The Effect of Filial Therapy on Depressive Symptoms of Children with Cancer and Their Mother’s Depression, Anxiety, and Stress: A Randomized Controlled Trial

Abstract

Background: Childhood cancer is an overwhelming life event that can completely change the lives of the sufferers and their parents. Todays, advances of medical science have shifted the fetal nature of childhood cancer to chronic one exposing children and their family to behavioral and psychosocial problems. The aim of this study was to investigate the effect of filial therapy on children's depressive symptoms and their mother's stress, anxiety, and depression. Materials and Methods: In this randomized controlled trial, 32 mothers with their children who suffered from cancer were recruited (16 in each group). During a 10-week training sessions, filial therapy group underwent child-parent relation therapy (CPRT). Training sessions were held once a week. Control group received no training and only individual counseling sessions were held for them we needed. Both groups were assessed before and after the intervention using depression, anxiety, and stress questionnaire-21 (DASS-21), children depression inventory (CDI), and Wong-Baker faces pain rating scale (WBFPRS). Sample randomization and data analysis were conducted by using SPSS (version 20) and running independent t-test and chi-square test. P value< 0.05 was set as the significant level. Results: Mothers in the filial therapy group experienced significant decrease in their level of depression, anxiety, and stress in the posttest (p < 0.001). In contrast to filial therapy group, mothers in the control group did not show an improvement in their level of depression, anxiety, and stress. Moreover, the results of the current investigative showed that depression of children in the filial therapy group significantly reduced at post-test (p < 0.001). On the other hand, the mean of children's depression in the control group remained steady. Conclusion: The findings of the present study revealed that using filial therapy could reduce the depression of children with cancer and their parent's depression, anxiety, and stress. Accordingly, we suggest filial therapy programs as a routine for addressing psychosocial problems of children with cancer and their families.

Couple and family interventions for depressive and bipolar disorders: Evidence base update (2010–2019)

“…Four studies compared the experimental condition to individual psychotherapy. In three of these studies, the family intervention was significantly better than individual psychotherapy at reducing depressive symptoms (Dietz et al, 2015; Ebrahimi et al, 2019; Spirito et al, et al, 2015); in the remaining study, both conditions improved symptoms but no group differences were found (Tompson et al, 2017). Three studies compared the experimental condition to treatment as usual or enhanced treatment as usual; one of the studies found that the experimental group was significantly better than treatment as usual at reducing symptoms (Israel & Diamond, 2013).…”

“…Control conditions in the studies on family interventions for depression included individual therapy modalities ( n = 4; Dietz et al, 2015; Ebrahimi et al, 2019; Spirito et al, 2015; Tompson et al, 2017), parenting groups ( n = 2; Luby et al, 2012; Poole et al, 2018), enhanced treatment as usual or treatment as usual ( n = 3; Diamond et al, 2010; Israel & Diamond, 2013; Esposito‐Smythers et al, 2019), family‐enhanced non‐directive supportive therapy ( n = 1; Diamond et al, 2019), waitlist ( n = 1; Luby et al, 2018), and placebo ( n = 1; Fristad et a., 2019).…”

“…Play‐based family interventions meet the criteria for classification as an experimental intervention for depression in early to middle childhood (3–12 years). This is based on findings from one small study on Filial Therapy (Ebrahimi et al, 2019).…”

“The effects of family therapeutic interventions on mental health and quality of life of children with cancer: A systematic review”

“…In Wilford et al (2020), the combination of TCM and peer support-based health promotion improved parent emotional distress, social support, and sleep disturbances and children’s physical activity, cognitive outcomes, and QoL. The filial therapy used in Ebrahimi et al (2019), was beneficial for depression, anxiety, and stress experienced by mothers, but also depressive symptoms experienced by children. In Shoshani et al (2016), fulfillment of the child’s greater wish reduced distress, depression, and anxiety symptoms and improved HRQoL and hope.…”

The effect of filial therapy on the interaction of deaf mothers with their hearing children.

“…The results of Ashori and Karimnezhad (2019) revealed that play therapy training with FT model had a significant effect on the behavioral problems of children and resilience of deaf mothers. Ebrahimi et al (2019) concluded that using FT could reduce the anxiety, depression, and stress in parent of children with cancer. The findings of Mirzaie et al (2019) revealed that FT could improve the attention and hyperactivity of children with attention deficit hyperactivity disorder.…”