Now researchers have found that caring for children with emotional disorders can take a toll on the child's family, causing harm to the family's well-being. The effects tend to worsen over time, suggesting that the families and caregivers of such children do not get used to caring for them.
The researchers, led by Theresa J. Early, an assistant professor of social work at the Ohio State University, drew these conclusions from a study that looked at 164 families with children who had emotional disorders.
Early and her colleagues - Thomas K. Gregoire, an assistant professor at Ohio State, and Thomas P. McDonald, a professor at the University of Kansas - reported their findings in a recent issue of the Journal of Family Issues.
For the study, the researchers surveyed caregivers of children with emotional problems who were receiving mental health services in North Carolina. The disorders of the children - aged between 3 and 12 at the time of the first survey - ranged from excessive shyness and paranoia to violent behavior. The caregivers - a group that included parents and other relatives of the children - were surveyed a second time 12 to 18 months after the first survey.
To evaluate how well a child was doing, the researchers asked his or her caregiver a standard set of questions about the child's behaviors. To measure the well-being of caregivers, the researchers asked them to rate the level of stress, pleasure and responsibility they were feeling with regard to different aspects of their lives including work, home, relationships and physical health.
From the data, Early and her colleagues found that child functioning and caregiver well-being affected each other. "How upset parents are about their own lives affected their child's behavior," Early said. "And the child's behavior had an effect on the parents' overall well-being."
But over time, Early said, the effect of the child's behavior on the parents intensified and became more significant than the effect parental well-being had on the child. "It seems that caregivers do not become accustomed to their children's problems as they go along," Early said.
Based on these conclusions, the researchers recommend providing counseling and other kinds of support to families of children with emotional disorders. "It's not just the children with problems who need care, the people caring for them also need help," Early said. "Our mental healthcare services need to pay attention to the families of these kids because the family members are the primary caregivers."
Early's recommendations gives finer shape to an emerging philosophy for treating children with emotional disorders that favors caregiving by the child's family as opposed to foster care or hospital treatment. According to this view, which has been gaining support among researchers and mental healthcare professionals since the 1980s, children with emotional and behavioral challenges do better when cared for at home by their close family as compared to when they are yanked away to an unfamiliar environment.
"There is a growing emphasis now on developing community-based services that can wrap around the needs of the child's family," Early said. A future research step, she explained, would be finding out what kinds of support parents and family members need to do a better job of care-giving without feeling less stressed in their own lives.
Early and her colleagues also suggest that intervention programs aimed at treating children's emotional disorders should be available on a long-term or open-ended basis. "These problems seem to continue for a long time," Early said. "Therefore, many of today's managed care policies that favor short-term treatment for such disorders need to be changed."
The research was funded by the National Institute on Disability and Rehabilitation Research, the U.S. Department of Education and the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration.
Written by Yudhijit Bhattacharjee, 614-292-8456; bhattacharjee.5@osu.edu
Journal
Journal of Family Issues