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Advances in Social Sciences Research Journal – Vol.7, No.8

Publication Date: August 25, 2020

DOI:10.14738/assrj.77.8821.

Abramovski, G. (2020). Factors Affecting Mothers' Satisfaction With Expressive And Creative Therapy Provided To Adolescents With

Learning Disabilities: Self-Efficacy, Stress And Duration Of Therapy. Advances in Social Sciences Research Journal, 7(8) 202-217.

Factors Affecting Mothers' Satisfaction With Expressive And Creative

Therapy Provided To Adolescents With Learning Disabilities: Self- Efficacy, Stress And Duration Of Therapy

Gal Abramovski

Doctoral School of Psychology,

Department of Psychology and Education,

Alexandru Ioan Cuza University, Romania.

ABSTRACT

In view of the paucity of evidence on satisfaction with expressive and

creative therapy among mothers to adolescents with learning disability

in the context of special education schools, the present study examined

the relationship between mothers' satisfaction with therapy and two

psychological measures – self-efficacy and stress. Satisfaction was also

examined in relation to duration of therapy. The sample comprised 54

mothers to adolescents with LD who were in therapy for at least one

year. Data was collected via five structured questionnaires. The findings

reveal that satisfaction with therapy in general was positively related to

mothers' self-efficacy and negatively related to level of stress, whereas

perceived effectiveness of therapy was not related to the two

psychological measures. Duration of therapy, on the other hand, was

positively related to perceived effectiveness of therapy but not related

to satisfaction with therapy in general. The theoretical implications of

the results and their practical implications for expressive and creative

therapy within schools are discussed.

Keywords: Expressive and creative therapy, Special Education, parental self- efficacy, parental stress, duration of therapy, adolescents, school children,

learning disabilities.

INTRODUCTION

Expressive and creative therapy (E.C.T) is a therapeutic technique that began to develop in the

1940s. This therapeutic domain encompasses a variety of artistic specialties: art therapy, music

therapy, drama therapy, movement therapy, psychodrama and bibliotherapy. Similar to any other

mental therapy, the main purpose of the therapy is to improve the client’s emotional, physical and

functional state. Expressive and creative therapy (E.C.T) is utilised directly as a healing expressive

tool and indirectly combines use of psychotherapeutic tools (Malchiodi, 2012; McNiff, 1992). Use of

expressive tools enables the client to connect experiences in the internal world to those in the

external world, experiences that often cannot be expressed in words.

The therapy uses the language of art, which serves as a tool for growth, personal progress, and

further on insights (Amir & Or, 2005; Case & Dalley, 2014). E.C.T is common at present in a wide

range of settings, from pre-schools and primary schools to hospitals and mental health centres, and

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URL: http://dx.doi.org/10.14738/assrj.78.8821 203

Abramovski, G. (2020). Factors Affecting Mothers' Satisfaction With Expressive And Creative Therapy Provided To Adolescents With Learning Disabilities:

Self-Efficacy, Stress And Duration Of Therapy. Advances in Social Sciences Research Journal, 7(8) 202-217.

is applied as a therapeutic and diagnostic tool (Malchiodi, 2003). E.C.T is recommended for a variety

of populations: both those who find it hard to express their feelings verbally and those with good

verbal skills. The expressive therapeutic process bypasses the need for words and facilitates many

insights (Rubin, 2016).

Due to the uniqueness of expressive and creative therapy (E.C.T), in recent decades efforts have

been made to integrate it in a variety of educational settings. Children and adolescents coping with

emotional and academic difficulties experience their world as one that suffers from a lack of order

and organisation. As a result, their ability to express their experiences in words is diminished. E.C.T

utilises additional communication and visual channels that can help them express their feelings

(Safran, 2002). Educational systems around the world have identified the significance and range of

benefits that E.C.T brings to the educational space and various schools have begun to use therapy

as another support tool (Cortina & Fazel, 2015; Snir & Regev, 2018). E.C.T in the school lets school

children with a variety of emotional, academic and functional difficulties connect with their creative

side and express their experiences and difficulties in a different way, as not enabled by any other

therapeutic process. The therapeutic interventions provide a response to emotional and academic

needs aimed at support, rehabilitation and hope, by means of the creative tool (Abramovski & Fogel

Simhony, 2019).

