Document Type : Research Article

Authors

Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran

Abstract

Background: The mothers of children with autism spectrum disorder (ASD) experience extreme stress due to the limited social, communicational, and emotional competencies of their children along with inefficient cognitive development and maladjustment. This study aimed to investigate the effectiveness of positive psychotherapy and pivotal response treatment (PRT) in family satisfaction in mothers of children with ASD.
Methods: The research method was a quasi-experimental study with a pretest-posttest control group design. The study population comprised all mothers of children with autism in Ahvaz, Iran in 2021. Forty-five mothers were selected through convenience sampling and were randomly divided into two experimental groups and one control group (each with 15 members). The experimental group underwent positive psychotherapy (fourteen 90-minute sessions) and PRT (twelve 90-minute sessions). However, the control group received no intervention. The data were analyzed using the analysis of covariance.
Results: The mean±standard deviation of the post-test scores of family satisfaction in the positive psychotherapy and PRT groups was 33.66±6.98 and 36.26±6.57, which was significantly different from the control group (18.53±4.05). The results suggested that both positive psychotherapy and PRT were effective in increasing family satisfaction in mothers of children with autism (p <0.001). There were no significant differences between the effectiveness of positive psychotherapy and PRT in increasing family satisfaction in mothers of children with autism.
Conclusion: It can be concluded that positive psychotherapy and PRT can be adopted to increase the family satisfaction of mothers.

