Raising a child with a congenital anomaly or other chronic medical problem challenges families. Although most families are resilient, depending on families' relative balance of strengths and vulnerabilities, chronic child health conditions can contribute to problems with parenting and family relationships. We believe interventions can broadly promote family well-being by focusing on parental emotional, cognitive, and behavioral adaptation to their child's condition. Parents' adaptation to their child's diagnosis has been found to predict both family well-being and their child's attachment security. After reviewing these and other relevant findings on families with children with chronic medical conditions, the second half of this article describes a parent group intervention designed to promote adaptation among such families. The rationale, goals, and guidelines of this 8-session intervention are provided. Considerations and unanswered questions about implementing the intervention are also discussed.
FOR MOST parents, the birth of their child is a joyous time. However, nearly 4% of parents receive distressing news about their child's health. In fact, about every 3.5 minutes a parent is told that their child has a serious chronic medical illness, health defect, disability, sensory impairment, or mental retardation (March of Dimes, 2000). For these parents, the time of their child's birth may become mixed with stress and despair. As reviewed in this article, social, emotional, and cognitive variables often pertaining to parents' reactions to their child's condition have consistently been identified as markers of parent and child well-being. We believe that they are more than markers. In our view, they represent social, emotional, cognitive, and behavioral processes that influence family functioning. Consequently, we contend that parents' adaptation to their child's condition can serve as a pivotal focus when intervening to improve parent and child functioning. Following a review of research on parent and child functioning when the child has a chronic medical condition, we present an outline of an intervention designed to promote parent and child well-being by focusing on parental adaptation to their child's condition. We define adaptation as an ongoing process whereby parents are able to sensitively read and respond to their child's signals in a manner conducive to healthy development. On the basis of our review of the research, we contend that parental perceptions, thoughts, and emotional reactions to their child's condition are effective avenues for promoting adaptation.