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.
Similar content being viewed by others
References
Arnett J (2000) Emerging adulthood: a theory of development from the late teens through the twenties. Am J Psychol 55(5):469–480
Reis O, Buhl H (2008) Individuation during adolescence and emerging adulthood—five German studies. Int J Behav Dev 32(5):369–371
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
Andrews G, Issakidis C, Carter G (2001) Shortfall in mental health service utilisation. Br J Psych 179:417–425
Maybery D, Reupert A, Patrick K et al (2009) Prevalence of children whose parents have a mental illness. Psych Bull 33(1):22–26
Weissman M, Wickramaratne P, Nomura Y et al (2006) Offspring of depressed parents: 20 years later. Am J Psych 163(6):1001–1008
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
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
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
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
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
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
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
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
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
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
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
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
Kazdin A (1997) Mediators and mechanisms of change in psychotherapy research. Ann Clin Psych 3(1):27
Doss B (2004) Changing the way we study change in psychotherapy. Clin Psych 11(4):368–386
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
Strauss A, Corbin C (1998) Basics of qualitative research: techniques and procedures for developing grounded theory, 2nd edn. Sage, Thousand Oaks
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
Charmaz K (2006) Constructing grounded theory: a practical guide through qualitative analysis. Sage Publications, New York
Tie YC, Birks M, Francis K (2019) Grounded theory research: a design framework for novice researchers. Open Medicine 7:1–8
Carcary M (2009) The research audit train—enhancing trustworthiness in qualitative inquiry. Electron J Bus Res Methods 7(1):11–24
Burnard P (1991) A method of analysing interview transcripts in qualitative research. Nurse Educ Today 11(6):461–466
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
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
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
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
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
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
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
Reupert A (2008) A trans-disciplinary study of the therapist’s self. Eur J Psychother Counsel 10(4):369–383
Seiffge-Krenke I (2013) “She’s leaving home …” Antecedents, consequences, and cultural patterns in the leaving home process. Emerg Adulthood 1(2):114–124
Murphy G, Peters K, Wilkes L et al (2018) Adult children of parents with mental illness: parenting journeys. BMC Psychol 6:37
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
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
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
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
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that there is no conflict of interest.
Rights and permissions
About this article
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
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00127-021-02082-0