Evaluating a Brief Mindfulness-based Intervention for Parents of Adults With Intellectual Disabilities: a Case Series.

A multitude of studies has established that parenting a child with intellectual disabilities (IDs) can negatively influence the psychological and physical wellbeing of primary caregivers. The same correlation between IDs and parental psychological distress exists in the parents of adults with IDs, with the transition from childhood to adulthood being particularly detrimental to the psychological wellbeing of the family. Carers of children with IDs often report increased levels of parental stress, a feature that is amplified in some categories of IDs, such as in autism spectrum disorder. Importantly, the effects of this especially demanding relationship are not limited to impacting the carers' wellbeing alone; they can also affect the carers' ability to respond to problematic child behaviour, and result in financial hardship.

In terms of psychological distress on the part of people with intellectual disabilities (PWIDs), this is most often observed in the form of challenging behaviour, which can be used by PWIDs to communicate their distress. Of interest to the present study, the complex and enduring pattern of difficulties observed within these families cannot be accounted for purely by the psychological distress of the carers, nor does it stem from challenging behaviour alone. Instead, it has been proposed that the relationship between parental stress and the child's challenging behaviour is bi-directional, and self-reinforcing, in that parental stress can increase challenging behaviour, just as challenging behaviour can induce stress, and other forms of psychological distress. This pattern has been observed in families with children, as well as in families with adults with IDs.

Given the link between challenging behaviour, parental stress, and their interdependent nature, there has recently been a focus on employing therapeutic modalities that are explicitly aimed at reducing stress, with third-wave cognitive behavioural therapies (CBT) at the forefront of such scrutiny. Among third-wave CBTs, mindfulness-based interventions (MBIs) have been employed with especially promising results, making them veritable candidates as effective interventions for what is a sizeable segment of the population.

MBI adaptations

It should be noted that the increased range of applicability derived from said universality can limit the scope and clarity of the MBIs' research base. Specifically, as observed in a recent review on the efficacy of MBIs in parents of children with disabilities, a plethora of different interventions and adaptations of MBIs are continuously being developed, from the classic programmes devised by Jon Kabat-Zinn and his team, to hybrid interventions that combine MBIs with other therapies, such as DBT or ACT. Such abundance of variation can limit the precision with which the various MBIs are comparable with one another, and frustrates the search for a definite analysis of precisely which mindfulness factors contribute to the self-reported decreases in psychological distress. In parallel, efforts are being made to distil the essential criteria a mindfulness intervention should be based on.