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Closing Thoughts AboutPromoting Parent-Child Co-Occupation Through Parent-Child Activity InterventionPublished online: 08 Sep 2008.

To cite this article: (2006) Closing Thoughts About Promoting Parent-Child Co-Occupation Through Parent-Child Activity Intervention, Occupational Therapy inMental Health, 22:3-4, 153-156, DOI: 10.1300/J004v22n03_10

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Chapter 10

Closing Thoughts About PromotingParent-Child Co-Occupation

Through Parent-Child Activity Intervention

SUMMARY. Parent-child and parent-adolescent activity groups andparent-child occupation-based intervention meet different mentalhealth needs and provide a different service than what is typicallyoffered in a psychiatric setting. These interventions are designed topromote and/or develop positive interactions and engagement betweenparents and children in co-occupations. doi:10.1300/J004v22n03_10[Article copies available for a fee from The Haworth Document Delivery Service:1-800-HAWORTH. E-mail address: <docdelivery@haworthpress.com> Website:<http://www.HaworthPress.com> © 2006 by The Haworth Press, Inc. All rightsreserved.]

KEYWORDS. Occupational therapy, families, mental illness

My qualitative research expands the therapeutic approach to assist-ing parents and their psychiatrically hospitalized children in establish-

[Haworth co-indexing entry note]: “Closing Thoughts About Promoting Parent-Child Co-OccupationThrough Parent-Child Activity Intervention.” Olson, Laurette. Co-published simultaneously in OccupationalTherapy in Mental Health (The Haworth Press, Inc.) Vol. 22, No. 3/4, 2006, pp. 153-156; and: ActivityGroups in Family-Centered Treatment: Psychiatric Occupational Therapy Approaches for Parents and Chil-dren (Laurette Olson) The Haworth Press, Inc., 2006, pp. 153-156. Single or multiple copies of this article areavailable for a fee from The Haworth Document Delivery Service [1-800- HAWORTH, 9:00 a.m. - 5:00 p.m.(EST). E-mail address: docdelivery@haworthpress.com].

Available online at http://otmh.haworthpress.com© 2006 by The Haworth Press, Inc. All rights reserved.

doi:10.1300/J004v22n03_10 153

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ing a positive relationship through structured activity in a group setting.Prior research about intervening with parents and their children withmental illness has been based upon expert opinion and anecdotes fromclinical practice.

In Chapters 3 through 7, I described a parent-child activity group thatI studied through persistent participant observation of the interactionsof group participants over an eight-month period and formal and infor-mal interviews of the participants throughout their participation in thegroup. I described the parents’ and children’s perspectives about theirinteractions prior to attending the parent-child activity group and overthe course of their participation in the group. The strengths and weak-nesses of the leaders’ approaches to providing a therapeutic environ-ment and activities for families, and intervening with parents andchildren as they participated in the group, were examined in depth.What I reported about the participants may resonate with leaders of sim-ilar parent-child activity groups. They may find that the descriptions ofthe participants or the vignettes that I used to illustrate the themes re-mind them of families with whom they work. They may find that thethemes and metathemes are helpful ways to think about my data as wellas about their own experiences. What the leaders reported and how I de-scribed their interactions with the families may also cause readers to re-flect upon how they might optimally lead a parent-child activity group.

I also hope that my descriptions of my activity based group interven-tion with adolescents with mental illness and their parents and my par-ent-child intervention with a mother diagnosed with depression mayhelp other clinicians think more deeply about the mental health needs ofparents and children related to their co-occupations. There is no re-search reported in the literature about similar interventions. These arevery fruitful areas for research in occupational therapy.

In closing, I would like to highlight what I grew to understand overthe course of my clinical work helping parents and children more posi-tively interact in their co-occupations and through my research about aparent-child activity group. Leading a parent-child group requires ahigh level of leadership skill to be effective in its stated goals. The find-ings of my study support the findings of prior researchers who have re-ported that parents and their offspring with mental illness often haveinteractions that are fraught with conflict, experience limited enjoymentin mutual activity, and have low expectations for family interactions. Itis a daunting challenge to help such families discover ways to find en-joyment in each other when they do not expect it.

