Programmes teaching “mindfulness” and “positive psychology” helped mothers of children with autism to reduce their stress and depression, according to new study.
Most services for such families focus on the disabled child, researchers say, but improving the mental health of parents is likely to make them better caregivers and that, in turn, could improve their child’s development.
“There are literally decades of studies that have described the high levels of stress and distress, anxiety and depressive symptoms that mums and dads of children with developmental disabilities suffer, and I didn’t want to describe anymore, I wanted to do something about it,” says Elizabeth Dykens, who led the new study.
“So this is really for parents – it was for their mental health and well-being, for their own adult development,” says Dykens, an associate director of the Vanderbilt Kennedy Center for Research on Human Development in Nashville, Tennessee.
“And I think that’s what really sets it apart from the traditional interventions that are much more child oriented,” she says.
Past research has found that cognitive behavioural therapies, such as Mindfulness Based Stress Reduction and so-called positive psychology, are effective at reducing symptoms of stress, anxiety and even depression, Dykens and her colleagues write in the journal Pediatrics.
Those two approaches have also been shown to lend themselves to group programmes and to being delivered by non-professionals who have undergone the therapy themselves and been thoroughly trained to help peers, the authors add.
For their study, Dykens and her colleagues enrolled 243 mothers of children with autism or other neurodevelopmental disabilities and randomly assigned them to groups that would receive either the mindfulness training or a positive psychology program called Positive Adult Development (PAD).
“Mindfulness basically helps people focus on the present moment in a non-judgmental way, and it does that through deep belly breathing, gentle movements like yoga orqigong and meditation,” Dykens says.
She says the PAD group was more focused on thoughts, including practicing gratitude and forgiveness and defining one’s own strengths. “Things that would counteract the anger or disappointment or feelings of guilt or sadness families often experience as they try to deal with the kids’ challenging behaviour and also work with the systems that are involved in providing care,” she says.
Four peer mentors, who were themselves mothers of children with developmental disabilities, had gone through the therapies and been trained to lead the groups under the supervision of a social worker. Both programmes consisted of hour-and-a-half weekly sessions for six weeks. Psychological questionnaires were used to assess the participating mothers a total of six times before, during and up to six months after treatment.
At the start, about 85% of the participating mothers had significantly elevated levels of stress, 48% were clinically depressed and 41% had anxiety disorders.
By the end of six weeks, both groups showed significant reductions in stress, depression and anxiety levels, with sharp drops starting after just two weeks. In addition, both groups reported improved sleep and life satisfaction.
Mothers in the mindfulness group had greater improvements in anxiety, depression, sleep and well-being and stronger responses in the categories of anxiety and depression, compared to the women in the positive psychology programme during that time.
The researchers speculate that may be because of the immediacy of physical relaxation promoted by the mindfulness approach. But over the longer follow-up period, mothers in the positive psychology group reported greater reductions in depression and improvements in life satisfaction compared to the mindfulness group, the researchers note.
They acknowledge the study had some limitations because it compared two active interventions without using a comparison group that got no treatment. But, the study team writes, “untreated mothers of offspring with disabilities do not necessarily become less depressed over time.” If anything, research shows they experience more health and mental health problems with age, the authors say.