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From Every Direction: Guilt, Shame, and Blame Among Parents of Adolescents with Co-occurring Challenges

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Abstract

This article explores the results of a qualitative inquiry into guilt, blame, and shame as experienced by parents of children with co-occurring mental health and substance use challenges. These interviews represent both the lived experience of parents, as well as the perspective of clinicians who work with these families. The parent–clinician alliance is taken as a central context for considering how these experiences may affect the dynamics of the helping relationship. Analyses of these results suggest that guilt, blame, and shame are often experienced by parents and have important implications for engagement and therapeutic processes. Parents associate feelings of blame with interactions from a number of helping professionals and connect personal characteristics, parenting behaviors, and relationship issues with experiences of shame and guilt surrounding their children’s behavioral health challenges. Finally, the information that is shared across these interviews is used to guide the development of a number of practice guidelines for social workers who work with families of adolescents that experience co-occurring mental health and substance use issues.

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References

  • Barrett, K. C. (1995). A functionalist approach to shame and guilt. In J. P. Tangney & K. W. Fischer (Eds.), Self-conscious emotions: The psychology of shame, guilt, embarrassment, and pride (pp. 25–63). New York: The Guilford Press.

    Google Scholar 

  • Blumer, H. (1969). Symbolic interactionism: Perspective and method. Englewood Cliffs, CA: Prentice Hall.

    Google Scholar 

  • Corrigan, P. W. (1998). The impact of stigma on severe mental illness. Cognitive and Behavioral Practice, 5, 201–222.

    Article  Google Scholar 

  • Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59, 614.

    Article  PubMed  Google Scholar 

  • Corrigan, P. W., & Miller, F. E. (2004). Shame, blame, and contamination: A review of the impact of mental illness stigma on family members. Journal of Mental Health, 13, 537–548.

    Article  Google Scholar 

  • Corrigan, P. W., Watson, A. C., & Miller, F. E. (2006). Blame, shame, and contamination: The impact of mental illness and drug dependence stigma on family members. Journal of Family Psychology, 20, 239.

    Article  PubMed  Google Scholar 

  • Creswell, J. D. (2007). Qualitative inquiry and research design: Choosing among five traditions (2nd ed.). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Feinstein, N. R., Fielding, K., Udvari-Solner, A., & Joshi, S. V. (2009). The supporting alliance in child and adolescent treatment: Enhancing collaboration among therapists, parents, and teachers. American Journal of Psychotherapy, 63, 319–344.

    PubMed  Google Scholar 

  • Fox, J. E. (2012). “Co-constructing” stigma and the therapist–parent alliance. Psychotherapy, 49, 38.

    Article  PubMed  Google Scholar 

  • Garland, A. F., Haine-Schlagel, R., Accurso, E. C., Baker-Ericzen, M. J., & Brookman-Frazel, L. (2012). Exploring the effect of therapists’ treatment practice on client attendance in community-based care for children. Psychological Services, 9, 74–88. doi:10.1037/a0027098.

    Article  PubMed Central  PubMed  Google Scholar 

  • Harden, J. (2005). “Uncharted waters”: The experience of parents of young people with mental health problems. Qualitative Health Research, 15, 207–223. doi:10.1177/1049732304697.

    Article  PubMed  Google Scholar 

  • Hawley, K. M., & Garland, A. F. (2008). Working alliance in adolescent outpatient therapy: Youth, parent and therapist reports and associations with therapy outcomes. Child and Youth Care Forum, 37, 59–74.

  • Hawley, K. M., & Weisz, J. R. (2005). Youth versus parent working alliance in usual clinical care: Distinctive associations with retention, satisfaction, and treatment outcome. Journal of Clinical Child and Adolescent Psychology, 34, 117–128.

    Article  PubMed  Google Scholar 

  • Heider, F. (1958). The psychology of interpersonal relations. New York: Wiley.

    Book  Google Scholar 

  • Hinshaw, S. P. (2005). The stigmatization of mental illness in children and parents: Developmental issues, family concerns, and research needs. Journal of Child Psychology and Psychiatry, 46, 714–734.

    Article  PubMed  Google Scholar 

  • Karver, M. S., Handelsman, J. B., Fields, S., & Bickman, L. (2006). Meta-analysis of therapeutic relationship variables in youth and family therapy: The evidence for different relationship variables in the child and adolescent treatment outcome literature. Clinical Psychology Review, 26, 50–65. doi:10.1016/j.cpr.2005.09.001.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E., Whitley, M., & Marciano, P. L. (2006). Child-therapist and parent-therapist alliance and therapeutic change in the treatment of children referred for oppositional, aggressive, and antisocial behavior. Journal of Child Psychology and Psychiatry, 47, 436–445. doi:10.1111/j.1469-7610.2005.01475.x.

