Acceptance and Commitment Therapy for left-behind older parents with adult children emigrated overseas

Author : Young Kimwan

Abstract : Background: There were approximately 304 million international migrants globally in 2024, representing about 3.7% of the world's population. There is increasing concern about the impact of adult children's emigration on the mental health of their left-behind older parents worldwide. Specifically, the mental health of left-behind older parents has been found to be worse, including higher levels of psychological distress, anxiety, and depression, than that of older adults living with their children. Research Gap: There is growing evidence supporting the efficacy of Acceptance and Commitment Therapy (ACT) for older adults managing separation, grief, and anxiety, but no study has yet evaluated the effectiveness of ACT specifically for left-behind older parents worldwide. Research Objective: This study aimed to evaluate the feasibility and efficacy of an ACT group for grief and anxiety in left-behind older parents in Hong Kong. Research Design: Using a quasi-experimental design, left-behind older parents with and without clinical anxiety received the same 8-session ACT group in addition to treatment-as-usual (TAU), such as interest classes and leisure activities, while the control group received TAU only. Feasibility of the ACT group was assessed by uptake rate, dropout rate, and adherence rate. To investigate the effectiveness of the ACT group, a research assistant conducted outcome assessments before and after intervention using standardised assessment tools, including the Chinese Depression Anxiety Stress Scale. The ethical aspects of this study were reviewed and approved by the research committee of a local university in Hong Kong. Research Results: The ACT group reported an uptake rate of 100%, a dropout rate of 5.6%, and a mean adherence rate of 78.63%. The findings also showed that the ACT group for left-behind older adults with clinical anxiety, compared with the control group and the group without clinical anxiety, demonstrated significantly greater improvement in anxiety. Conclusion: This study supports the feasibility and effectiveness of the ACT group for left-behind older parents with clinical anxiety in reducing anxiety and stress. No previous study has been conducted in this area. Future randomised controlled trials with larger sample sizes and long-term follow-up in diverse cultural and clinical backgrounds are needed to further validate the efficacy of ACT for left-behind older parents in different cultures and societies.

Keywords : Acceptance and commitment therapy, Anxiety, Left-behind older parents, Adult child emigrated abroad.

Conference Name : International Conference on Cognitive Behavioral Therapy and Mental Health (ICCBTMT-26)

Conference Place : Singapore, Singapore

Conference Date : 3rd Jul 2026