Abstract
Objectives
Parenting children with mental health problems poses multiple challenges, including coping with difficult behavior and negative child emotions. The impact on parents includes financial strain, negative social stigma, and negative feelings of guilt or blame, resulting in significant stress and lower levels of well-being. Given findings that self-compassion plays a significant role in reducing stress and improving well-being, the current study examined the role of self-compassion in the experience of parents raising a child with mental health problems. The study tested (1) whether child behavioral/emotional problem severity is associated with higher parental stress and lower parental well-being; (2) whether self-compassion is associated with lower parental stress and higher parental well-being; and (3) whether self-compassion is a stronger predictor of parental stress and well-being than child behavioral/emotional problem severity.
Methods
Three hundred and six mothers and two hundred and fifty-six fathers of children attending a hospital child and adolescent psychiatric center were assessed at admission. Consenting parents completed four questionnaires: child strength and difficulty, parent version; self-compassion; parent feeling inventory; and well-being.
Results
Child behavioral/emotional problem severity was associated with higher parental stress and lower parental well-being, and self-compassion was a stronger predictor of parental stress and well-being levels than child behavioral/emotional problem severity. For children with internalizing but not externalizing behavioral/emotional problems, parental self-compassion was the only predictor of parental well-being beyond the severity of child behavioral/emotional problems.
Conclusions
Cultivating self-compassion is important in reducing parental stress and increasing parental well-being, particularly with internalizing presentations, and should be considered when designing therapeutic interventions for parents.
Similar content being viewed by others
Data Availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
References
Angold, A., Messer, S. C., Stangl, D., Farmer, E. M., Costello, E. J., & Burns, B. J. (1998). Perceived parental burden and service use for child and adolescent psychiatric disorders. American Journal of Public Health, 88(1), 75–80. https://doi.org/10.2105/AJPH.88.1.75
Athay, M. M. (2012). Satisfaction with Life Scale (SWLS) in caregivers of clinically-referred youth: Psychometric properties and mediation analysis. Administration and Policy in Mental Health and Mental Health Services Research, 39(1–2), 41–50. https://doi.org/10.1007/s10488-011-0390-8
Barroso, N. E., Mendez, L., Graziano, P. A., & Bagner, D. M. (2018). Parenting stress through the lens of different clinical groups: A systematic review and meta-analysis. Journal of Abnormal Child Psychology, 46(3), 449–461. https://doi.org/10.1007/s10802-017-0313-6
Becker, A., Wang, B., Kunze, B., Otto, C., Schlack, R., Hölling, H., ... & BELLA study group, T. (2018). Normative data of the self-report version of the German strengths and difficulties questionnaire in an epidemiological setting. Zeitschrift für Kinder-und Jugendpsychiatrie und Psychotherapie, 46(6), 523-533. https://doi.org/10.1024/1422-4917/a000589
Belfer, M. L. (2008). Child and adolescent mental disorders: The magnitude of the problem across the globe. Journal of Child Psychology and Psychiatry, 49(3), 226–236. https://doi.org/10.1111/j.1469-7610.2007.01855.x
Bögels, S. M., Lehtonen, A., & Restifo, K. (2010). Mindful parenting in mental health care. Mindfulness, 1(2), 107–120. https://doi.org/10.1007/s12671-010-0014-5
Bohadana, G., Morrissey, S., & Paynter, J. (2019). Self-compassion: A novel predictor of stress and quality of life in parents of children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 49(10), 4039–4052. https://doi.org/10.1007/s10803-019-04121-x
Bradley, E. G., Hurwitz, S. D., Harvey, E. A., Hodgson, S., & Perugini, E. M. (2013). Factor analytic structure and validity of the parental feelings inventory: A brief report. Journal of Child and Family Studies, 22(6), 801–806.
