Document Type : Research Paper
Authors
1 M.A. in Psychology and Education of Exceptional Children, University of Guilan, Rasht, Iran
2 Associate of Professor, Department of Psychology, University of Guilan, Rasht, Iran
3 Professor, Department of Psychology, University of Guilan, Rasht, Iran
Abstract
The birth of a child with an intellectual disability can significantly challenge parents' psychological well-being. Therefore, it is essential to implement approach-oriented, short-term, and cost-effective interventions to improve the specific psychological conditions of these parents. In this regard, the current study aimed to investigate the effectiveness of emotional-cognitive resilience training on parenting stress, emotion regulation, and resilience in parents of children with mild intellectual disability. The statistical population consisted of parents of 8 to 12-year-old boys with mild intellectual disability at the Marjoei School for Exceptional Children (2) in Karaj. Using available (convenience) sampling, a sample of 30 parents who met the study criteria was selected and randomly assigned to either an experimental or a control group. The research instruments included the Parenting Stress Index (Abidin, 1995), the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004), and the Connor-Davidson Resilience Scale (2003). The experimental group received Smith and Ascoff's (2016) emotional-cognitive resilience training program, which was conducted in six 50- to 60-minute weekly group sessions. The data were analyzed using univariate and multivariate analysis of covariance (ANCOVA/MANCOVA). The findings indicated that the training program had a significant effect on reducing parenting stress, improving emotion regulation, and increasing resilience among parents of children with intellectual disabilities (p < 0.05). Therefore, it appears that this approach-oriented, short-term, and interaction-focused program, which combines cognitive-behavioral strategies with relaxation training, mindfulness, and other techniques, was able to enhance the cognitive-emotional flexibility of parents in their interactions with their children.
Keywords: Emotional-Cognitive Resilience, Parenting Stress, Emotion Regulation, Mild Intellectual Disability
Extended Abstract
Introduction
Intellectual disability is a neurodevelopmental disorder characterized by significant impairments in intellectual functioning and adaptive behavior across conceptual, practical, and social domains. This disability originates during the developmental period and is considered present before the age of 22 (Schalock et al., 2021; American Psychiatric Association, 2023). Children with mild intellectual disability—who represent approximately 85% of this population and typically have an IQ range of 50-55 to 70—often demonstrate difficulties in acquiring complex language skills and a limited ability to understand social norms and interactions. However, with appropriate support, they can improve their basic functional abilities (World Health Organization, 2020). A diagnosis of intellectual disability in a child can trigger a wide range of emotional responses within the entire family system, particularly for parents, which is associated with increased psychosocial difficulties (Singh & Lohum, 2023; Kumar et al., 2020; Giallo et al., 2015). One of the primary emotional challenges faced by these parents is parenting stress (Hsiao, 2017).
Parenting stress is a set of distressing psychological and physical reactions arising from a perceived mismatch between the demands of parenting and an individual's available resources (Fu et al., 2023). It is the product of the interactive effects of characteristics within the parent, the child, and the broader context of their relationship (Deng et al., 2018; Díaz-Herrero et al., 2011). Another significant challenge for parents of a child with intellectual disability is difficulty in emotion regulation (Littlewood et al., 2018). According to Gratz and Roemer (2004), emotion regulation encompasses several dimensions: a) awareness and understanding of emotions; b) acceptance of emotions (i.e., accepting emotional responses and related events in a non-evaluative manner, often linked to cognitive reappraisal); c) the ability to engage in goal-directed behavior and refrain from impulsive actions when experiencing negative emotions; and d) access to and flexible use of effective emotion regulation strategies.
Given the documented emotional and affective challenges faced by parents of children with intellectual disabilities, it is evident that the issues and concerns related to these children can also impact parental resilience. The importance of resilience lies in its role as a predictor of better health outcomes and higher self-esteem (Luo et al., 2021). Conceptually, resilience enables an individual to enhance social competence and overcome adversity, even when exposed to significant stressors and risk factors (Masten, 2018). Therefore, resilience training appears to be an effective intervention for increasing the quality of life and reducing stress among parents of children with intellectual disabilities (Shadi Zavareh et al., 2024; Hosseini Ghomi & Jahanbakhshi, 2021).
In this context, one recommended program grounded in resilience theory and designed for the context of parent-child interaction is Cognitive-Affective Stress Management Training (CASMT) with an emphasis on strengthening emotional resilience. Derived from the Smith and Ascough (2016) treatment program, this intervention promotes cognitive-emotional flexibility by integrating cognitive-behavioral strategies with relaxation training, mindfulness, and other techniques. Key characteristics that distinguish CASMT from other resilience programs include: 1) its foundation in the cognitive-behavioral approach; 2) its focus on teaching self-management skills, generalization, and relapse prevention; and 3) its short-term (6 sessions), interactive format. Essentially, this intervention emphasizes the practical application of skills needed by parents and caregivers during interactions with their child. By providing multidimensional training and supplementary materials in addition to the core sessions, the program enhances the practical utility and comprehensiveness of the training process.
Research Question
The main research question was whether cognitive-emotional resilience training is effective in reducing parenting stress, improving emotion regulation, and increasing resilience in parents of boys with mild intellectual disability.
