Abstract
Objectives
Children of parents with mental illness have higher rates of social and emotional difficulties compared to their peers. One factor associated with lower psychological distress and higher well-being is self-compassion. However, the concept of self-compassion has not been explored in the population of children of parents with mental illness. Self-compassion is an attitude toward oneself. It involves non-judgemental openness to one’s own suffering, accompanied by a sense of common humanity and a motivation to alleviate one’s own suffering with kindness. This review scoped qualitative literature regarding children and adult children of parents with mental illness concerning their experiences related to self-compassion.
Methods
This review employed a scoping method to examine the presence of self-compassion in the qualitative literature pertaining to children of parents with mental illness. Peer-reviewed articles published in English after 1990 were eligible. Only those reporting children’s experiences which contained concepts of self-compassion were included. Directed content analysis was employed to characterise self-compassion.
Results
Twenty-seven studies were identified, from 10 countries involving 374 children (6–78 years old, approximately 32% male, 68% female). Although examples of self-compassion were described (kind self-talk, acknowledging difficult emotions and sharing experiences in peer support groups), participants typically described experiences which directly opposed self-compassion. Children of all ages reported being isolated by their experience, ignoring their emotions and engaging in self-judgement and self-blame.
Conclusions
Results indicate the presence of barriers and facilitators of self-compassion for children of parents with mental illness. Implications for clinical practice and suggestions for future research are presented.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Studies included in the scoping review are marked by an (*).
Arksey, H., & O’Malley, L. (2005). Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616.
Assarroudi, A., Armat, M. R., Nabavi, F. H., Ebadi, A., & Vaismoradi, M. (2018). Directed qualitative content analysis: The description and elaboration of its underpinning methods and data analysis process. Journal of Research in Nursing, 23(1), 42–55. https://doi.org/10.1177/1744987117741667.
*Blake-Holmes, K. (2019). Young adult carers: Making choices and managing relationships with a parent with a mental illness. Advances in Mental Health, 1-11. https://doi.org/10.1080/18387357.2019.1636691
*Carroll, L., & Tuason, M. T. G. (2015). ‘Perpetually self-reflective’: Lesbian daughters of mothers with severe mental illness. The Counselling Psychologist, 43(7), 1059-1083. https://doi.org/10.1177/0011000015602316.
Critical Appraisal Skills Program (2018). CASP qualitative checklist. Retrieved from: https://casp-uk.net/wp-content/uploads/2018/01/CASP-Qualitative-Checklist-2018.pdf.
Corrigan, P. W., & Miller, F. E. (2004). Shame, blame, and contamination: A review of the impact of mental illness stigma on family members. Journal of Mental Health, 13(6), 537–548. https://doi.org/10.1080/09638230400017004.
Dam, K., & Hall, E. O. C. (2016). Navigating in an unpredictable daily life: A meta-synthesis on children’s experiences living with a parent with severe mental illness. Scandinavian Journal of Caring Sciences, 30(3), 442–457. https://doi.org/10.1111/scs.12285.
Dean, K., Stevens, H., Mortensen, P. B., Murray, R. M., Walsh, E., & Pedersen, C. B. (2010). Full spectrum of psychiatric outcomes among offspring with parental history of mental disorder. Archives of General Psychiatry, 67, 822–829. https://doi.org/10.1001/archgenpsychiatry.2010.86.
Ferrari, M., Hunt, C., Harrysunker, A., Abbott, M. J., Beath, A. P., & Einstein, D. A. (2019). Self-compassion interventions and psychosocial outcomes: A meta-analysis of rcts. Mindfulness, 10, 1455–1473. https://doi.org/10.1007/s12671-019-01134-6.
*Fjone, H. H., Ytterhus, B., & Almvik, A. (2009). How children with parents suffering from mental health distress search for ‘normality’ and avoid stigma: To be or not to be... is not the question. Childhood, 16(4), 461-477. https://doi.org/10.1177/0907568209343743.
