened by extreme adversity: Frameworks for research, practice, and translational synergy. Development and Psychopathology, 23(2), 493–506. doi:10.1017/S0954579411000198.

    Article  PubMed  Google Scholar 

  • Masuda, A., Cohen, L. L., Wicksell, R. K., Kemani, M. K., & Johnson, A. (2011). A case study: Acceptance and commitment therapy for pediatric sickle cell disease. Journal of Pediatric Psychology, 36(4), 398–408. doi:10.1093/jpepsy/jsq118.

    Article  PubMed  Google Scholar 

  • McCracken, L. M., & Vowles, K. E. (2014). Acceptance and commitment therapy and mindfulness for chronic pain: Model, process, and progress. The American Psychologist, 69(2), 178–187. doi:10.1037/a0035623.

    Article  PubMed  Google Scholar 

  • Moon, J. R., Huh, J., Kang, I. S., Park, S. W., Jun, T. G., & Lee, H. J. (2009). Factors influencing depression in adolescents with congenital heart disease. Heart & Lung, 38(5), 419–426. doi:10.1016/j.hrtlng.2008.11.005.

    Article  Google Scholar 

  • Pai, A. L., Greenley, R. N., Lewandowski, A., Drotar, D., Youngstrom, E., & Peterson, C. C. (2007). A meta-analytic review of the influence of pediatric cancer on parent and family functioning. Journal of Family Psychology, 21(3), 407–415. doi:10.1037/0893-3200.21.3.407.

    Article  PubMed  Google Scholar 

  • Ruiz, F. J. (2012). Acceptance and commitment therapy versus traditional cognitive behavioral therapy: A systematic review and meta-analysis of current empirical evidence. International Journal of Psychology & Psychological Therapy, 12, 333–357.

    Google Scholar 

  • Rutter, M. (2013). Annual research review: Resilience—Clinical implications. Journal of Child Psychology and Psychiatry, 54(4), 474–487. doi:10.1111/j.1469-7610.2012.02615.x.

    Article  PubMed  Google Scholar 

  • Sapienza, J. K., & Masten, A. S. (2011). Understanding and promoting resilience in children and youth. Current Opinion in Psychiatry, 24(4), 267–273. doi:10.1097/Yco.0b013e32834776a8.

    Article  PubMed  Google Scholar 

  • Sawicki, G. S., Sellers, D. E., & Robinson, W. M. (2009). High treatment burden in adults with cystic fibrosis: Challenges to disease self-management. Journal of Cystic Fibrosis, 8(2), 91–96. doi:10.1016/j.jcf.2008.09.007.

    Article  PubMed  Google Scholar 

  • Stewart, D. E., & Yuen, T. (2011). A systematic review of resilience in the physically ill. Psychosomatics, 52(3), 199–209.

    Article  PubMed  Google Scholar 

  • Van Cleave, J., Gortmaker, S. L., & Perrin, J. M. (2010). Dynamics of obesity and chronic health conditions among children and youth. JAMA, 303(7), 623–630. doi:10.1001/jama.2010.104.

    Article  PubMed  Google Scholar 

  • Wetherell, J. L., Afari, N., Rutledge, T., Sorrell, J. T., Stoddard, J. A., Petkus, A. J., … Atkinson, J. H. (2011). A randomized, controlled trial of acceptance and commitment therapy and cognitive-behavioral therapy for chronic pain. Pain, 152(9), 2098–2107. doi:10.1016/j.pain.2011.05.016.

    Google Scholar 

  • Whittingham, K., Wee, D., Sanders, M. R., & Boyd, R. (2013). Predictors of psychological adjustment, experienced parenting burden and chronic sorrow symptoms in parents of children with cerebral palsy. Child: Care, Health and Development, 39(3), 366–373. doi:10.1111/j.1365-2214.2012.01396.x.

    Google Scholar 

  • Wicksell, R. K., Melin, L., Lekander, M., & Olsson, G. L. (2009). Evaluating the effectiveness of exposure and acceptance strategies to improve functioning and quality of life in longstanding pediatric pain—A randomized controlled trial. Pain, 141(3), 248–257. doi:10.1016/j.pain.2008.11.006.

    Article  PubMed  Google Scholar 

  • Zolkoski, S. M., & Bullock, L. M. (2012). Resilience in children and youth: A review. Children and Youth Services Review, 34(12), 2295–2303. doi:10.1016/j.childyouth.2012.08.009.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Michelle M. Ernst Ph.D. & Michael W. Mellon Ph.D., A.B.P.P.

Authors
  1. Michelle M. Ernst Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael W. Mellon Ph.D., A.B.P.P.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michelle M. Ernst Ph.D. .

Editor information

Editors and Affiliations

  1. Department of Applied Psychology and Human Development Joint Center for Bioethics, University of Toronto, Toronto, Ontario, Canada

    Carey DeMichelis

  2. Department of Applied Psychology and Human Development, University of Toronto, OISE, Toronto, Ontario, Canada

    Michel Ferrari

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Ernst, M.M., Mellon, M.W. (2016). Acceptance and Commitment Therapy (ACT) to Foster Resilience in Pediatric Chronic Illness. In: DeMichelis, C., Ferrari, M. (eds) Child and Adolescent Resilience Within Medical Contexts. Springer, Cham. https://doi.org/10.1007/978-3-319-32223-0_11

Download citation

Publish with us

Policies and ethics

Search

Navigation