Buchner, A., Faul, F., & Erdfelder, E. (1998). A priori, post-hoc, and compromise power analyses for MS-DOS (German Version). http://www.psycho.uni-duesseldorf.de/ aap/projects/gpower
Collishaw, S. (2015). Annual research review: Secular trends in child and adolescent mental health. Journal of Child Psychology and Psychiatry, 56, 370–393. https://doi.org/10.1111/jcpp.12372
Crowe, M., Inder, M., Joyce, P., Luty, S., Moor, S., & Carter, J. (2011). Was it something I did wrong? A qualitative analysis of parental perspectives of their child’s bipolar disorder. Journal of Psychiatric and Mental Health Nursing, 18(4), 342–348. https://doi.org/10.1111/j.1365-2850.2010.01673.x
Deater-Deckard, K. (1998). Parenting stress and child adjustment: Some old hypotheses and new questions. Clinical Psychology: Science and Practice, 5(3), 314–332. https://doi.org/10.1111/j.1469-7610.2012.02582.x
Dubois-Comtois, K., Moss, E., Cyr, C., & Pascuzzo, K. (2013). Behavior problems in middle childhood: The predictive role of maternal distress, child attachment, and mother-child interactions. Journal of Abnormal Child Psychology, 41, 1311–1324. https://doi.org/10.1007/s10802-013-9764-6
Early, T. J., Gregoire, T. K., & McDonald, T. P. (2002). Child functioning and caregiver well-being in families of children with emotional disorders: A longitudinal analysis. Journal of Family Issues, 23, 374–391. https://doi.org/10.1177/0192513X02023003003
Eaton, K., Ohan, J. L., Stritzke, W., & Corrigan, P. W. (2016). Failing to meet the good parent ideal: Self-stigma in parents of children with mental health disorders. Journal of Child and Family Studies, 25, 3109–3123. https://doi.org/10.1007/s10826-016-0459-9
Ekas, N., & Whitman, T. L. (2010). Autism symptom topography and maternal socioemotional functioning. American Journal on Intellectual and Developmental Disabilities, 115(3), 234–249. https://doi.org/10.1352/1944-7558-115.3.234
Gerkensmeyer, J., Perkins, S. M., Day, J., Austin, J. K., Scott, E. L., & Wu, J. (2011). Maternal depressive symptoms when caring for a child with mental health problems. Journal of Child and Family Studies, 20, 685–695. https://doi.org/10.1007/s10826-011-9445-4
Gilbert, P. (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53, 6–41. https://doi.org/10.1111/bjc.12043
Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: A pilot study of a group therapy approach. Clinical Psychology and Psychotherapy, 13, 353–379. https://doi.org/10.1002/cpp.507
Goldstein, H. (2003). Multilevel statistical models (3rd ed). Edward Arnold
Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581–586. https://doi.org/10.1111/j.1469-7610.1997.tb01545.x
Gouveia, M. J., Carona, C., Canavarro, M. C., & Moreira, H. (2016). Self-compassion and dispositional mindfulness are associated with parenting styles and parenting stress: The mediating role of mindful parenting. Mindfulness, 7(3), 700–712. https://doi.org/10.1007/s12671-016-0507-y
Hasson-Ohayona, I., Tuval-Mashiacha, R., Morag-Yaffe, M., Gaziel, M., Schapir, L., Zalsman, G., & Shoval, G. (2014). Parents of adolescents with psychiatric disorders: Insight into the disorder, self-stigma, and parental stress. Comprehensive Psychiatry, 55, 1106–1110. https://doi.org/10.1016/j.comppsych.2010.04.008
He, J. P., Burstein, M., Schmitz, A., & Merikangas, K. R. (2013). The Strengths and Difficulties Questionnaire (SDQ): The factor structure and scale validation in U.S. adolescents. Journal of Abnormal Child Psychology, 41, 583–595. https://doi.org/10.1007/s10802-012-9696-6
Hinshaw, S. P. (2007). The mark of shame: Stigma of mental illness and an agenda for change. Oxford University Press
Hinshaw, S. P., & Stier, A. (2008). Stigma as related to mental disorders. Annual Review of Clinical Psychology, 4, 367–393. https://doi.org/10.1146/ANNUREV.CLINPSY.4.022007.141245
International Wellbeing Group. (2006). Personal wellbeing index (4th ed.). Deakin University.