*Foster, K. (2010). ‘You’d think this roller coaster was never going to stop’: Experiences of adult children of parents with serious mental illness. Journal of Clinical Nursing, 19(21-22), 3143-3151. https://doi.org/10.1111/j.1365-2702.2010.03293.x.
Galla, B. M. (2016). Within-person changes in mindfulness and self-compassion predict enhanced emotional well-being in healthy, but stressed adolescents. Journal of Adolescence, 49, 204–217. https://doi.org/10.1016/j.adolescence.2016.03.016.
*Garley, D., Johnston, N., Gallop, R., & Pipitone, J. (1997). Children of the mentally ill: A qualitative focus group approach. Journal of Psychiatric and Mental Health Nursing, 4(2), 97–103. https://doi.org/10.1046/j.1365-2850.1997.00036.x.
Gatt, J. M., Burton, K. L. O., Williams, L. M., & Schofield, P. R. (2015). Specific and common genes implicated across major mental disorders: A review of meta-analysis studies. Journal of Psychiatric Research, 60, 1–13. https://doi.org/10.1016/j.jpsychires.2014.09.014.
Gilbert, P. (2009). Introducing compassion-focused therapy. Advances in Psychiatric Treatment, 15, 199–208. https://doi.org/10.1192/107.005264.
Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clinical Psychology & Psychotherapy, 13, 353–379. https://doi.org/10.1002/cpp.507.
Gladstone, B. M., McKeever, P., Seeman, M., & Boydell, K. M. (2014). Analysis of a support group for children of parents with mental illnesses: Managing stressful situations. Qualitative Health Research, 24(9), 1171–1182. https://doi.org/10.1177/1049732314528068.
Goodyear, M., Hill, T.-L., Allchin, B., McCormick, F., Hine, R., Cuff, R., & O’Hanlon, B. (2015). Standards of practice for the adult mental health workforce: Meeting the needs of families where a parent has a mental illness. International Journal of Mental Health Nursing, 2, 169. https://doi.org/10.1111/inm.12120.
*Griffiths, J., Norris, E., Stallard, P., & Matthews, S. (2012). Living with parents with obsessive–compulsive disorder: Children’s lives and experiences. Psychology and Psychotherapy: Theory, Research and Practice, 85(1), 68-82. https://doi.org/10.1111/j.2044-8341.2011.02016.x.
*Harrison, D., Albanese, P., & Berman, R. (2014). Parent-adolescent relationships in military families affected by post-traumatic stress disorder. Canadian Social Work Review / Revue Canadienne de Service Social, 31(1), 85. Retrieved from www.jstor.org/stable/43486312.
Hinrichs, J., Defife, J., & Westen, D. (2011). Personality subtypes in adolescent and adult children of alcoholics: a two-part study. Journal of Nervous and Mental Disease, 199(7), 487–498. https://doi.org/10.1097/NMD.0b013e3182214268.
Hinshaw, S. P. (2005). The stigmatization of mental illness in children and parents: Developmental issues, family concerns, and research needs. The Journal of Child and Adolescent Psychology and Psychiatry, 46(7), 714–734. https://doi.org/10.1111/j.1469-7610.2005.01456.x.
Hosman, C. M., Van Doesum, K. T., & Van Santvoort, F. (2009). Prevention of emotional problems and psychiatric risks in children of parents with a mental illness in the Netherlands: I. The scientific basis to a comprehensive approach. Australian E-Journal for the Advancement of Mental Health, 8(3), 250–263. https://doi.org/10.5172/jamh.8.3.250.
Iacono, G. (2017). A call for self-compassion in social work education. Journal of Teaching in Social Work, 37(5), 454–476. https://doi.org/10.1080/08841233.2017.1377145.
*Kahl, Y., & Jungbauer, J. (2014). Challenges and coping strategies of children with parents affected by schizophrenia: Results from an in-depth interview study. Child & Adolescent Social Work Journal, 31(2), 181-196. https://doi.org/10.1007/s10560-013-0316-2.
