Interventions that target improvements in mental health for parents of children with autism spectrum disorders: A narrative review

Abstract

• Narrative review of mental health interventions for parents of autistic children • Some treatments reported improvements in stress, depression, and anxiety.• Post-test produced weaker effects than follow-up assessments two months and beyond.• Small sample size, homogeneity, and self-report limited generalizability of results • Outcomes encouraging, but existing data cannot yet support definitive conclusions a b s t r a c t a r t i c l e i n f o Prevalence of autism spectrum disorders (ASD) suggest that one in 68 children is affected. With convincing evidence that parenting a child with ASD is associated with elevated distress and mental health problems, researchers have begun to investigate treatments that directly target parents' psychological well-being. We conducted a narrative review of studies that empirically tested the effects of interventions targeting improvements in the mental health of parents of children with ASD. Following a range of search strategies, a total of 13 studies, seven randomized controlled trials (RCTs) and six pre-post test designs, met inclusion criteria. We calculated and reported effect sizes for all RCTs. On average, treatment produced medium to large effect sizes with improvements in parenting stress and general health, and reductions in depression and anxiety. Interventions that appeared promising included: Stress Management and Relaxation Techniques, Expressive Writing, MindfulnessBased Stress Reduction, and Acceptance and Commitment Therapy. However, only one study conducted a followup assessment N 3 months post intervention. Study populations primarily consisted of English-speaking mothers, ages 39 to 42 years. Conclusions were limited by small sample sizes, homogeneity of sample population, and reliance on self-report. Therefore, this body of research contains significant limitations in need of improvement for this field to move forward and benefit a sizable number of parents.

Acceptance or Despair? Maternal Adjustment to Having a Child Diagnosed with Autism

“…Respite care and most interventions studied so far do not appear to have consistent effects on reducing psychological stress or depression (Dababnah & Parish, 2016; Whitmore, 2016). Social support groups are natural and accessible interventions for caregivers, and can be helpful for some (Da Paz & Wallander, 2017). However, depending on types of groups, especially those not guided by a professional, there could be modeling or norms for non-acceptance and despair.…”

Effects of written disclosure on psychophysiological stress among parents of children with autism: A randomized controlled pilot study

“…However, a growing number of studies have targeted parent-focused outcomes such as maternal depression and stress management with methods ranging from mindfulness interventions and parent-clinician partnerships to relaxation training and manual-based stress reduction practices (Da Paz & Wallander, 2017). The current research joins this emerging trend by directly targeting improvement in parent outcomes, rather than relying on indirect collateral effects of child-focused treatment.…”

Psychological interventions in reducing stress, depression and anxiety among parents of children and adolescents with developmental disabilities: A systematic review and meta‐analysis

“…Studies obtained from searches conducted in the electronic databases as well as identified from the references were complied, and their citations were exported to EndNote X8 (Clarivate Analytics, 2019). Duplicate studies were removed electronically using EndNote X8.…”

“…However, the two reviews were outdated as they were conducted more than a decade ago. Da Paz and Wallander () narratively reviewed varied forms of psychological interventions on their efficacy in augmenting the mental health of parents with children living with ASD, but inconclusive evidence was found. Four reviews examined the efficacy of mindfulness‐based interventions on the mental health of parents of children with developmental disabilities (Cachia et al, ; Keenan‐Mount et al, ; Ó Donnchadha, ; Rayan & Ahmad, ).…”

“…Reviews that aim to evaluate the efficacy of psychological interventions in improving the stress, depression as well as anxiety of parents with children and adolescents with developmental disabilities are warranted as previous reviews are outdated, synthesized narratively or focused on a specific type of psychological intervention (Cachia, Anderson, & Moore, 2016;Da Paz & Wallander, 2017;Hastings & Beck, 2004;Keenan-Mount, Albrecht, & Waters, 2016;Ó Donnchadha, 2018;Rayan & Ahmad, 2018;Singer, Ethridge, & Aldana, 2007). Hastings and Beck (2004) evaluated the efficacy of stress management interventions in relieving stress faced by parents of children with learning disabilities using a narrative summary.…”