Jefferson, F. A., Shires, A., & McAloon, J. (2020). Parenting self-compassion: A systematic review and meta-analysis. Mindfulness, 11(9), 2067–2088. https://doi.org/10.1007/s12671-020-01401-x
Koskelainen, M., Sourander, A., & Kaljonen, A. (2000). The Strengths and Difficulties Questionnaire among Finnish school-aged children and adolescents. European Child & Adolescent Psychiatry, 9, 277–284. https://doi.org/10.1007/s007870070031
Lecavalier, L., Leone, S., & Wiltz, J. (2006). The impact of behaviour problems on caregiver stress in young people with autism spectrum disorders. Journal of Intellectual Disability Research, 50, 172–183. https://doi.org/10.1111/j.1365-2788.2005.00732.x
Lindgren, E., Söderberg, S., & Skär, L. (2016). Being a parent to a young adult with mental illness in transition to adulthood. Issues in Mental Health Nursing, 37(2), 98–105. https://doi.org/10.3109/01612840.2015.1092621
Mak, W. W. S., & Cheung, R. Y. M. (2012). Psychological distress and subjective burden of caregivers of people with mental illness: The role of affiliate stigma and face concern. Community Mental Health Journal, 48, 270–274. https://doi.org/10.1007/s10597-011-9422-9
McDonald, T. P., Gregoire, T. K., Poertner, J., & Early, T. J. (1997). Building a model of family caregiving for children with emotional disorders. Journal of Emotional and Behavioral Disorders, 5, 138–148. https://doi.org/10.1177/106342669700500302
Moreira, H., Carona, C., Silva, N., Nunes, J., & Canavarro, M. C. (2015a). Exploring the link between maternal attachment-related anxiety and avoidance and mindful parenting: The mediating role of self-compassion. Theory, Research and Practice. Advance online publication. https://doi.org/10.1111/papt.12082
Moreira, H., Gouveia, M. J., Carona, C., Silva, N., & Canavarro, M. C. (2015b). Maternal attachment and children’s quality of life: The mediating role of self-compassion and parenting stress. Journal of Child and Family Studies, 24, 2332–2344. https://doi.org/10.1007/s10826-014-0036-z
Moses, T. (2010). Being treated differently: Stigma experiences with family, peers, and school staff among adolescents with mental health disorders. Social Science & Medicine, 70(7), 985–993. https://doi.org/10.1111/j.1741-3729.2010.00589.x
Muris, P. (2016). A protective factor against mental health problems in youths? A critical note on the assessment of self-compassion. Journal of Child and Family Studies, 25(5), 1461–1465. https://doi.org/10.1007/s10826-015-0315-3
Neece, C. L., Green, S. A., & Baker, B. L. (2012). Parenting stress and child behavior problems: A transactional relationship across time. American Journal on Intellectual and Developmental Disabilities, 117(1), 48–66. https://doi.org/10.1352/1944-7558-117.1.48
Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250. https://doi.org/10.1080/15298860309027
Neff, K. D. (2009). Self-compassion. In M. R. Leary & R. H. Hoyle (Eds.), Handbook of individual differences in social behavior (pp. 561–573). Guilford Press
Neff, K. D. (2012). The science of self-compassion. In C. Germer & R. Siegel (Eds.), Compassion and wisdom in psychotherapy (pp. 79– 92). Guilford Press
Neff, K. D., & Beretvas, S. (2013). The role of self-compassion in romantic relationships. Self and Identity, 12(1), 78–98. https://doi.org/10.1080/15298868.2011.639548
Neff, K. D., & Faso, D. J. (2015). Self-compassion and well-being in parents of children with autism. Mindfulness, 6(4), 938–947. https://doi.org/10.1007/s12671-014-0359-2
Neff, K. D., Rude, S. S., & Kirkpatrick, K. (2007). An examination of self-compassion in relation to positive psychological functioning and personality traits. Journal of Research in Personality, 41, 908–916. https://doi.org/10.1016/j.jrp.2006.08.002
Niclasen, J., Teasdale, T. W., Andersen, A.-M.N., Skovgaard, A. M., Elberling, H., & Obel, C. (2012). Psychometric properties of the Danish strength and difficulties questionnaire: The SDQ assessed for more than 70, 000 raters in four different cohorts. PLoS ONE, 7, e32025. https://doi.org/10.1371/journal.pone.0032025
Oruche, U. M., Gerkensmeyer, J., Stephan, L., Wheeler, C. A., & Hanna, K. M. (2012). The described experience of primary caregivers of children with mental health needs. Archives of Psychiatric Nursing, 26(5), 382–391. https://doi.org/10.1016/j.apnu.2011.12.006
Podsakoff, P. M., MacKenzie, S. B., Lee, J. Y., & Podsakoff, N. P. (2003). Common method biases in behavioral research: A critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879–903.
