Effectiveness of parent training in improving stress-coping capability, anxiety, and depression in mothers raising children with autism spectrum disorder

Abstract

Purpose

Raising a child with autism spectrum disorder (ASD) can be a stressor, and mothers of ASD children often present with high levels of stress and depression. Interventional steps to enhance parental coping skills and resiliency are more important for parental mental health and the family-centered care of children with ASD than merely reducing parental stress. Although the importance of stress-coping skills is well established, only a few studies have investigated interventional steps to improve parental coping or resiliency. Parent training (PT) is known to improve a mother’s mental health. Here, we aimed to assess the effectiveness of PT in improving the stress-coping style of mothers raising children with ASD.

Patients and methods

Thirty mothers of children with ASD aged 4–11 years participated in this study. The mothers underwent PT based on the Hizen Parenting Skills Training in Japan, which comprised seven sessions. Each session included education on behavior therapy, individual consultation, and workshops in small groups. Sixteen mothers completed psychological assessment, including the Stress Coping Inventory, the Beck Depression Inventory Second Edition, the State–Trait Anxiety Inventory, and the Child Behavior Checklist conducted before and after 2 months of PT.

Results

The outcomes before and after the PT program were compared using the paired t-test and Pearson’s correlation. After the PT program, the mothers’ stress-coping strategy “positive appraisal” significantly increased (P<0.01) and “escape/avoidance” significantly decreased (P<0.01). The Beck Depression Inventory Second Edition (P<0.05) and the trait anxiety scores (P<0.01) also significantly decreased. The change in the stress-coping strategy “distancing” had a significantly negative correlation with the change in the externalizing Child Behavior Checklist T-scores of children with ASD (Pearson r=−0.518, P<0.05).

Conclusion

PT may be effective for mothers of children with ASD to improve their stress-coping style and to decrease their depression and trait anxiety.

Keywords:

• parent training
• autism spectrum disorder
• parents’ stress coping
• anxiety
• depression

Acknowledgments

We thank our colleagues from Kyoto Prefectural Child Development Center, Shigeru Sugimura, Katsuo Shimabayashi, Kazushi Takeda, Kensuke Sakai, Rui Nakahara, Fukumi Hasegawa, Ryuji Kitamura, and Maiko Tsukuda from Bukkyo University. We also thank Nobutaka Ayani for assistance with statistical analyses, and Toshiyuki Tominaga for comments about stress coping. We would like to thank Enago (www.enago.jp) for the English language review.

Author contributions

Naoko Iida, Yoshihisa Wada, and Tatsuhisa Yamashita designed the study. Naoko Iida wrote the initial draft of the manuscript. Yoshihisa Wada and Tatsuhisa Yamashita contributed to analysis and interpretation of data and assisted in the preparation of the manuscript. All other authors have contributed to data collection and interpretation and critically reviewed the manuscript. All authors approved the final version of the manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Disclosure

The authors report no conflicts of interest in this work.