The Problem
Researchers have defined a disability as any mental, physical, or emotional deficiency that causes impairment in functioning to the typical standard. For decades, it has been recognized by many researchers that having a child with a disability, whether mental, physical, or both, increases stress experienced by the family (Abrams & Kaslow, 1977). Parents of children suffering from disabilities report “lower satisfaction with their parental role, lower self-efficacy, higher levels of depression, lower marital satisfaction, and higher rates of divorce” (as cited in Shechtman & Gilat, 2005).
The turning point in these families’ lives is when they first hear that their child has a disability. The child may be diagnosed inutero, as an infant, or their disability may reveal itself slowly as they age. Regardless of when this information is revealed to the parents, it can have a significant effect on their family dynamics. Fantasies of cheering for a son whose playing baseball, or watching a daughter walk across her high graduation stage as valedictorian are shattered (Ziolko, 1991). The discrepancy between their child’s real self and their expectation become hard to bear.
The amount a family is being affected can be judged by “sleep disturbances the child’s disability might cause the parents; physical burdens related to dressing, lifting, feeding, and so on that an illness or disability might create for the parents; complicated diets which require extra time; extra housekeeping which might be necessary; financial stress and strain; adaptations that may be needed in housing and furnishings; and the unpredictability of the disease or disability” (as cited in Ziolko, 1991). The greater these areas of the lives of the family members are affected, the greater amount of stress and burden that the family experiences. Sometimes the burden placed on the family member will escalate into occasional outbursts of anger towards the child, thus promoting a painful cycle of resentment, guilt, overprotection, and permissiveness (Abrams & Kaslow, 1977).
As mothers are more likely to be responsible for day-to-day care taking, most studies have focused their research in the past on the effect that a child’s disability has on mothers’ stress levels and coping strategies. Mothers whose children possess “higher levels of behavior problems and low levels of functional skills seem to be more at risk” (Knussen & Sloper, 1992). Margalit, Raviv, and Ankonina (1992) concluded that the great discrepancies in how mothers and fathers rate their family dynamics demonstrate low degrees of agreements regarding personal coherence, family opportunities for personal growth, and avoidant coping. Mothers are more likely to experience health problems (Shechtman & Gilat, 2005). Many fathers view their child’s disability as a representation of their masculinity and struggle with directly participating in activities with their child (Ziolko, 1991). Frequently, fathers view their child’s disability as less laborious and sometimes deny the majority of the problem (Shechtman & Gilat, 2005).
Siblings commonly suffer from a lack of routine due to the unpredictability of the child’s disability. Siblings of the disabled child often have feelings of anger and resentment for the amount of parental attention that the child’s disability consumes. Macks and Reeve (2007) found that siblings of children suffering from autism were “much more likely to have positive view of their behavior, intelligence, scholastic performance, and anxiety than siblings of non-disabled children,” but that demographic characteristics were more likely to effect them. Collectively, all family members of disabled children are inevitably affected by their special needs. Research has shown that these family members are negatively influenced by their situation and that only through adjustment and coping strategies can they learn to confront and manage their difficulties.
Counseling Therapy
Research interventions support counseling therapy (Conn-Blowers, 1990). The goal of family intervention via counseling therapy is to create a supportive and confidential environment for families of disabled children to seek guidance and to diminish the increased stress caused by the child’s disability by learning applicable coping behaviors. The therapy should serve the emotional and mental needs of the family members by providing sound counsel. For these intervention therapies to be effective, professionals must learn how to specifically assist families coping with disability-related stressors (Bailey & Smith, 2000). Conn-Blowers (1990) says that “counselors are challenged to assist disabled clients and their families to recognize their strengths and limitations while continuing to view themselves as valued and valuable members of society.” Professionals need to become more aware that all interventions for the child affect the family and visa versa. A correlation has been identified between the psychological well-being of a family and the emotional, mental, and physical health of a disabled child (Abrams & Kaslow, 1977).
Research suggests that there are three major, formal approaches that have produced positive results for family members of children with special needs: individual counseling, family counseling, and group counseling (Abrams & Kaslow, 1977). These therapy options are used to accomplish the same goals; however, they each offer different perspectives to aiding families. These approaches are designed to be used either independently or collectively. Involvement in counseling therapy can restore hope, reframe negative issues, promote self-forgiveness, facilitate awareness, reconnect family members, and empower individuals (Hulnick & Hulnick, 1989; Morison, 2003).
