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.