Psychological flexibility in caregivers of children with congenital craniofacial conditions in the United Kingdom

Journal article

Objectives: Some children born with a craniofacial condition, and their caregivers, can experience psychological difficulties. Psychological flexibility involves responding to internal distressing experiences (eg, emotions) with openness rather than avoidance, being present-focused, and behaving in ways that align with personal values. Psychological flexibility is typically associated with greater psychological well-being. The current study aimed to investigate whether psychological flexibility in caregivers of a child with a congenital craniofacial condition was associated with caregiver and child psychological well-being, to inform the development of interventions likely to help caregivers. It was hypothesized that higher levels of both general and parenting-specific psychological flexibility would be associated with greater psychological well-being in both caregivers and children.

Design: A cross-sectional questionnaire study.

Setting: Questionnaires were completed online.

Participants: Caregivers (N = 89) of children aged 1-5 years with a congenital craniofacial condition.

Main outcome measure(s): Questionnaires measuring psychological flexibility, parenting-specific psychological flexibility, caregiver depression and anxiety, and caregiver-reported child well-being.

Results: Correlational and linear regression analyses revealed that higher parenting-specific psychological flexibility in caregivers was associated with—and predictive of—lower depression and anxiety in caregivers, and greater well-being in children. Higher general psychological flexibility in caregivers was associated with—and predictive of—reduced caregiver depression and anxiety and increased child well-being.

Conclusions: Early identification of caregivers of children with craniofacial conditions exhibiting difficulties with parenting-specific psychological flexibility, and the provision of psychological interventions to enhance psychological flexibility (acceptance and commitment therapy), is indicated for benefiting caregiver and child well-being.

Authors: Shepherd, L; Zucchelli, F; Aspland, R; White, P; Hotton, M

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: SAGE Publications
• Journal: Cleft Palate Craniofacial Journal
• Publication date: 2025-11-17
• DOI: 10.1177/10556656251392271
• EISSN: 1545-1569
• ISSN: 1055-6656
• Language: English
• Keywords: craniofacial; cleft; psychological flexibility; caregiver; parent; well-being