*Knutsson-Medin, L., Edlund, B., & Ramklint, M. (2007). Experiences in a group of grown-up children of mentally ill parents. Journal of Psychiatric & Mental Health Nursing, 14(8), 744-752. https://doi.org/10.1111/j.1365-2850.2007.01181.x.
Korstjens, I., & Moser, A. (2018). Series: Practical guidance to qualitative research. Part 4: Trustworthiness and publishing. The European Journal of General Practice, 24(1), 120–124. https://doi.org/10.1080/13814788.2017.1375092.
MacBeth, A., & Gumley, A. (2012). Exploring compassion: A meta-analysis of the association between self-compassion and psychopathology. Clinical Psychology Review, 32(6), 545–552. https://doi.org/10.1016/j.cpr.2012.06.003.
*Maunu, A., & Stein, C. H. (2010). Coping with the personal loss of having a parent with mental illness: Young adults’ narrative accounts of spiritual struggle and strength. Journal of Community Psychology, 38(5), 645–655. https://doi.org/10.1002/jcop.20385.
Maybery, D. J., Reupert, A. E., Patrick, K., Goodyear, M., & Crase, L. (2009). Prevalence of parental mental illness in Australian families. Psychiatric Bulletin, 33(1), 22–26. https://doi.org/10.1192/pb.bp.107.018861.
*McCormack, L., & Devine, W. (2016). Childhood and the imposition of war: Self-blame, absolution/nonabsolution, and vicarious growth in adult children of Vietnam veterans. Traumatology, 22(4), 278–287. https://doi.org/10.1037/trm0000097.
*McCormack, L., & Sly, R. (2013). Distress and growth: The subjective “lived” experiences of being the child of a Vietnam veteran. Traumatology, 19(4), 303–312. https://doi.org/10.1177/1534765613481855.
*McCormack, L., White, S., & Cuenca, J. (2016). A fractured journey of growth: Making meaning of a ‘broken’ childhood and parental mental ill-health. Community, Work & Family, 20, 1-19. https://doi.org/10.1080/13668803.2015.1117418.
*Meadus, R. J., & Johnson, B. (2000). The experience of being an adolescent child of a parent who has a mood disorder. Journal of Psychiatric & Mental Health Nursing, 7(5), 383-390. https://doi.org/10.1046/j.1365-2850.2000.00319.x.
*Metz, D., & Jungbauer, J. (2019). “My Scars Remain Forever”: A qualitative study on biographical developments in adult children of parents with mental illness. Clinical Social Work Journal. https://doi.org/10.1007/s10615-019-00722-2.
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6(7), e1000097. https://doi.org/10.1371/journal.pmed1000097.
*Mordoch, E. (2010). How children understand parental mental illness: ‘You don’t get life insurance. What’s life insurance?’. Journal of the Canadian Academy of Child and Adolescent Psychiatry / Journal de l’Académie canadienne de psychiatrie de l’enfant et de l’adolescent, 19(1), 19-25. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2809442/.
*Mordoch, E., & Hall, W. A. (2008). Children’s perceptions of living with a parent with a mental illness: Finding the rhythm and maintaining the frame. Qualitative Health Research, 18(8), 1127-1144. https://doi.org/10.1177/1049732308320775.
Mowbray, C. T., Bybee, D., Oyserman, D., MacFarlane, P., & Bowersox, N. (2006). Psychosocial outcomes for adult children of parents with severe mental illnesses: Demographic and clinical history predictors. Health & Social Work, 31(2), 99–108. https://doi.org/10.1093/hsw/31.2.99.
Murphy, G., Peters, K., Jackson, D., & Wilkes, L. (2011). A qualitative meta-synthesis of adult children of parents with a mental illness. Journal of Clinical Nursing, 20(23-24), 3430–3442. https://doi.org/10.1111/j.1365-2702.2010.03651.x.
*Murphy, G., Peters, K., Jackson, D., & Wilkes, L. (2015). Childhood parental mental illness: Living with fear and mistrust. Issues in Mental Health Nursing, 36(4), 294-299. https://doi.org/10.3109/01612840.2014.971385.