154 ACTIVITY GROUPS IN FAMILY-CENTERED TREATMENT

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In the parent-child activity group that I studied, I observed that theleaders learned by doing. The group leaders tended to share pragmaticinformation among themselves when necessary, but did not reflect to-gether on the process of a particular group or plan the group activities inadvance together. Though the group that I observed was helpful to somefamilies, it was not therapeutic for others where the parents and childrenremained uninvolved with each other. After one leader resigned as agroup leader, the remaining leaders shared their feelings of being un-sure what to do to help some families. They often did little beyond set-ting behavioral limits in response to disruptive child behavior andproviding materials for the chosen activity for each group.

In Chapter 7, I reflected a great deal on what the alternatives were forintervention and discussed my thoughts about them. I described howviewing parents’ and children’s participation in the parent-child activitygroup as cultural voyages may provide a lens for understanding the per-spectives of parents and children. It might support the development ofcollaborative and cooperative relationships between parents and thera-pists, which is critical for any intervention to be effective.

Parent-child and parent-adolescent activity groups and parent-childoccupation-based individual intervention meet different mental healthneeds and provide a different service than what is typically offered in apsychiatric setting. Parents typically participate in individual and groupcounseling sessions. Most often, professionals focus on remediatingproblem behaviors and educating families about mental illness. Whilethese are very important foci, it is also important that families that in-clude a child or parent with mental illness be guided towards learninghow to interact in pleasurable and productive ways after hospitalization.So often, these families do not experience the same kind of satisfactionin everyday play and leisure activities that families without a memberwith mental illness regularly enjoy. Identifying the positive interactionsthat occur in typical parent-child interaction, but are not occurring in aparticular family is as important as identifying the negative behaviorsthat need to change (Olson, 2001).

Positive and supportive parenting has been linked to the children’sadjustment (Pettit, Bates, & Dodge, 1997). Positive and supportiveparenting grows in part from feeling confident and effective inparenting one’s children and enjoying interactions with those children.Before parents can expect to be effective in limit setting, the first stepidentified in behavior management plans is for the adult caregiver tosuccessfully engage the child in play. Creating or strengthening a warmrelationship between a parent and child positively influences the chil-

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dren’s behavior. Children with frequent and high quality positive inter-action with a parent will more likely respond to that parent’s requestsand directions than children who are accustomed to only negative feed-back (Foote, Eyberg, & Schuhmann, 1998).

I hope that my work increases readers’ awareness of the mental healthco-occupational needs and perspectives of children with mental illnessand the adults who serve as their primary caregivers, as well as parentswith mental illness and the children for whom they serve as primarycaregivers. Though interactions between these parents and children areoften fraught with conflict, and limited enjoyment of mutual activity isnot uncommon, the situation for these families should not be viewed ashopeless. After reading this publication, I hope that readers feel in-creased empathy for families that include members with mental illnessand consider creating occupation-based family groups or individualfamily interventions.

REFERENCES

Foote, R., Eyberg, S., & Schuhmann, E. (1998). Parent-child interaction approaches tothe treatment of child behavior disorders. In T. H. Ollendick & R. J. Prinz (Eds.),Advances in Clinical Child Psychology (Vol. 20, pp. 125-151), NY: Plenum Press.

Olson, L. (2001). Child psychiatry in the USA. In L. Lougher (Ed.), OccupationalTherapy for Child and Adolescent Mental Health (pp. 173-191). Edinburgh: Chur-chill Livingstone

Pettit, G. S., Bates, J. E. & Dodge, K. A. (1997). Supportive parenting, ecological con-text, and children’s adjustment: A seven-year longitudinal study. Child Develop-ment, 68, 908-923.

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