• By Laura Whybra
  • Posted on Thursday 06th March, 2014

Growing up with a mentally ill parent: can support groups help?

strong>Children of mentally ill or addicted parents are vulnerable to a range of psychological, social and cognitive problems. Attending a support group can help these children to reduce their negative thoughts and improve their social skills, a new study claims.Children growing up with a mentally ill parent are at least twice as likely as their peers to develop a psychiatric illness – and in some cases their risk may be as much as 13 times higher than children of mentally healthy parents. These children are also more likely to struggle in school, experience difficulties socially, run into trouble with adult work environments and relationships, and develop certain physical illnesses.And it’s a relatively common situation, with up to a quarter of children in some developed nations living with a mentally ill or addicted parent. While some of the problems may be partly hereditary, stressful family situations – and the feelings of shame, loneliness, and helplessness that often result – play a major role.To address this issue, many countries, including Australia, Germany, and the United Kingdom, have introduced support groups for children of parents with a mental health and/or substance abuse disorder. In collaboration with mental health services, these support groups aim to increase children’s social support, reduce their negative thoughts, and improve how they interact with their parents.How effective are they? Recent research in the Netherlands found that up to three months following attendance at a support group, children reported having less negative thoughts compared to children who did not attend a support group. They also reported a feeling of having more social support: they were more likely to communicate their problems with others and engage in recreational activities with family and friends. The Dutch studyThe study was conducted by researchers from the Netherlands, a country where almost all mental health centers offer preventive interventions for the children of their clients. It’s an approach that is “unique in the world,” the authors say. The research targeted children between the ages of 8 and 12. Twenty mental health centers across the Netherlands participated. The team recruited 254 Dutch children, all of whom had a parent who had been diagnosed with a mental illness or substance abuse disorder. Children were randomly assigned to a preventive support group or to a waitlist. Support groups ran for a period of eight weeks, with a session of 90 minutes each week. In these sessions, children used role-play and games to achieve emotional and behavioral goals. Each session was overseen by a mental health professional. Parents were also invited to meet with a therapist and to have a family talk. Three months after the program, a “booster session” was held to catch up with the children and remind them about what they had learned.Almost a third of children in the support groups experienced clinically meaningful improvements in emotional and behavioral problems, compared to less than 20% of the children in the control group. Children in the experimental group also reported larger improvements in social support and negative thoughts.These findings are promising and encourage the use of preventive support groups to improve certain social and cognitive outcomes for children with a mentally ill parent. Complex needs, complex solutionsHowever, the variety of emotional and behavioral issues experienced by children with a parent who has been diagnosed with a mental health condition is complex. Support groups can’t address every problem experienced by every child. Indeed, in this study, the majority of children in both the control and intervention groups experienced no meaningful change in the severity of their emotional and behavioral problems. Similarly, support groups may not be able to improve every outcome. In this study, for instance, parent-child relationships did not improve more for children in the support groups than for those in the wait-list group. Some goals may be too complex to address in a support group setting alone, the authors said; other types of intervention may also be required.Retaining children and families in the program is also a challenge. Here, about 20% of the children dropped out between the pre-test and post-test questionnaires. Levels of parent involvement were lower still, with almost half the parents missing either the parent meeting or the family talk or both. The longer-term benefits of support groups remain unknown. This study examined the impact of support groups on children only up to six months after the program. Do the positive effects of support groups remain a year after the first session, or into adolescence or adulthood? Finally, this research only looked at the children of parents who were receiving treatment at a mental health center. Many children live with a parent who is mentally ill, but relatively few parents seek help for their illness. It is essential that alternative approaches are used to reach this “silent” at-risk group of children.***************Reference:Van Santvoort, F., Hosman, C.M., Doesum, K.T., & Janssens, J.M. (2013). Effectiveness of preventive support groups for children of mentally ill or addicted parents: a randomized controlled trial. European Child and Adolescent Psychiatry, DOI 10.1007/s00787-013-0476-9.

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