Online Acceptance and Commitment Therapy and Nutrition Workshop for Parents of Children with Inflammatory Bowel Disease: Feasibility, Acceptability, and Initial Effectiveness.

Parents of children with inflammatory bowel disease (IBD) are important members of their healthcare team and influence their child's adaptation to disease. The primary aim of this research was to test the feasibility and acceptability of a three-session online parent workshop based on acceptance and commitment therapy (ACT) and address concerns about eating well and nutrition in IBD. The secondary aim was to explore the initial effectiveness of this workshop in parent reported psychological flexibility, mindfulness, experiential avoidance, cognitive fusion, valued living, and symptoms of depression, anxiety, and stress. We used a single arm pragmatic prospective study design with parents of children attending the IBD program at a tertiary pediatric healthcare centre in Canada. Mixed methods patient reported outcomes were measured at baseline, immediate post participation, and 3 months post participation in the workshop. Thirty-seven parents enrolled in the study and feasibility and acceptability goals were largely met. Parents qualitatively described changes to their parenting, what aspects of the workshop were most helpful, and targeted feedback on how to improve workshop. Findings suggest that providing parents of children with IBD a brief online ACT workshop including nutrition guidance is feasible and leads to changes in parenting behaviours.

Consent to treatment in adolescents with anorexia nervosa.

OBJECTIVE: This study examined the ability of adolescents with anorexia nervosa (AN) to make treatment decisions. METHOD: The MacArthur Competence Assessment Tool-Treatment (MacCAT-T) was used to compare the decision making abilities of 35 adolescents with AN who were receiving inpatient treatment with that of 40 healthy, community-based adolescents. Vignettes of both a medical and psychiatric illness were provided, requiring participants to work through the process of making a hypothetical treatment decision. The MacCAT-T was also administered to participants with AN to examine decision-making about their own illness, which allowed for comparison of competencies across contexts. RESULTS: Group differences were found, with the community group showing superior reasoning skills to the adolescents with AN. DISCUSSION: The results provide evidence to suggest that adolescents with AN tend toward a thinking disposition that is concrete and lacking in abstract reasoning and reflection, which may negatively affect their ability to reason about treatment options.

Adolescents with anorexia nervosa: multiple perspectives of discharge readiness.

PROBLEM: Little is known about the conditions that must be in place to help adolescent patients and their families gain the confidence needed to continue recovery at home, following the adolescents' hospitalization for anorexia nervosa. METHODS: Beliefs about discharge readiness were obtained through an open-ended questionnaire following the patients' first weekend pass home from an in-patient unit. The perceptions of patients, parents, and registered nurses were obtained using parallel versions of a questionnaire. FINDINGS: An examination of the responses revealed four themes; medical stability, education, psychological changes, and community resource planning, that were common to all respondents, as well as themes specific to adolescents and to nurses. CONCLUSIONS: The findings suggest that each group of respondents has unique discharge readiness needs and that registered nurses have an important role to play in helping patients and families make the transition home as successful as possible. Implications for nursing practice are highlighted.

A longitudinal investigation of the dynamics of mental state talk in families.

Thirty-seven mothers and fathers were observed in their homes interacting with their 2- and 4-year-old-children at Time 1 and 2 years later. Parental mental state talk to children varied as a function of children's age, the context in which talk occurred, and the gender of the parent. Four-year-old children, with an older sibling, produced and heard more cognitive talk and less desire talk than children without an older sibling. Cognitive and feeling talk by family members at Time 1 predicted change in younger children's cognitive and feeling talk (respectively) 2 years later, after controlling for initial levels of younger children's talk and general language ability. Findings are discussed in the context of theory of mind understanding and family talk about the mind.