    Article  PubMed  Google Scholar 

  • Keeley, M. L., Geffken, G. R., Ricketts, E., McNamara, J. P., & Storch, E. A. (2011). The therapeutic alliance in the cognitive behavioral treatment of pediatric obsessive-compulsive disorder. Journal of Anxiety Disorders, 25, 855–863. doi:10.1016/j.janxdis.2011.03.017.

    Article  PubMed  Google Scholar 

  • Kuehl, B. P., Newfield, N. A., & Joanning, H. (1990). A client-based description of family therapy. Journal of Family Psychology, 92, 310–321.

    Article  Google Scholar 

  • Lopez, K. A., & Willis, D. G. (2004). Descriptive versus interpretive phenomenology: Their contributions to nursing knowledge. Qualitative Health Research, 14, 726–735.

    Article  PubMed  Google Scholar 

  • Mason, R. A., Watts, E. L., & Hewison, J. (1995). Parental expectations of a child and adolescent psychiatric out-patient service. Association of Child Psychology and Psychiatry Review and Newsletter, 17, 313–332.

    Google Scholar 

  • Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook. Beverly Hills: Sage.

    Google Scholar 

  • Morrissey-Kane, E., & Prinz, R. J. (1999). Engagement in child and adolescent treatment: The role of parental cognitions and attributions. Clinical Child and Family Psychology Review, 2, 183–198. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/1122707.

  • Morse, J. (1995). The significance of saturation. Qualitative Health Research, 5, 147–149.

    Article  Google Scholar 

  • Moses, T. (2010). Exploring parent’s self-blame in relation to adolescents’ mental disorders. Family Relations, 59, 103–120. doi:10.1111/j.1741-3729.2010.00589.x.

    Article  Google Scholar 

  • Moustakas, C. (1994). Phenomenological research methods. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Peters, K., & Jackson, D. (2008). Mothers’ experiences of parenting a child with attention deficit hyperactivity disorder. Journal of Advanced Nursing, 65, 62–71. doi:10.1111/j.1365-2648.2008.04853x.

    Article  Google Scholar 

  • Shelef, K., Diamond, G. M., Diamond, G. S., & Liddle, H. A. (2005). Adolescent and parent alliance and treatment outcome in multidimensional family therapy. Journal of Consulting and Clinical Psychology, 73, 689–698. doi:10.1037/0022-006X.73.4.689.

    Article  PubMed  Google Scholar 

  • Sheridan, M., Peterson, B. D., & Rosen, K. H. (2010). The experiences of parents of adolescents in family therapy: A qualitative investigation. Journal of Marital and Family Therapy, 36, 144–157. doi:10.1111/j.1752-0606.2010.00193.x.

    Article  PubMed  Google Scholar 

  • Treasure, J., Murphy, T., Szmukler, T., Todd, G., Gavan, K., & Joyce, J. (2001). The experience of caregiving for severe mental illness: A comparison between anorexia nervosa and psychosis. Social Psychiatry and Psychiatric Epidemiology, 36, 343–347.

    Article  PubMed  Google Scholar 

  • Usher, K., Jackson, J., & O’Brien, L. (2007). Shattered dreams: Parental experiences of adolescent substance abuse. International Journal of Mental Health Nursing, 16, 422–430. doi:10.1111/j.1447-0349.2007.00497.x.

    Article  PubMed  Google Scholar 

  • Weiner, B. (1986). An attribution theory of motivation and emotion. New York: Springer.

    Book  Google Scholar 

  • Wertz, F. J. (2005). Phenomenological research methods for counseling psychology. Journal of Counseling Psychology, 52, 167.

    Article  Google Scholar 

  • Wolpert, M. (2000). Is anyone to blame? Whom families and their therapists blame for the presenting problem. Clinical Child Psychology and Psychiatry, 5, 115–131. doi:10.1177/1359104500005001012.

    Article  Google Scholar 

  • Yeh, M., McCabe, K., Hough, R. L., Lau, A., Fakhry, F., & Garland, A. (2005). Why bother with beliefs? Examining relationships between race/ethnicity, parental beliefs about causes of child problems, and mental health service use. Journal of Consulting and Clinical Psychology, 73, 800.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors would like to acknowledge the work of Cory R. Cummings in the preparation of the manuscript.

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Correspondence to Kia J. Bentley.

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Cohen-Filipic, K., Bentley, K.J. From Every Direction: Guilt, Shame, and Blame Among Parents of Adolescents with Co-occurring Challenges. Child Adolesc Soc Work J 32, 443–454 (2015). https://doi.org/10.1007/s10560-015-0381-9

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  • DOI: https://doi.org/10.1007/s10560-015-0381-9

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