*Murphy, G., Peters, K., Wilkes, L. M., & Jackson, D. (2016). Adult children of parents with mental illness: Losing oneself. Who am I? Issues in Mental Health Nursing, 37(9), 668-673. https://doi.org/10.1080/01612840.2016.1178359.
*Murphy, G., Peters, K., Wilkes, L. M., & Jackson, D. (2017). Adult children of parents with mental illness: Navigating stigma. Child and Family Social Work, 22(1), 330-338. https://doi.org/10.1111/cfs.12246.
Neff, K. D. (2003a). Development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250. https://doi.org/10.1080/15298860390209035.
Neff, K. D. (2003b). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2(2), 85–101. https://doi.org/10.1080/15298860390129863.
Neff, K. D., & McGehee, P. (2009). Self-compassion and psychological resilience among adolescents and young adults. Self and Identity, 9(3), 225–240. https://doi.org/10.1080/15298860902979307.
Neff, K. D., Tóth-Király, I., & Colosimo, K. (2018). Self-compassion is best measured as a global construct and is overlapping with but distinct from neuroticism: A response to Pfattheicher, Geiger, Hartung, Weiss, and Schindler (2017). European Journal of Personality, 32(4), 371–392. https://doi.org/10.1002/per.2148.
Newton, B. J., Rothlingova, Z., Gutteridge, R., LeMarchand, K., & Raphael, J. H. (2012). No room for reflexivity? Critical reflections following a systematic review of qualitative research. Journal of Health Psychology, 17(6), 866–885. https://doi.org/10.1177/1359105311427615.
*Oskouie, F., Zeighami, R., & Joolaee, S. (2011). Outcomes of parental mental illness on children: A qualitative study from Iran. Journal of Psychosocial Nursing and Mental Health Services, 49(9), 32-40. https://doi.org/10.3928/02793695-20110802-06.
*Östman, M. (2008). Interviews with children of persons with a severe mental illness—Investigating their everyday situation. Nordic Journal of Psychiatry, 62(5), 354-359. https://doi.org/10.1080/08039480801960065.
Ouzzani, M., Hammady, H., Fedorowicz, Z., & Elmagarmid, A. (2016). Rayyan — A web and mobile app for systematic reviews. Systematic Reviews, 5, 210. https://doi.org/10.1186/s13643-016-0384-4.
*Patrick, P. M., Reupert, A. E., & McLean, L. A. (2019). We are more than our parents’ mental illness”: Narratives from adult children. International Journal of Environmental Research and Public Health, 16(5), 839. https://doi.org/10.3390/ijerph16050839.
Perera, D. N., Short, L., & Fernbacher, S. (2014). ‘It’s not that straightforward’: When family support is challenging for mothers living with mental illness. Psychiatric Rehabilitation Journal, 37, 170–175. https://doi.org/10.1037/prj0000074.
*Petrowski, C., & Stein, C. (2016). Young women’s accounts of caregiving, family relationships, and personal growth when mother has mental illness. Journal of Child and Family Studies, 25(9), 2873-2884. https://doi.org/10.1007/s10826-016-0441-6.
*Pölkki, P., Ervast, A. S. E., & Huupponen, M. (2004). Coping and resilience of children of a mentally ill parent. Social Work in Health Care, 39(1), 151-163. https://doi.org/10.1300/J010v39n01_10.
Rasic, D., Hajek, T., Alda, M., & Uher, R. (2014). Risk of mental illness in offspring of parents with schizophrenia, bipolar disorder, and major depressive disorder: A meta-analysis of family high-risk studies. Schizophrenia Bulletin, 40(1), 28–38. https://doi.org/10.1093/schbul/sbt114.
Reupert, A., & Maybery, D. (2007). Families affected by parental mental illness: A multiperspective account of issues and interventions. American Journal of Orthopsychiatry, 77(3), 362–369. https://doi.org/10.1037/0002-9432.77.3.362.
Reupert, A., & Maybery, D. (2016). What do we know about families where parents have a mental illness? A systematic review. Child and Youth Services, 37(2). https://doi.org/10.1080/0145935X.2016.1104037.
