Children and parents with psychosis-Balancing between relational attunement and protection from parental illness.
Petra Kristin Boström, Jennifer Strand
PMID 33285033WHAT IT FOUND
Parents with psychosis and their children described the parent-child relationship as nonhierarchical and mutually caring.
Children often had unclear images of the illness, and children who were highly attuned to the parent presented the most severe mental health problems.
Key findings
01The children did not use words such as psychosis, hallucinations, or delusions, and their images of the parent's illness remained fragmented.
02Both parents and children described the parents as permissive and exercising little controlling parenting behavior, and children sometimes took on responsibilities beyond their maturity.
03Children who were highly attuned to the ill parent presented the most severe mental health problems, while children who were more emotionally independent and had other close adults or social networks presented fewer problems.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Seven parent-child dyads is a very small sample, so the themes may not represent all families affected by parental psychosis. Participants were recruited through adult psychiatric outpatient clinics and had already taken part in Beardslee's family intervention, so the findings may reflect families already engaged with services. The authors excluded data related to Beardslee's family intervention, so the study cannot say what that intervention achieved. The parents who volunteered were likely a relatively well-functioning group, and the children were aged 8 to 15, limiting transferability to other ages or contexts. The analysis is an interpretation by the researchers, and they state their reading is one possible understanding of the narratives. The authors say the clinical implications are tentative because of the limited sample size.
Declared interests
The authors declared no conflicts of interest. The study was funded by the Swedish Research Council for Health, Working Life and Welfare.
The easy way to misread this
Do not read this as proof that talking more openly with children about psychosis improves their wellbeing. The study describes experiences in seven parent-child dyads, does not test an intervention, and excluded data about the family intervention.