From Every Direction: Guilt, Shame, and Blame Among Parents of Adolescents with Co-occurring Challenges
- 355 Downloads
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.
KeywordsParent–clinician alliance Guilt Blame Shame Attribution Adolescent co-occurring
The authors would like to acknowledge the work of Cory R. Cummings in the preparation of the manuscript.
- 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
- Creswell, J. D. (2007). Qualitative inquiry and research design: Choosing among five traditions (2nd ed.). Thousand Oaks, CA: Sage.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.PubMedCentralCrossRefPubMedGoogle 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.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.CrossRefPubMedGoogle 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.CrossRefPubMedGoogle 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.
- Moustakas, C. (1994). Phenomenological research methods. Thousand Oaks, CA: Sage.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.CrossRefPubMedGoogle Scholar