Within the school expanse, understanding and awareness of the significance of including parents in

the therapeutic process have increased in recent years (Ishai-Karin, 2004). Parent attitudes to their

child’s treatment are directly related to their parental attitude, both at the basis of their self-concept

as meaningful and main figures and consequently in the implications regarding their involvement

in therapy (Abramovski, 2020; Oren, 2012). The parents’ encounter with special education settings

is complex and encompasses many varied difficulties. As a result, the emphasis on the encounter

between the parent and adolescents on one hand and the educational therapeutic elements on the

other has been expanded (Ishai-Karin, 2004; Greenbank, 2016). When a pupil is placed in special

education, the parents naturally bear a sense of guilt about his or her condition. Sometimes others

in the parents’ environment also create guilt feelings and thus increase the parents’ distress (Hagai

& Hagai, 2014).

Parents’ satisfaction with their children’s school-based therapy depends on a variety of factors: the

child’s (client) features, the therapeutic method, the therapist’s features and the parents’ features.

The current study focuses on two parent features: one is cognitive – parental efficacy, and the other

mental – level of stress. In the following part these two topics shall be reviewed.

Parental Efficacy

Perceived self-efficacy refers to belief in one's ability to successfully perform a certain task. Parents'

belief in their self-efficacy is their perceived ability to fulfil their role and confidence in performing

parental tasks. High self-efficacy regarding spousal relations and parenting was found associated,

respectively, with better adjustment to parenting and with the quality of the parent's functioning in

the family (Bandura et al., 2011). According to the basic principles of Bandura's self-efficacy theory,

the parent's self-efficacy includes the parent's knowledge of child rearing as well as the parent's

confidence in his ability to maintain the behaviour expected of him or her (Bandura, 1977). Parents’

coping with raising children with special needs is a process that requires a dialogue between the

parents’ abilities, conduct and recognition between the internal and external powers.

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The parents have a need to constantly reduce and expand their resources according to the

requirements and situations with which they must contend (Al-Kandari, 2005). Parental efficacy is

a developmental, acquired and gradual process whereby any mission, challenge or fault in their

parenting can contribute considerably to shaping their level of efficacy. The parent’s encounter with

adolescents who has learning disabilities and emotional difficulties might generate an experience

of failure with regard to parenting.

A parent’s encounter with an adolescent who has learning disabilities can shape the parent’s

efficacy either positively or negatively (Oren, 2012). Past experience with the therapeutic field has

a considerable impact on parental efficacy. Positive past experiences associated with success raise

parental efficacy and future expectations of therapy and of the therapist (Hoffman, 1984; Sutton &

Hughes, 2005). In contrast, a succession of failures resulting from the encounter with the

therapeutic world can reduce the parent’s level of self-efficacy (Bandura, 1993).

Parental Stress

The medical term "stress" was coined by the endocrinologist Selye (1955, 1976). He claimed that a

strain is formed between external situations and demands (pressure) and physical processes

(tension). The parameters for assessing pressure and tension are based on the medical research

approaches in the fields of physiology and psychobiology. The psychological theory surrounding

stress was defined earlier by Lazarus (1966). He coined two major psychological variables:

appraisal: i.e., one's ability to give meaning to an event experienced, and coping: the effort one puts

into thinking or acting in order to deal with what is expected of him in an event. The most common

definition of stress over the years refers to the result of an interaction between people and their

environment when coping resources required are beyond those at their disposal (Lazarus, 1990).

With regard to parental stress, the prevalent definition at present relates to the difficulty stemming

from the requirements involved in being a parent (Anthony et al., 2005).

Any factor that leads to change in the balance within the family system might generate stress. When

the complexity of the difficulty involved in being a parent is joined by the parameter of the birth of

a child with special needs, the stress level might rise significantly. Degree of stress is assessed by

the degree of threat brought to bear on the family (McCubbin, 1993). Measures of parental stress

were examined with a variety of parents who have children with special needs (autism, cognitive

difficulties and so on). Notably, each child is characterised by a different impairment directly related

to his or her disability, and these have a direct relationship to intensifying parents’ stress levels

(Esdaile & Greenwood, 2003). In addition, it should be noted that external variables, i.e., cooperation

with professionals and social support, have an impact on the level of stress (Scorgie et al., 1998).

Satisfaction With Therapy

In recent decades new trends are apparent in the health field, trends that focus on consumers’ point

of view and emphasise the significance of client satisfaction measures. These measures help shape

the decision making of health suppliers (Kessler & Mroczek, 1995). There is almost no measuring

of client (patient and family) satisfaction with mental health services, both in public systems and in

private systems. Measuring consumer satisfaction is inexpensive, efficient, and usually provides a

real good quality reflection of the service provider (Edlund et al., 2003). Mental health consumers

are vague and disagreed as to the significance and meaning of satisfaction. The question is to what

degree is satisfaction with treatment directly related to changes in clients’ clinical symptoms or