Keywords

1. Wilfert AB, Turner TN, Murali SC, Hsieh P, Sulovari A, Wang T, et al. Recent ultra-rare inherited variants implicate new autism candidate risk genes. Nat Genet. 2021;53(8):1125-1134. doi: 10.1038/s41588-021-00899-8. PubMed PMID: 34312540; PubMed Central PMCID: PMC8459613. ## 2. Kerr-Gaffney J, Hayward H, Jones EJH, Halls D, Murphy D, Tchanturia K. Autism symptoms in anorexia nervosa: a comparative study with females with autism spectrum disorder. Mol Autism. 2021;12(1):47. doi: 10.1186/s13229-021-00455-5. PubMed PMID: 34193255; PubMed Central PMCID: PMC8247081. ## 3. Isaksson J, Van't Westeinde A, Cauvet É, Kuja-Halkola R, Lundin K, Neufeld J, et al. Social Cognition in Autism and Other Neurodevelopmental Disorders: A Co-twin Control Study. J Autism Dev Disord. 2019;49(7):2838-2848. doi: 10.1007/s10803-019-04001-4. PubMed PMID: 30972652; PubMed Central PMCID: PMC6606667. ## 4. Milgramm A, Wilkinson E, Christodulu K. Brief Report: Family Recreation for Individuals with Autism Spectrum Disorder. International Journal of Disability, Development and Education. 2021:1-9. doi: 10.1080/1034912X.2021.1925879. ## 5. Su S, Paynter J, Gilmore L. Chinese Parents’ Understanding of Autism Spectrum Disorder. International Journal of Disability, Development and Education. 2021;68(3):414-426. doi: 10.1080/1034912X.2019.1687857. ## 6. Barokova M, Tager-Flusberg H. Commentary: Measuring Language Change Through Natural Language Samples. J Autism Dev Disord. 2020;50(7):2287-2306. doi: 10.1007/s10803-018-3628-4. PubMed PMID: 29873016. ## 7. Brisini KSC, Solomon DH. Distinguishing relational turbulence, marital satisfaction, and parenting stress as predictors of ineffective Arguing among parents of children with autism. Journal of Social and Personal Relationships. 2020;38(1):65-83.‏ doi: 10.1177/0265407520958197. ## 8. Porter N, Loveland KA. An Integrative Review of Parenting Stress in Mothers of Children with Autism in Japan. International Journal of Disability, Development and Education. 2019;66(3):249-272.‏ doi: 10.1080/1034912X.2018.1439159. ## 9. Wang Y, Huang Z, Kong F. Parenting stress and life satisfaction in mothers of children with cerebral palsy: The mediating effect of social support. J Health Psychol. 2020;25(3):416-425. doi: 10.1177/1359105317739100. PubMed PMID: 29129110. ## 10. Mooghali A, Bagheri Lankarani K, Abedi H, Sarikhani Y. The Relationship Between Job Characteristics and Work-Family Conflict Among Married Women Employed in Clinical Wards of Shiraz University-Affiliated Hospitals. Women’s Health Bull. 2015;2(1):e25141. doi: 10.17795/whb-25141. ## 11. Amah OE. Managing the negative effects of work-to-family and family-to-work conflicts on family satisfaction of working mothers’ in Nigeria: the role of extended family support. Community, Work & Family. 2021;24(3):257-271. doi: 10.1080/13668803.2019.1697646. ## 12. Li X, Guan X. Mother–Daughter Work–Family Role Transmission: Effects on Daughters’ Work and Family Satisfaction. Family Journal. 2020;29(2):227-36.‏ doi: 10.1177/1066480720934484. ## 13. Da Paz NS, Wallander JL. Interventions that target improvements in mental health for parents of children with autism spectrum disorders: A narrative review. Clin Psychol Rev. 2017;51:1-14. doi: 10.1016/j.cpr.2016.10.006. PubMed PMID: 27816800. ## 14. Pandya SP. Examining the Effectiveness of WhatsApp-Based Spiritual Posts on Mitigating Stress and Building Resilience, Maternal Confidence and Self-efficacy Among Mothers of Children with ASD. J Autism Dev Disord. 2021;51(5):1479-1495. doi:10.1007/s10803-020-04633-x. PubMed PMID: 32734420. ## 15. Brown M, Whiting J, Kahumoku-Fessler E, Witting AB, Jensen J. A Dyadic Model of Stress, Coping, and Marital Satisfaction Among Parents of Children with Autism. Family Relations. 2020;69(1):138-150. doi: 10.1111/fare.12375. ## 16. Sisto A, Vicinanza F, Campanozzi LL, Ricci G, Tartaglini D, Tambone V. Towards a Transversal Definition of Psychological Resilience: A Literature Review. Medicina. 2019;55(11):745. doi: 10.3390/medicina55110745. PubMed PMID: 31744109; PubMed Central PMCID: PMC6915594. ## 17. Khaledinia A, Makvandi B, Asgari P, Pasha R. Comparison of Group Psychotherapy Effectiveness based on Acceptance and Commitment Therapy Matrix with Group Behavioral Activation Therapy on Quality of Life and Alexithymia in Depress Mood Females. Women’s Health Bull. 2021;8(1):26-36. doi: 10.30476/WHB.2021.87951.1082. ## 18. Seligman MEP. Positive Psychology: A Personal History. Annu Rev Clin Psychol. 