Brief Mental Health Treatment For Parents of Children with Pediatric Feeding Disorder - PROJECT SUMMARY Parent mental health (MH) problems are an unaddressed barrier to effective treatment of pediatric feeding disorder (PFD). PFD affects up to one-third of young children and is characterized by severely restricted volume or variety of food intake. Many children do not respond to our most effective treatments, and addressing barriers to effective treatment is critical to improving our ability to treat PFD. Without effective treatment, PFD can lead to malnutrition and high healthcare utilization. Up to 40% of parents of children with PFD experience mental health (MH) problems such as depression, anxiety, and parenting stress, which is far greater than rates in parents of healthy children. Parent MH problems are associated with suboptimal child feeding practices and poor adherence to treatment recommendations. Positive, non-coercive, parent-child mealtime interactions are paramount to effective treatment of PFD. However, parent MH problems contribute to increased stress at meals and parents often report having “battles” with their children over eating, rather than engaging in recommended strategies. Despite the well-known impact of parent MH problems on effective PFD treatment, it is extremely rare that parent MH is addressed in PFD care. No MH treatments have been tested with parents of children with PFD, and there are no universal PFD standards of care to encourage or guide parent MH treatment implementation. Without identifying an effective and efficient (i.e., brief) MH treatment for parents of children with PFD, our most effective PFD treatments will continue to fail many children. Focused Acceptance and Commitment Therapy (FACT) is ideal to address this gap, as it can be effective in just 1-2 sessions. In a recent study of FACT with parents of children with neurodevelopmental disorders, parent depression and anxiety improved in 2-sessions, and demonstrated downstream improvements in child behavior. The developers of FACT propose this treatment effect likely occurs through psychological flexibility, which is associated with adaptive parenting behaviors (e.g., positive reinforcement, limit setting). However, the association between parent psychological flexibility and parent-child mealtime interactions remains untested. The objective of this K23 study is to assess the efficacy of a 2-session FACT intervention for parents of children with PFD. We hypothesize that FACT-PFD will be effective in reducing parent MH problems, improving parent psychological flexibility, and improving parent-child mealtime interactions. The proposed training will focus on clinical trial conduct and analysis, observational behavioral coding, and implementation science. Results of this project have the potential to identify an effective parent MH treatment and to launch the independent career of a highly promising junior scientist.
