Strengthening Family Resilience Using a Single Session Mindset Following a Child's Diagnosis of Autism
Aspasia Stacey Rabba1
Coping with a young child’s diagnosis of autism and navigating the pathway to early intervention presents many challenges for families. From the emotional experience of coming to terms with the diagnosis (e.g., loss, denial, acceptance) to the practical decisions that follow (e.g., identifying what supports are required), the post-diagnostic journey can lead to distress and uncertainty for families (Crane, Chester, Goddard, Henry, & Hill, 2016; Feinberg et ah, 2014; McGrew & Keyes, 2014; Stuart & McGrew, 2009). Given the difficulties experienced by parents post-diagnosis, family-based interventions utilizing practical and effective therapeutic techniques are fundamental to addressing parental and family needs, enabling them to make the next steps confidently. Conventional parent interventions typically include multiple sessions or group therapy, with little regard for the time commitment required by parents to participate. With previous research identifying excessive time commitments as a specific challenge that impacts caregivers’ psychosocial strain (Phelps, Hodgson, McCammon, & Lamson, 2009), it is important that we do not add to these constraints, but instead work to alleviate them. To address a family’s needs and provide immediate support, it is important to identify a model of care that would be suitable, effective, and practical for parents following their child’s diagnosis, and at the same time one that promotes a strengths-based approach to supporting families, thereby building resilience.
This chapter considers the use of Single Session Therapy (SST) with parents following their child’s diagnosis of autism. This proactive approach to supporting families will also likely be beneficial to a diverse range of families, including those of children with other diagnosed conditions.
Family Resilience
Family resilience is defined here as a family’s ability to adapt to risk and adversity by drawing on protective factors and internal and community resources (Mackay, 2003; Walsh, 2002). Strengthening family functioning and capacities in the face of adversity is the process by which to build family resilience. A family’s response and adaptation to adversity (i.e., coping mechanisms) is an important element to consider as it may provide the initial indication of a family’s ability to “bounce back.” Family resilience provides a framework to guide prevention and intervention and to support and strengthen vulnerable families. It can serve as an important foundation for SST. By using focused brief intervention, we can help families identify their risks and protective factors to better understand their vulnerabilities and their strengths that could help them through the difficult times. Family resilience is more than managing crises and stressful life events - it is about recognizing potential for personal and relational transformation and growth, and a heightening of attention to what really matters. By fostering the underlying processes for resilience, families can become stronger and more resourceful.
Processes for resilience operating at the family level - including strong emotional attachments, effective communication, use of coping strategies, and family belief systems, especially those grounded in spiritual and religious values - are all important means by which families manage to cope with adversity (Mackay, 2003). Resilient families are described as those that show active persistence, perseverance, maintenance of hope and optimism, and confidence that they can overcome difficult situations.
Existing evidence has shown that the best approaches to instill family resilience involved early intervention that is sensitive to families’ cultures and values, and that assist in relieving families’ ecological stresses (Mackay, 2003). The period immediately post-diagnosis could be referred to as the “early intervention period.” In the resilience literature, intervening early has been identified as a hallmark of successful intervention programs (Mackay, 2003). Given this recognition, a brief family clinic intervention built on single session therapy may be the most appropriate and realistic pathway to promote family resilience post-diagnosis. In addition to focusing on parents’ reactions to diagnosis, the proposed single session model seeks to enhance family resilience by helping families tap into their existing resources and increase individual and family protective factors (e.g., social support, effective coping strategies, parenting self-efficacy).
