Skip to main content

Advertisement

Log in

An online intervention for vulnerable young adults: identifying mechanisms of change using a grounded theory approach

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study is to qualitatively identify the mechanisms of change as young adults, whose parents have a mental illness and/or substance use issue, navigate their way through a 6-week, moderated online intervention.

Methods

Using a qualitative, grounded theory approach, data were collected and triangulated for analysis from participants before, during, and after engaging in the intervention. First, 31 young people’s motivations for enrolling in the intervention were identified from one open ended question on an online survey. Second, online chat sessions were analysed to identify those topics the 31 participants engaged in throughout the intervention. Finally, 19 interviews were conducted 2 weeks post-intervention, to ascertain participants’ perceptions of the impacts of the intervention and how the intervention promoted changes.

Results

The main storyline was that of participants “making sense” of their parents, themselves and other relationships, in collaboration with peers, in a safe online space. This storyline of “making sense” drove their motivation to join the intervention and was the focus of the online chats. After the intervention, some were closer to having “made sense” of their families while others struggled differentiating themselves away from their families. An anonymous, professionally moderated online site afforded participants opportunities to think about who they were and for some, who they wanted to be.

Conclusion

Generating an explanatory theory of how vulnerable young people navigate their way through an online intervention provides important information that can be used to inform future services, interventions, and research.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Arnett J (2000) Emerging adulthood: a theory of development from the late teens through the twenties. Am J Psychol 55(5):469–480

    Article  CAS  Google Scholar 

  2. Reis O, Buhl H (2008) Individuation during adolescence and emerging adulthood—five German studies. Int J Behav Dev 32(5):369–371

    Article  Google Scholar 

  3. Adams S, Knopf D, Park M (2014) Prevalence and treatment of mental health and substance use problems in the early emerging adult years in the United States: findings from the 2010 national survey on drug use and health. Emerg Adulthood 2(3):163–172

    Article  Google Scholar 

  4. Andrews G, Issakidis C, Carter G (2001) Shortfall in mental health service utilisation. Br J Psych 179:417–425

    Article  CAS  Google Scholar 

  5. Maybery D, Reupert A, Patrick K et al (2009) Prevalence of children whose parents have a mental illness. Psych Bull 33(1):22–26

    Article  Google Scholar 

  6. Weissman M, Wickramaratne P, Nomura Y et al (2006) Offspring of depressed parents: 20 years later. Am J Psych 163(6):1001–1008

    Article  Google Scholar 

  7. Wong M, Puttler L, Nigg J et al (2018) Sleep and behavioral control in earlier life predicted resilience in young adulthood: a prospective study of children of alcoholics and controls. Add Behav 82:65–71

    Article  Google Scholar 

  8. Jones TM, Hill KG, Epstein M et al (2016) Understanding the interplay of individual and social-developmental factors in the progression of substance use and mental health from childhood to adulthood. Dev Psychopathol 28(3):721–741

    Article  Google Scholar 

  9. Reupert A, Maybery D (2016) What do we know about families where a parent has a mental illness: a systematic review. Child Youth Serv 37(2):98–111

    Article  Google Scholar 

  10. Abraham K, Stein C (2012) Emerging adults’ perspectives on their relationships with mothers with mental illness: implications for caregiving. Am J Orthod 82(4):542–549

    Google Scholar 

  11. Bountress K, Haller M, Chassin L (2013) The indirect effects of parent psychopathology on offspring affective disorder through difficulty during the leaving home transition. Emerg Adulthood 1(3):196–206

    Article  Google Scholar 

  12. Foster K (2010) ‘You’d think this roller coaster was never going to stop’: experiences of adult children of parents with serious mental illness. J Clin Nurs 19(21–22):3143–3151

    Article  Google Scholar 

  13. Blake-Holmes K (2019) Young adult carers: making choices and managing relationships with a parent with a mental illness. Adv Ment Health. https://doi.org/10.1080/18387357.2019.1636691

    Article  Google Scholar 

  14. Reupert A, Cuff R, Drost L et al (2012) Intervention programs for children whose parents have a mental illness: a review. Med J Aust 199(3 Suppl):S18-22

    Google Scholar 

  15. Reupert A, Maybery D, Bartholomew C et al (2020) The acceptability and effectiveness of an online intervention for youth with parents with a mental illness and/or substance use issue. J Adolesc Health 66(5):551–558

    Article  Google Scholar 

  16. Wetterlin F, Mar M, Neilson E et al (2014) eMental health experiences and expectations: a survey of youths’ web-based resource preferences in Canada. J Med Internet Res 16(12):e293

    Article  Google Scholar 

  17. van Doesum K, Riebshleger J, Carroll J et al (2016) Successful recruitment strategies for prevention programs targeting children of parents with mental health challenges: an international study. Child Youth Serv 37(2):156–174

    Article  Google Scholar 

  18. Matar J, Maybery D, McLean L et al (2018) Web-based health intervention for young people who have a parent with a mental illness: Delphi study among potential future users. J Med Internet Res 20(1):e10158