2019;15:1-23. doi: 10.1146/annurev-clinpsy-050718-095653. PubMed PMID: 30525996. ## 19. Stemmler A, Staehle R, Heinemann T, Bender M, Hennig J. Positive psychology interventions in in-patients with depression: influences of comorbidity and subjective evaluation of the training programme. BJPsych Open. 2021;7(4):e109. doi: 10.1192/bjo.2021.65. PubMed PMID: 34078512; PubMed Central PMCID: PMC8220852. ## 20. Yousefnia Pasha M, Ghorbanshiroudi S, Homayouni A. The Role of Dysfunctional Beliefs and Self-Sacrifice Motivation in Predicting Marital Adjustment of Married Women. Women’s Health Bull. 2021;8(2):107-113. doi: 10.30476/WHB.2021.89993.1105. ## 21. Alipour Z, Kazemi A, Kheirabadi G, Eslami AA. Marital communication skills training to promote marital satisfaction and psychological health during pregnancy: a couple focused approach. Reprod Health. 2020;17(1):23. doi: 10.1186/s12978-020-0877-4. PubMed PMID: 32041615; PubMed Central PMCID: PMC7011212. ## 22. Antoine P, Andreotti E, Congard A. Positive psychology intervention for couples: A pilot study. Stress Health. 2020;36(2):179-190. doi: 10.1002/smi.2925. PubMed PMID: 31943738. ## 23. Verschuur R, Huskens B, Korzilius H, Bakker L, Snijder M, Didden R. Pivotal response treatment: A study into the relationship between therapist characteristics and fidelity of implementation. Autism. 2020;24(2):499-514. doi: 10.1177/1362361319876213. PubMed PMID: 31538812; PubMed Central PMCID: PMC6985992. ## 24. Lei J, Ventola P. Pivotal response treatment for autism spectrum disorder: current perspectives. Neuropsychiatr Dis Treat. 2017;13:1613-1626. doi: 10.2147/NDT.S120710. PubMed PMID: 28790824; PubMed Central PMCID: PMC5488784. ## 25. Smeekens I, Oosterling IJ, den Boer JC, Buitelaar JK, Staal WG, van Dongen‐Boomsma M. Pivotal Response Treatment for autism spectrum disorder (ASD). Cochrane Database Syst Rev. 2017;2017(12):CD012887. doi: 10.1002/14651858.CD012887. PubMed Central PMCID: PMC6486148. ## 26. Popovic SC, Starr EM, Koegel LK. Teaching Initiated Question Asking to Children with Autism Spectrum Disorder Through a Short-Term Parent-Mediated Program. J Autism Dev Disord. 2020;50(10):3728-3738. doi: 10.1007/s10803-020-04426-2. PubMed PMID: 32112233. ## 27. Franke KB, Hills K, Huebner ES, Flory K. Life Satisfaction in Adolescents with Autism Spectrum Disorder. J Autism Dev Disord. 2019;49(3):1205-1218. doi: 10.1007/s10803-018-3822-4. PubMed PMID: 30443699. ## 28. Khoshvaght N, Naderi F, Safarzadeh S, Alizadeh M. Comparison of the Effects of Metacognitive Therapy and Compassion-Focused Therapy on Anxiety in the Mothers of Children with Cerebral Palsy. Women Health Bull. 2021;8(1):1-9. doi: 10.30476/WHB.2020.88585.1087. ## 29. Olson DH, Wilson M. Family satisfaction scale. Minneapolis, MN: Life Innovations; 1995. ## 30. ‏ Mohtashami T, Ebrahimi F, Aliakbari Dehkordi M, Chimeh N. Comparison of Parental Stress, Satisfaction and Family Functioning in Mothers of Children with Autism and Normally-developing Children. JOEC. 2017;16(4):51-62. doi: 20.1001.1.16826612.1395.16.4.6.5. Persian. ## 31. Rashid T. Positive psychotherapy: A strength-based approach. The Journal of Positive Psychology. 2015;10(1):25-40. doi: 10.1080/17439760.2014.920411. ## 32. Minjarez MB, Williams SE, Mercier EM, Hardan AY. Pivotal response group treatment program for parents of children with autism. J Autism Dev Disord. 2011;41(1):92-101. doi: 10.1007/s10803-010-1027-6. PubMed PMID: 20440638. ## 33. Alexander R, Aragón OR, Bookwala J, Cherbuin N, Gatt JM, Kahrilas IJ, et al. The neuroscience of positive emotions and affect: Implications for cultivating happiness and wellbeing. Neurosci Biobehav Rev. 2021;121:220-49. doi: 10.1016/j.neubiorev.2020.12.002. PubMed PMID: 33307046. ## 34. An S, Ji L-J, Marks M, Zhang Z. Two Sides of Emotion: Exploring Positivity and Negativity in Six Basic Emotions across Cultures. Frontiers in Psychology. 2017;8:610. doi: 10.3389/fpsyg.2017.00610. PubMed PMID: 28473791; PubMed Central PMCID: PMC5397534. ##