Literature Review
To the best of the researcher's knowledge, the Cognitive-Emotional Resilience Training program by Smith and Ascough (2016) has not yet been implemented in Iran. Relevant background research is summarized as follows. Studies have shown that mothers of children with intellectual disabilities under the age of 12 experience more parenting stress than mothers of typically developing children (Biabani et al., 2019; Kumar et al., 2018; Patra et al., 2016). Furthermore, Alidoosti et al. (2019) found that mothers of children with intellectual disabilities had significantly higher scores for emotion regulation difficulties, anxiety, and depression compared to a control group. In a comparison of parents of children with and without special needs, Priego-Ojeda and Rusu (2023) demonstrated that the relationship between emotional dysregulation and relationship satisfaction is mediated by parental stress and conflict. Finally, research indicates that the level of resilience in parents of children with intellectual disabilities is often low due to sustained psychological pressure (Hassanein et al., 2021; Mohan & Kulkarni, 2018).
Hosseini Ghomi and Jahanbakhshi (2017) examined the effectiveness of resilience training based on the Kumpfer model (1999), as detailed by Pan and Sánchez (2021), for reducing stress in 30 mothers of children with intellectual disabilities in Tehran. The training, conducted in eight one-hour sessions, covered three dimensions: 1) familiarity with the concept of resilience, 2) familiarity with internal and external supportive factors (e.g., optimism, self-esteem, locus of control, social support systems), and 3) familiarity with strategies to build resilience (e.g., establishing relationships, purposefulness, hope for the future, and accepting change). Separately, Moradikia et al. (2017) investigated the effect of resilience training on the psychological well-being of mothers of students with intellectual disabilities in Arak.
Methodology
This study was applied in nature and utilized a quasi-experimental design with a pre-test, post-test, and a control group. The statistical population consisted of 30 parents of 8 to 12-year-old boys with mild intellectual disability from the Marjoui Exceptional Children's School in Karaj during the 2021-2022 academic year. The research instruments were the Connor-Davidson Resilience Scale (CD-RISC), the Parenting Stress Index-Short Form (PSI-SF; Abidin, 1995), and the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004). The cognitive-emotional resilience training sessions were adapted from the manual Cognitive-Emotional Stress Management Training: Promoting Emotional Resilience by Smith and Ascough (2016).
Results (Times New Roman 12 bold)
The effect of emotional-cognitive resilience training on dependent variables in parents of children with mild intellectual disability was investigated using univariate and multivariate analysis of covariance. The results of the multivariate analysis of covariance test for parenting stress components showed that the difference between the two groups was significant in terms of the dependent variable components, and the effect size for the parenting stress variable combination was 0.856; that is, 85.6 percent of the variance in the parenting stress variable was due to the intervention effect. The results of the multivariate analysis of covariance test for emotion regulation difficulty components indicated a significant difference between the two groups in terms of the dependent variable components, and the amount of this difference was 0.920 for the emotion regulation variable combination; that is, 92.0 percent of the variance in the emotion regulation variable was due to the intervention effect. The results of the multivariate analysis of covariance test for resilience components indicated that the difference between the two groups was significant in terms of the dependent variable components, and the amount of this difference was 0.429 for the resilience variable combination; that is, 42.9 percent of the variance in the resilience variable was due to the intervention effect.
Discussion (Times New Roman 12 bold)
The present study aimed to investigate the effectiveness of emotional-cognitive resilience training on parenting stress, emotion regulation, and resilience in parents of children with mild intellectual disability. The results demonstrated that this training had a significant effect on all three variables and their components. This finding aligns with previous studies, including those by Shadi Zavareh et al. (2024), Hosseini Ghomi and Jahanbakhshi (2021), Luo et al. (2021), Hassanein et al. (2021), Biabani et al. (2019), Mohan and Kulkarni (2018), and Moradikia et al. (2017).
One key result was the effectiveness of the training on parenting stress. The effect can be explained by three primary mechanisms. First, within the training program, parents learned through the ABC model how the stress experienced in various life situations—particularly concerning their children—results from the interaction between an Activating event, their Beliefs (thoughts), and the resulting emotional Consequences. Second, the intervention successfully modified parents' attributional styles. Instead of attributing events to factors such as their own inadequacy in parental duties, their child's weaknesses, or a loss of control, they learned to approach problems with optimism, self-assertion, and self-confidence.
Third, the training sessions focused on attracting social support. As the sessions were held in groups with both parents present, they provided a space for parents to realize they were not alone in their journey and that others shared similar experiences.
Another finding was the effect of emotional-cognitive resilience training on improving emotion regulation. During the sessions, parents learned about the critical role emotions play in guiding their thoughts and behaviors. They were taught that emotion regulation is a fundamental and generalizable skill, directly and indirectly linked to a wide range of positive health outcomes, and that it can influence functioning in both personal and interpersonal contexts. Parents also learned that their interactive environment—with each other and with their child—plays a significant role in both the emergence and regulation of emotions.
Finally, the emotional-cognitive resilience training was effective in increasing parental resilience. The training enabled parents to adopt a problem-oriented approach when facing unpleasant life events. Consequently, instead of feeling unworthy and inadequate towards themselves and their child, parents learned to focus on their abilities and strengths, foster intimacy in their relationships with their spouse and child, accept that relationships have the capacity to change, and experience greater personal confidence and competence—all of which are skills that can be learned.
Conclusion
Parents of children with neurodevelopmental disorders face significant challenges, stress, and negative emotions in their caregiving roles, which consequently reduces their resilience. Therefore, cognitive-emotional resilience training, based on a cognitive-behavioral approach, aims to teach parents how to enhance their capabilities when facing various challenges. By using methods such as situation assessment, cognitive coping skills (e.g., identifying irrational thoughts), inducing skills (e.g., induced forgiveness), mindfulness, acceptance-based control, and desensitization, the training helps parents develop a more positive sense of competence in their parenting interactions with their children.
Acknowledgments
The authors extend their sincere appreciation to the administration and staff of Marjoui School for their essential collaboration. We are also grateful to the parents and children whose participation was fundamental to this research.
Keywords
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