Mental Illness in Parents/Caregivers and its Impact on Carrying out Home OT Intervention for Children

Every once in a while, even a seasoned occupational therapist needs to take a step back and re-assess all contexts of their intervention styles. Specifically, in regards to this article, pediatric OTs need to carefully analyze the surrounding and relevant details of a child’s life prior to carrying out interventions at home. Why??? Because even if the OT selects the most innovative and beneficial therapy interventions for a child at home, those interventions mean absolutely nothing when all barriers and influences are ignored.

A child and their OT participation are heavily impacted by their home environment and the people who care for him or her. Parents, guardians, caregivers, and other biological or legally binding adults are the facilitators of what OT brings into the home. Pediatric OTs can only visit a child so often per month, thus it is a huge responsibility for the parents to carry out learned interventions in the OT’s absence. More often than not, OTs can just safely assume that every parent or directly connecting adult will have the full physical and mental capacity to carry out those interventions.

This article blatantly discusses those times when parents and caregivers lack that capacity and what can be done to remediate the gap that prevents children from receiving full benefits of therapeutic intervention in the home. Take a look at the following scenario:

Kathy is a single mom of 3 children under the age of 9 years old. Her youngest child, Elsie, is 2 years old and was recently diagnosed with autism. Early intervention services, including OT, have been visiting the home regularly to work with Elsie and Kathy in order to improve Elsie’s ability to transition from one task to another without massive behavioral episodes. Kathy appears to be a very dedicated mother and actively attends all of her daughter’s therapy sessions. Unfortunately, Kathy has kept it well hidden from professionals and from her family that she’s been dealing with severe symptoms of depression. As a result, there are times in which she struggles to get out of the bed in the morning. Her decreased motivation and her emotional turmoil frequently prevents her from helping Elsie with her OT-related activities. Additionally, managing two other kids by herself and trying to keep the household running only adds to her depressive symptoms.

In pediatric occupational therapy, sometimes the OTs get so caught up with assessing the child that they forget that assessing parents and caregivers are equally as important, especially when it comes to their mental health status. Some children have parents or caregivers who suffer from a wide variety of psychiatric/neurotic and diagnosable disorders such as:

  • Schizophrenia
  • Bipolar disorder and other mood disorders
  • Autism
  • Obsessive compulsive disorder
  • Eating disorders
  • Personality disorders
  • Substance-induced mental disorders
  • Depression

Other informal conditions include stress, anxiety-like symptoms, and caregiver burnout may not be as obvious but can still dramatically impact a parent’s mental health and their ability to carry out tasks. So, what can proactive parents and caregivers do about it?

  • Don’t be shy and bring up concerns about your own mental health with the OT: As mentioned earlier, the pediatric OT might get so caught up in working with your child that they’ll forget to inquire about you and your personal struggles. Bring it up with the OT if you think that your mental health is strained or if you have a diagnosed condition that will impact your ability to carry out interventions with your child. It is very likely that the OT will welcome this discussion warmly and surprise you with adaptive strategies that consider your own mental health.
  • Consult with a professional for yourself if needed: There is a reason that flight attendants on airplanes tell adult passengers to secure their own oxygen masks in an emergency before assisting a child with their own mask. If you as the parent are not taking care of yourself, then you will not be able to effectively help your child. Consult with a mental health professional and get yourself figured out.
  • Recruit help for your child: Even though you are the parent and the primary provider for your child, there is no law saying you have to do all of the work. If carrying out interventions with your child is too much and is compromising your mental health, recruit friends and family who know and have a good relationship with your child. Involve siblings in some of the interventions if they are old enough to understand and to carry some out.

You aren’t alone in this. There are many parents and caregivers who are in your position and haven’t vocalized their personal challenges with mental health. Consult with someone immediately and prepare to have an open and honest discussion with your children’s therapy providers.