Service Delivery

The role of parental and extrafamilial social support in the psychosocial adjustment of children with a chronically ill father.

Kotchick et al. (1997) · Behavior modification 1997
★ The Verdict

More parent and community support equals fewer stress symptoms in kids living with a chronically ill father.

✓ Read this if BCBAs writing home programs for families facing long-term parental illness.
✗ Skip if Clinicians who only treat in clinics without family contact.

01Research in Context

01

What this study did

The team asked the kids, about life while Dad had a long-term illness.

They used simple rating sheets to measure three things: illness stress, support from parents and others, and the child’s own sadness or worry.

Most kids lived with both parents; moms usually gave the most help.

02

What they found

Kids who felt lots of support had fewer stomach-aches, sad moods, and school worries, even when illness stress was high.

Support from Mom and from people outside the family worked like a shock absorber.

Without that cushion, stress leaked straight into the child’s mood.

03

How this fits with other research

Wilkinson et al. (1998) saw the same buffer in Smith-Magenis families: more family friends meant lower parent stress.

Giofrè et al. (2014) widened the lens to any disability home and still found high support plus low money trouble predicted better family life.

Chaki et al. (2025) moved the buffer one generation up: Bedouin grandmas’ emotional help lifted moms’ mood and then the child’s daily skills.

Together the four studies draw a clear line—outside hands steady the whole family when chronic stress hits.

04

Why it matters

You can’t cure Dad’s illness, but you can map who backs the child.

Add one question to your intake: “Name three people you can text when sad.”

If the list is short, link the family to aunties, uncles, parent groups, or church clubs before behavior plans stall.

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→ Action — try this Monday

Ask the child to list trusted adults, then schedule one new weekly contact from that list.

02At a glance

Intervention
not applicable
Design
other
Sample size
53
Population
not specified
Finding
positive

03Original abstract

The relationships among illness stress, perceived support, and child psychosocial adjustment were examined for children living with a chronically ill father. Participants included fathers, mothers, and one child from 53 families in which the father had hemophilia and, in some cases, was HIV seropositive. Objective indicators of severity of illness and subjective measures of the physical and psychological impact of illness were used as sources of children's stress. Results indicated that the impact of illness, but not the severity of illness itself, related to child psychosocial adjustment. Main effects were observed for parental support on child- and parent-reported internalizing problems and stress-buffering effects were obtained for parental support and extrafamilial support on parent-reported internalizing problems. Parental support also demonstrated a stress-buffering effect for child-reported depression. Assessment and intervention implications for behavioral clinicians and researchers are discussed.

Behavior modification, 1997 · doi:10.1177/01454455970214002