Online Group Course for Parents With Mental Illness: Development and Pilot Study

Abstract

BackgroundChildren of parents with mental illness (COPMI) are at greater risk of developing mental disorders themselves. Since impaired parenting skills appear to be a crucial factor, we developed a facilitated 8-session preventative group course called KopOpOuders (Chin Up, Parents) delivered via the Internet to Dutch parents with psychiatric problems. The goal was to promote children’s well-being by strengthening children’s protective factors via their parents. To reach parents at an early stage of their parenting difficulties, the course is easily accessible online. The course is delivered in a secure chat room, and participation is anonymous.ObjectiveThis paper reports on (1) the design and method of this online group course and (2) the results of a pilot study that assessed parenting skills, parental sense of competence, child well-being, and course satisfaction.MethodThe pilot study had a pre/post design. Parenting skills were assessed using Laxness and Overreactivity subscales of the Parenting Scale (PS). Sense of parenting competence was measured with the Ouderlijke Opvattingen over Opvoeding (OOO) questionnaire, a Dutch scale assessing parental perceptions of parenting using the Feelings of Incompetence and Feelings of Competence subscales. Child well-being was assessed with the total problem score, Emotional Problems, and Hyperactivity subscales of the Strengths and Difficulties Questionnaire (SDQ). Paired samples t tests were performed, and Cohen’s d was used to determine effect sizes. Intention-to-treat analyses and analyses of completers only were both performed. Course satisfaction was evaluated using custom-designed questionnaires.ResultsThe sample comprised 48 parents with mental illness. The response rate was 100% (48/48) at pretest and 58% (28/48) at posttest. Significant improvements were found on PS Laxness and Overreactivity subscales (P < .01) and on the OOO Feelings of Incompetence and Competence subscales (P < .01) in analysis of completers only as well as by intention-to-treat analysis. Effects were moderate on the PS (d = .52 and d = .48) and were large and moderate on the OOO (d = 0.61 and d = 0.46). At pretest, 75% and 64% of PS scores were in the clinical range, which declined to 43% and 39% at posttest. No significant changes were found for child well-being. Scores for approximately two thirds of children were not in the clinical range at both pretest and posttest. The mean course satisfaction score was 7.8 on a 10-point scale. Of all participants, 20% (10/48) followed all the sessions.ConclusionThis online group course on parenting skills is innovative in the field of e-support and among interventions for mentally ill parents. The pilot results are promising, showing moderate to large effects for parenting skills and parental sense of competence. Test scores at baseline indicating parenting problems were largely in the clinical range, and baseline scores indicating problems among the children were in the nonclinical range, suggesting that parents were reached at an early stage. Cour...

Risk of Psychosocial Problems in Children Whose Parents Receive Outpatient Substance Abuse Treatment

“…However, lower SDQ scores were observed in our study than in previous studies concerning Dutch children from at-risk populations (Kaptein, Jansen, Vogels, & Reijneveld, 2008;van der Zanden, Speetjens, Arntz, & Onrust, 2010;van Santvoort, Hosman, van Doesum, & Janssens, 2014;Wansink, Janssens, Hoencamp, Middelkoop, & Hosman, 2015). Furthermore, studies that used the SDQ to address psychosocial problems in CSAP showed comparable (Dawe & Harnett, 2007;Comiskey, Milness, & Daly, 2017) or somewhat lower (Gruenert et al, 2006;Redelinghuys & Dar, 2008) mean scores than those reported in children of parents with predominantly nonsubstance-related mental disorders (van Santvoort et al, 2013;van der Zanden et al, 2010;Wansink et al, 2015). Still, the SDQ scores in the present study were the lowest.…”

“…In line with the literature (Hosman et al, 2009), our sample showed higher SDQ scores than Dutch children from general populations (Bot, de Leeuw den Bouter, & Adriaanse, 2011;Crone et al, 2008;Mieloo et al, 2012;Muris et al, 2003;van Widenfelt et al, 2003;Vogels, Crone, Hoekstra, & Reijneveld, 2009). However, lower SDQ scores were observed in our study than in previous studies concerning Dutch children from at-risk populations (Kaptein, Jansen, Vogels, & Reijneveld, 2008;van der Zanden, Speetjens, Arntz, & Onrust, 2010;van Santvoort, Hosman, van Doesum, & Janssens, 2014;Wansink, Janssens, Hoencamp, Middelkoop, & Hosman, 2015). Furthermore, studies that used the SDQ to address psychosocial problems in CSAP showed comparable (Dawe & Harnett, 2007;Comiskey, Milness, & Daly, 2017) or somewhat lower (Gruenert et al, 2006;Redelinghuys & Dar, 2008) mean scores than those reported in children of parents with predominantly nonsubstance-related mental disorders (van Santvoort et al, 2013;van der Zanden et al, 2010;Wansink et al, 2015).…”

“…For example, some studies included children who participated in support groups (van Santvoort et al, 2014;van der Zanden et al, 2010) or whose families received additional parenting support (Dawe & Harnett, 2007;Wansink et al, 2015). Perhaps these children were receiving support because they had already shown signs of problem behavior.…”

“…However, as far as we know, differences in parent-reported SDQ scores between substance-abusing parents and parents with other mental disorders have not been addressed in earlier research. The available Dutch studies on the SDQ in at-risk populations were mainly conducted among children whose parents suffered from non-substance-related disorders such as depression and anxiety and only included a small proportion of CSAP (van Santvoort et al, 2014;van der Zanden et al, 2010;Wansink et al, 2015).…”

Needs, expectations and consequences for children growing up in a family where the parent has a mental illness

“…Different types of intervention to address the issue of parental mental illness have been proposed including: support groups for children (van Santvoort et al 2013); a parent-focused approach (Solantaus 2006); online courses for parents with mental illness (van der Zanden et al 2010), and psycho-education interventions (Lucksted, et al 2012). A lot of programs use peer support groups for improving resilience of children of parents with mental illness (Forster et al 2014;Gladstone et al (2014); Goodyear et al 2009;Hargreaves et al 2008;Pitman & Matthey 2004).…”