Reducing Distress in Mothers of Children With Autism and Other Disabilities: A Randomized Trial

Abstract

BACKGROUND: Compared with other parents, mothers of children with autism spectrum disorder or other neurodevelopmental disabilities experience more stress, illness, and psychiatric problems. Although the cumulative stress and disease burden of these mothers is exceptionally high, and associated with poorer outcomes in children, policies and practices primarily serve the identified child with disabilities. METHODS: A total of 243 mothers of children with disabilities were consented and randomized into either Mindfulness-Based Stress Reduction (mindfulness practice) or Positive Adult Development (positive psychology practice). Well-trained, supervised peer mentors led 6 weeks of group treatments in 1.5-hour weekly sessions, assessing mothers 6 times before, during, and up to 6 months after treatment. Mothers had children with autism (65%) or other disabilities (35%). At baseline, 85% of this community sample had significantly elevated stress, 48% were clinically depressed, and 41% had anxiety disorders. RESULTS: Using slopes-as-outcomes, mixed random effects models, both treatments led to significant reductions in stress, depression, and anxiety, and improved sleep and life satisfaction, with large effects in depression and anxiety. Mothers in Mindfulness-Based Stress Reduction versus Positive Adult Development had greater improvements in anxiety, depression, sleep, and well-being. Mothers of children with autism spectrum disorder improved less in anxiety, but did not otherwise differ from their counterparts. CONCLUSIONS: Future studies are warranted on how trained mentors and professionals can address the unmet mental health needs of mothers of children with developmental disabilities. Doing so improves maternal well-being and furthers their long-term caregiving of children with complex developmental, physical, and behavioral needs.

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

“…These included cognitive behavioral therapy (Feinberg et al, 2014;Kenney, 2010), expressive writing (Campbell, 2003;Whitney & Smith, 2014), mindfulness training (Benn, Akiva, Arel, & Roeser, 2012;Ferraioli & Harris, 2013), positive psychology strategies (LaPlante, 2013), and relaxation therapy (Gika et al, 2012). One study utilized a two-arm intervention design comparing the effects of two separate therapies (mindfulness training versus positive psychology) (Dykens, Fisher, Taylor, Lambert, & Miodrag, 2014). Four studies, employed a mixedmodel approach that combined elements from various therapies and treatment techniques.…”

“…The content also focused on the application of forgiveness and compassion in parenting practices. Also implementing MBSR, Dykens et al (2014) tested an intervention that taught parents deep breathing techniques, non-judgmental self-observation, and meditation practices. Ferraioli and Harris (2013) sought to reduce parental stress through training that centered on five core mindfulness components: (a) observing and describing events and personal responses, (b) nonjudgmental acceptance, (c) distancing self from thoughts, (d) staying present, and (e) making effective commitment to maintain mindfulness practices.…”

“…TGT charges participants to find three good things that happened during their day. Dykens et al (2014) assessed whether Positive Adult Development (PAD) would be effective where parents are taught to identify character strengths through experiential exercises involving gratitude, forgiveness, grace, and optimism. Theoretically, PP does not seek to change the person's circumstances.…”

“…The second most utilized location was the family home or a location of the parents' choosing (Campbell, 2003;Feinberg et al, 2014;Gika et al, 2012). Other intervention locations included ASD school sites (Benn et al, 2012;Bitsika & Sharpley, 2000), an ASD treatment center (Blackledge & Hayes, 2006), and convenient community locations (Dykens et al, 2014). LaPlante (2013) and Whitney and Smith (2014) were the only studies conducted online.…”

“…Rather than utilizing professionals, Dykens et al (2014) used peer-mentors, mothers of children with developmental disabilities, to lead group workshops. Three interventions were implemented using a self-administration method: Parents completed intervention activities at home using an instructional CD (Gika et al, 2012) or they received instructions and completed activities online (LaPlante, 2013;Whitney & Smith, 2014).…”