Polanczyk, G., Salum, G., Sugaya, L. S., Caye, A., & Rohde, L. A. (2015). Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry, 56, 345–365. https://doi.org/10.1111/jcpp.12381
Rodriguez, C. M. (2011). Association between independent reports of maternal parenting stress and children’s Internalizing symptomatology. Journal of Child and Family Studies, 20, 631–639. https://doi.org/10.1007/s10826-010-9438-8
Rodríguez-Meirinhos, A., Antolín-Suárez, L., & Oliva, A. (2018). Support needs of families of adolescents with mental illness: A systematic mixed studies review. Archives of Psychiatric Nursing, 32(1), 152–163. https://doi.org/10.1016/j.apnu.2017.09.004
Sirois, F. M., Bögels, S., & Emerson, L. M. (2019). Self-compassion improves parental well-being in response to challenging parenting events. The Journal of Psychology, 153(3), 327–341. https://doi.org/10.1080/00223980.2018.1523123
Smith, A. M., & Grzywacz, J. G. (2014). Health and well-being in midlife parents of children with special health needs. Families, Systems, & Health, 32(3), 303. https://doi.org/10.1037/fsh0000049
Sumiati, N. T. (2018). The influence of self-compassion and coping strategies to subjective well-being of parents with intellectual disabled children. Atlantis Press, 153, 106–110. https://doi.org/10.2991/icddims-17.2018.22
Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Pearson Education
Van der Sanden, R., Bos, A., Stutterheim, S., Pryor, J., & Kok, G. (2013). Experiences of stigma by association among family members of people with mental illness. Rehabilitation Psychology, 58, 73–80. https://doi.org/10.1037/a0031752
Vaughan, E., Feinn, R., Bernard, S., Brereton, M., & Kaufman, J. S. (2013). Relationships between child emotional and behavioral symptoms and caregiver strain and parenting stress. Journal of Family Issues, 34, 534–556. https://doi.org/10.1177/0192513X12440949
Vohra, R., Madhavan, S., Sambamoorthi, U., & Peter, C. S. (2014). Access to services, quality of care, and family impact for children with autism, other developmental disabilities, and other mental health conditions. Autism, 18, 815–826. https://doi.org/10.1177/1362361313512902
Westerlund, A., Ivarsson, A., & Richter‐Sundberg, L. (2020). Evidence‐based practice in child and adolescent mental health services: The challenge of implementing national guidelines for treatment of depression and anxiety. Scandinavian Journal of Caring Scienceshttps://doi.org/10.1111/scs.12859
Yarnell, L. M., & Neff, K. D. (2013). Self-compassion, interpersonal conflict resolutions, and well-being. Self and Identity, 12, 146–159. https://doi.org/10.1080/15298868.2011.649545
Author information
Authors and Affiliations
Contributions
VS designed and executed the study, assisted with the data analyses, and wrote the paper. NW designed and executed the study, assisted with the data analyses, and wrote the paper. UY directed execution of the research onsite, including data collection. All authors approved the final version of the manuscript for submission.
Corresponding author
Ethics declarations
Ethics Approval
This research was approved by the Ethics Committee of Ziv Medical Center in Israel. Informed consent was obtained from all individual participants included in the study. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.
Conflict of Interest
The authors declare no competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Shenaar-Golan, V., Wald, N. & Yatzkar, U. Parenting a Child with Mental Health Problems: the Role of Self-Compassion. Mindfulness 12, 2810–2819 (2021). https://doi.org/10.1007/s12671-021-01744-z
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12671-021-01744-z