    Article  Google Scholar 

  19. Kazdin A (1997) Mediators and mechanisms of change in psychotherapy research. Ann Clin Psych 3(1):27

    Google Scholar 

  20. Doss B (2004) Changing the way we study change in psychotherapy. Clin Psych 11(4):368–386

    Google Scholar 

  21. Reupert A, Bartholomew C, Cuff R et al (2019) An online intervention to promote mental health and wellbeing for young adults whose parents have mental illness and/or substance use problems: theoretical basis and intervention description. Front Psych 2019(10):59

    Article  Google Scholar 

  22. Strauss A, Corbin C (1998) Basics of qualitative research: techniques and procedures for developing grounded theory, 2nd edn. Sage, Thousand Oaks

    Google Scholar 

  23. Sbaraini A, Carter S, Evans R, Blinkhorn A (2011) How to do a grounded theory study: a worked example of a study of dental practices. BMC Med Res Methodol 11:128

    Article  Google Scholar 

  24. Charmaz K (2006) Constructing grounded theory: a practical guide through qualitative analysis. Sage Publications, New York

    Google Scholar 

  25. Tie YC, Birks M, Francis K (2019) Grounded theory research: a design framework for novice researchers. Open Medicine 7:1–8

    Google Scholar 

  26. Carcary M (2009) The research audit train—enhancing trustworthiness in qualitative inquiry. Electron J Bus Res Methods 7(1):11–24

    Google Scholar 

  27. Burnard P (1991) A method of analysing interview transcripts in qualitative research. Nurse Educ Today 11(6):461–466

    Article  CAS  Google Scholar 

  28. Birks M, Mills J, Francis K et al (2009) A thousand words paint a picture: the use of storyline in grounded theory research. J Res Nurs 14(5):405–417

    Article  Google Scholar 

  29. Abraham K, Stein C (2015) Stress-related personal growth among emerging adults whose mothers have been diagnosed with mental illness. Psych Rehabil J 38(3):227–233

    Article  Google Scholar 

  30. Patrick P, Reupert A, McLean L (2019) “We are more than our parents’ mental illness”: narratives from adult children. Int J Environ Res Public Health 16:839

    Article  Google Scholar 

  31. Oppenheimer C, Hankin B (2011) Relationship quality and depressive symptoms among adolescents: a short-term multiwave investigation of longitudinal, reciprocal associations. J Clin Child Adol Psych 40:486–493

    Article  Google Scholar 

  32. Klodnick V, Sabella K, Brenner C et al (2015) Perspectives of young emerging adults with serious mental health conditions on vocational peer mentors. J Emot Behv Disord 23(4):226–237

    Article  Google Scholar 

  33. Czyz EK, Liu Z, King CA (2012) Social connectedness and one-year trajectories among suicidal adolescents following psychiatric hospitalization. J Clin Child Adolesc Psychol 41(2):214–226

    Article  Google Scholar 

  34. Naslund JA, Grande SW, Aschbrenner KA et al (2014) Naturally occurring peer support through social media: the experiences of individuals with severe mental illness using YouTube. PLoS ONE 9(10):e110171

    Article  Google Scholar 

  35. Reupert A (2008) A trans-disciplinary study of the therapist’s self. Eur J Psychother Counsel 10(4):369–383

    Article  Google Scholar 

  36. Seiffge-Krenke I (2013) “She’s leaving home …” Antecedents, consequences, and cultural patterns in the leaving home process. Emerg Adulthood 1(2):114–124

    Article  Google Scholar 

  37. Murphy G, Peters K, Wilkes L et al (2018) Adult children of parents with mental illness: parenting journeys. BMC Psychol 6:37

    Article  Google Scholar 

  38. Cowan B (2019) Working with families of emerging adults: the interface of clinical and legal issues. Evidence-Based Pract Child Adol Mental Health 4(2):105–112

    Article  Google Scholar 

  39. Maher C, Lewis L, Ferrar K et al (2014) Are health behavior change interventions that use online social media networks effective? A systematic review. J Med Internet Res 14 16(2):e40

    Article  Google Scholar 

  40. Ellis LA, Collin P, Hurley PJ et al (2013) Young men’s attitudes and behaviour in relation to mental health and technology: implications for the development of online mental health services. BMC Psych 13:119

    Article  Google Scholar 

  41. van Santvoort F, Hosman C, Janssens J et al (2015) The impact of various parental mental disorders on children’s diagnoses: a systematic review. Clin Child Family Psych Rev 18(4):281–299

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andrea Reupert.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Reupert, A., Maybery, D., Bartholomew, C. et al. An online intervention for vulnerable young adults: identifying mechanisms of change using a grounded theory approach. Soc Psychiatry Psychiatr Epidemiol 57, 293–303 (2022). https://doi.org/10.1007/s00127-021-02082-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-021-02082-0

Keywords

Navigation