Reupert, A. E., Cuff, R., Drost, L., Foster, K., van Doesum, K. T. M., & van Santvoort, F. (2013). Intervention programs for children whose parents have a mental illness: A review. The Medical Journal of Australia, 199(3), 18–22. https://doi.org/10.5694/mja11.11145.
Reupert, A., Maybery, D., Nicholson, J., Goepfert, M., & Seeman, M. (2015). Parental psychiatric disorder: Distressed parents and their families. London: Cambridge University Press.
*Riebschleger, J. (2004). Good days and bad days: The experiences of children of a parent with a psychiatric disability. Psychiatric Rehabilitation Journal, 28(1), 25-31. https://doi.org/10.2975/28.2004.25.31.
Riebschleger, J., Freddolino, P., Kanaga, B., & Miller, J. (1993). Invisible people: Children of parents with mental illness. Paper presented at the National Association of State Mental Health Program Directors Research Institute Inc., Annapolis, MD.
Robinson, S., Hastings, R. P., Weiss, J. A., Pagavathsing, J., & Lunsky, Y. (2017). Self-compassion and psychological distress in parents of young people and adults with intellectual and developmental disabilities. Journal of Applied Research in Intellectual Disabilities, 31(3), 454–458. https://doi.org/10.1111/jar.12423.
Smith, J. A., & Osborn, M. (2015). Interpretative phenomenological analysis as a useful methodology for research on the lived experience of pain. British Journal of Pain, 9(1), 41–42. https://doi.org/10.1177/2049463714541642.
Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Change, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., et al. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 169, 467–473. https://doi.org/10.7326/M18-0850.
*Trondsen, M. V. (2012). Living with a mentally ill parent: Exploring adolescents’ experiences and perspectives. Qualitative Health Research, 22(2), 174-188. https://doi.org/10.1177/1049732311420736.
*Valdez, C. R., Raines, C. R., Davies, K. D., & D’Costa, S. (2019). Latina/o children living with an immigrant mother with depression: Developmental and cultural nuances in recognition and coping. Family Process, 58(4), 986–1002. https://doi.org/10.1111/famp.12398.
*Valiakalayil, A., Paulson, L. A., & Tibbo, P. (2004). Burden in adolescent children of parents with schizophrenia: The Edmonton high risk project. Social Psychiatry & Psychiatric Epidemiology, 39(7), 528–535. https://doi.org/10.1007/s00127-004-0778-9.
*van Parys, H., & Rober, P. (2013). Trying to comfort the parent: A qualitative study of children dealing with parental depression. Journal of Marital and Family Therapy, 39(3), 330-345. https://doi.org/10.1111/j.1752-0606.2012.00304.x.
Yoshikawa, H., Aber, J. L., & Beardslee, W. R. (2012). The effects of poverty on the mental, emotional, and behavioural health of children and youth. American Psychologist, 67(4), 272–284. https://doi.org/10.1037/a0028015.
Zessin, U., Dickhäuser, O., & Garbade, S. (2015). The relationship between self-compassion and well-being: A meta-analysis. Applied Psychology. Health and Well-Being, 7(3), 340–364. https://doi.org/10.1111/aphw.12051.
Author information
Authors and Affiliations
Contributions
A.D.S: conducted the literature search, scoping review, content analysis and wrote the manuscript; J.S. and A.R.: assisted with scoping review, content analysis and writing of manuscript; M.L.: assisted with scoping review and critically reviewed the manuscript. All authors approved the final version of the manuscript for submission.
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflicts of interest.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
ESM 1
(DOCX 16 kb)
Rights and permissions
About this article
Cite this article
Dunkley-Smith, A.J., Sheen, J.A., Ling, M. et al. A Scoping Review of Self-compassion in Qualitative Studies About Children’s Experiences of Parental Mental Illness. Mindfulness 12, 815–830 (2021). https://doi.org/10.1007/s12671-020-01560-x
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12671-020-01560-x