Mental health challenges and resilience among mothers with intellectual and developmental disabilities

The effectiveness of dialectical behavior group therapy on stress, depression, and cognitive emotion regulation in mothers of intellectually disabled students: A randomized clinical trial

INTRODUCTION

This study aimed to evaluate the effectiveness of dialectical behavior group therapy (DBGT) regarding stress, depression, and cognitive emotion regulation in mothers of intellectually disabled students.

MATERIAL AND METHODS

This was an experimental study with a pretest-posttest design and a control group. The statistical population included 133 mothers with intellectually disabled children divided into wait-list control and experimental groups. Then, DBGT was performed on the treatment subjects. Data collection tools included the Emotion Regulation Questionnaire, Beck Depression Inventory-II, Depression-Anxiety-Stress Scale, Clinical Global Improvement Scale, Client Satisfaction Questionnaire, and Working Alliance Inventory-Short Form. A p-value less than 0.05 was considered statistically significant.

RESULTS

A significant difference in depression, stress, and cognitive emotion regulation was observed between the intervention and control groups (p < 0.001). In the post-test, the adjusted mean of depression and stress in the intervention group showed a significant decrease compared to the control group mothers. Also, cognitive reappraisal, expressive suppression, and total cognitive emotion regulation scores increased following DBGT. Participants in DBGT had a good therapeutic relationship, were satisfied with the treatment, and showed notable improvements.

CONCLUSION

The results indicated that DBGT might affect stress, depression, and cognitive emotion regulation in mothers of intellectually disabled students.

Barriers and requirements for parenting supports and mental health care among mothers with intellectual disabilities: Health and social service-provider perspectives

BACKGROUND

Mothers with intellectual disability (ID) experience high rates of mental illness, but these needs are not adequately addressed.

AIMS

We examined health and social service-provider perceptions of barriers to parenting and mental health care among mothers with ID and strategies for building good practice capacity.

METHODS AND PROCEDURES

In this qualitative study in Ontario, Canada, we interviewed 13 service-providers working with mothers with ID about their experiences supporting parenting and mental health in mothers with ID, including barriers to services and strategies for building good practice capacity. Data were analyzed via inductive, semantic-level thematic analysis.

OUTCOMES AND RESULTS

Perceived barriers to care provision were the vulnerable social context of women with ID, distrust of "the system" by women with ID, and siloed services. Increased training of service-providers, making accommodations in existing services, and building a community of support for women with ID were offered as strategies for good practice capacity.

CONCLUSIONS AND IMPLICATIONS

Efforts to improve mental health among mothers with ID should focus on improving service-provider capacity and accommodations in existing services, and enhancing coordination of care. WHAT THIS PAPER ADDS?: Mothers with intellectual disability (ID) experience high rates of mental illness, but supports for mothers with ID typically focus on parenting skills, and women's mental health care services do not consider the unique needs of those with ID. Health and social service-providers have reported inadequate training, fragmented services, high caseloads, and lack of practical supports as barriers to providing quality care to mothers with ID. However, no studies have examined service-providers' perceptions of needs related specifically to parenting and mental health among mothers with ID. This study provides new information on barriers to parenting and mental health care among mothers with ID and strategies for good practice capacity, from the perspectives of service-providers. Perceived barriers to care provision include social determinants of health, a distrust of "the system" by women with ID, and siloed services. Providers recommended that providing better training, including accommodations in existing services, and building a community of support could be beneficial to improving practice capacity in the context of mental health care and parenting supports. These factors need to be addressed to improve mental health among mothers with ID.

Responding to the Unique Complexities of Fetal Alcohol Spectrum Disorder

Fetal alcohol spectrum disorder (FASD) is a multifaceted disability, characterized not only by brain- and body-based challenges, but also high rates of environmental adversity, lifelong difficulties with daily living, and distinct sociocultural considerations. FASD is one of the most common neurodevelopmental disabilities in the Western world and associated with significant social and economic costs. It is important to understand the complexities of FASD and the ways in which FASD requires unique consideration in research, practice, and policy. In this article, we discuss our perspectives on factors that distinguish FASD from other disabilities in terms of complexity, co-occurrence, and magnitude. We provide an overview of select literature related to FASD as a socially rooted disability with intergenerational impacts and multiple layers of stigma. These social issues are intertwined with notable experiences of adversity across the lifespan and high rates of co-occurring health concerns for individuals with FASD, all of which present unique challenges for individuals, caregivers, families, service providers, and policy makers. Understanding these factors is the first step in developing and implementing specialized initiatives in support of positive outcomes for individuals with FASD and their families. Future directions are proposed for advancing research, practice, and policy, and responding to the unique complexities of FASD.