A non randomized mentalization intervention for parents of children with autism

Abstract

Parents of children diagnosed with autism spectrum disorder (ASD) report higher levels of stress and other negative affective states than parents of typically developing children. One important resource in managing these heightened levels of negative affect is emotion regulation, which in turn depends upon the ability to recognize and understand one's own and others' mental states (referred to as mentalization or reflective functioning). In this study, parents of children with ASD either participated in a mentalization‐based group intervention (N = 36) or a delayed treatment (N = 28). Compared to delayed treatment participants, parents in the mentalization‐based group had increases in reflective functioning and in the belief that emotions can change. Moreover, they reported decreased behavioral and emotional symptoms in their children, and greater parental self‐efficacy. These preliminary findings support previous studies, which have shown that mentalization‐based interventions for parents lead to positive outcomes, and suggest that these findings may apply to a diverse population of parents such as those of children with broader autism phenotype or children with different neurological disorders. Further studies to evaluate the effects of the intervention are recommended. Autism Res 2019, 12: 1077–1086. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary In this study, parents of children with ASD participated in a group intervention designed to increase their awareness of mental states (their own and their children's) and to enhance their emotion regulation. Compared to delayed treatment parents, those in the intervention group showed increased awareness of developmental states, and reported increased belief that emotions can change and decreased levels of behavioral and emotional symptoms in their children.

Mentalization-based treatments with children and families: A systematic review of the literature

“…Byrne and colleagues (2019) reported that parents showed no significant improvement in parental mentalizing capacity following completion of the 20-session Lighthouse programme. In contrast, Enav and colleagues (2019) found that the intervention group demonstrated a significant improvement in RF at treatment end ( p = .0002). This was the only study that focused on parents of children with neurodevelopmental delays.…”

“…Adkins and colleagues (2018) noted a significant interaction effect on three of the five subscales of the Parenting Stress Index (Abidin, 1995) with moderate effect sizes noted. Enav et al (2019) reported no difference in parents’ emotional regulation capacity following treatment, however, parents’ sense of self-efficacy showed a significant improvement with small effect sizes noted ( d = .37). Midgley et al (2019b) reported significant reductions in total parenting stress ( d = .56) but non-significant improvement in parental self-efficacy.…”

“…Byrne et al (2019) also used the PDI in the Lighthouse Study for families where children were at risk of maltreatment. Enav et al, (2019) also used the PDI for parents of children with autism. Bammens et al (2015) and Adkins et al (2018) assessed parental RF using the five minute speech sample (FMSS; Magaña-Amato, 1983) coded for RF using the RF scale (Fonagy et al, 1998) in their respective analysis of the Family Minds programme for foster and adoptive parents.…”

Contextual determinants of parental reflective functioning: Children with autism versus their typically developing siblings

“…In future studies, it will be important to assess the association between variation in PRF and child-level outcomes in both ASD and typically developing children. Given that reflective functioning has been found to improve with intervention (Enav et al, 2019), it will be interesting to see whether a parental intervention to improve reflective functioning would be successful to support the typically developing siblings’ emotional adjustment.…”

“…The current study was a part of a 4-week, non-randomized controlled intervention designed for parents of children with ASD (Enav et al, 2019).…”