Individual Counseling
Individual counseling tailors therapy specifically to each family member based on the child’s disabilities, as well as their individual needs. During the sessions, several methods of treatment could be used. Often the counselor will encourage techniques of reflecting, self-disclosing, positive reinforcement, role modeling, and problem solving (Kriegsman & Celotta, 1981). If the individual is a sibling of the disabled child, play therapy, narrative therapy, or relaxation training may be applicable (Curle, Bradford, Thompson, & Cawthron, 2005). Individual counseling offers the family member more privacy and specialized attention. Because they are the only subject in the session a more in depth exploration and analysis can take place. In family counseling, the counselor must divide the alloted time between every family member and the family as a whole, thus resulting in less in depth personal counseling.
Family Counseling
Family group therapy also uses the same model of intervention; however, it focuses more on how the group performs together rather than as individuals. During sessions, the counselor may try to assess and mend relationships and improve communication on the whole rather than develop a counseling model for each attending member (Abrams & Kaslow, 1977). Involving any mixture of relatives to the child, family members are able to discuss and evaluate difficulties as a unit and gain a sense of joint problem solving (Abrams & Kaslow, 1977). Because family members are present, there is less distortion in stories and facts, therefore, the counselor can evaluate the family dynamics more accurately.
Group Counseling
The final therapy option is group counseling or support groups. This type of therapy often meets in a location other than a psychologist’s office. The group is made up of several family members of different disabled children and attendants are invited to share emotions, reactions, and concerns with fellow group members who are experiencing similar situations (Ziolko, 1991). Abrams and Kaslow (1977) found that “group meetings offer a respite, a time when parents do not have to hide concerns or pretend that all is well if it isn’t.” Through group therapy interventions, isolation and withdrawal can be reduced as members discover that they are not alone and begin to gain knowledge about their child’s disabilities and new coping strategies (Shechtman & Gilat, 2005). Many of these support groups can be specific to a certain disorder, which can be helpful for gaining information, but lacking in addressing familial matters such a marital distress. It is important that in large groups members are still able to develop deep insight through personal awareness. Families of Abbott and Meredith’s (1986) research testified that “participation in a parents’ support group or other social services were additional helpful resources.” Individual, family group, and group therapies are all successful interventions for family members struggling with the increased stress of having a child with special needs.
Resources
- Abbott, D. A. & Meredith, W. H. (1986). Strengths of parents with retarded children. Family Relations, 35(3), 371-375.
- Abrams, J. C. & Kaslow, F. (1977). Family systems and the learning disabled child: Intervention and treatment. Journal of Learning Disabilities, 10(2), 27-31.
- Bailey, A. B. & Smith, S. W. (2000). Providing effective coping strategies and supports for families with children with disabilities. Intervention in School and Clinic, 35(5), 294-297.
- Conn-Blowers, E. A. (1990). Counsellor roles in support networks for the families of disabled children. Guidance & Counseling, 6(2).
- Curle, C., Bradford, J., Thompson, J., & Cawthron, P. (2005). Users' guide of a group therapy intervention for chronically ill of disabled children and their parents: Towards a meaningful assessment of therapeutic effectiveness. Clinical Child Psychology and Psychiatry, 10(4), 509-527.
- Hulnick, M. R. & Hulnick, H. R. (1989). Life's Challenges: Curse of opportunity? Counseling families of persons with disabilities. Journal of Counseling and Development, 68(2), 166-171.
- Knussen, C. & Sloper, P. (1992). Stress in families of children with disability: A review of risk and resistance factors. Journal of Mental Health, 1(3), 241-256.
- Kreigsman, K. H. & Celotta, B. (1981). A program of group counseling for women with physical disabilities. Journal of Rehabilitation, 47(3).
- Macks, R. J. & Reeve, R. E. (2007). The adjustment of non-disabled siblings of children with autism. Journal of Autism and Developmental Disorders, 37(6), 1060-1067.
- Margalit, M., Raviv, A., & Ankonina, D. B. (1992). Coping and coherence among parents with disabled children. Journal of Clinical Child Psychology, 21(3), 202-209.
- Morison, J. E., Bromfield, L. M., & Cameron, H. J. (2003). A therapeutic model for supporting families of children with a chronic illness of disability. Child and Adolescent Mental Health, 8(3), 125-130.
- Shechtman, Z. & Gilat, I. (2005). The effectiveness of counseling groups in reducing stress of parents with children with learning disabilities. Group Dynamics: Theory, Research, and Practice, 9(4), 275-286.
- Ziolko, M. (1991). Counseling parents of children with disabilities: A review of the literature and implications for practice. Journal of Rehabilitation, 57(2), 29-34.
