A systematic review of psychosocial interventions to reduce parenting stress and strain among caregivers of autistic children

Background: Parents of autistic children experience high levels of parenting stress, which has a maladaptive transactional relationship with child emotional and behavioral problems. Most autism-specific interventions focus on modifying child behaviors, with parenting stress included as a secondary outcome, if at all. Previous research on interventions to specifically reduce parenting stress is mixed, and wide heterogeneity in study design and intervention modalities makes it difficult to parse apart which elements of interventions are effective at reducing parental stress. Methods: A thorough database search of empirical articles evaluating parent-focused interventions designed to reduce parenting stress or strain among parents of autistic children was conducted. Articles that met the inclusion criteria were reviewed and relevant data was extracted. Results: The search yielded 42 articles which were included in the review. The interventions varied widely in terms of format, study design, and the therapeutic elements included. The most commonly used therapeutic element was psychoeducation (used in 23 interventions), followed by behavior management strategies (17), cognitive/coping strategies (17), relaxation/mindfulness/stress reduction techniques (17) and support/discussion with other parents (16). Thirty-five of the 42 interventions reported at least a partially significant reduction in parent stress/strain. Conclusions: There may be some general trends in the effectiveness of intervention components. For example, psychoeducation and social support may be more impactful for parents from low-resource areas or parents of newly diagnosed children. However, researchers and clinicians designing interventions should consider the culture and needs of the community of interest.