Intrapersonal and Interpersonal Outcomes of Multiple Family Narrative Therapy for Chinese Families of Children with Dyslexia

Introduction. Dyslexia is a common learning disorder that significantly impacts on family functioning and child development. Despite the availability of educational interventions, Chinese families of children with dyslexia (CFCD) continue to experience difficulties in handling negative emotions and parent-child dyadic interactions associated with specific disabilities. Most of the interventions take place at schools focus on children with dyslexia in isolation, with less consideration of the interrelated family systems children are immersed in and the impact of parental distress and family tensions on child functioning. The present study examines the effectiveness of Multiple Family Narrative Therapy (MFNT), a novel family-based intervention that combines narrative therapy and multiple family therapy, in addressing invisible impacts of dyslexia on CFCD at intrapersonal and interpersonal levels.

Methods. A multi-site randomized controlled trial was undertaken with N = 54 CFCD with primary school age children in Hong Kong recruited through referrals from schools and non-government organizations. For the treatment group (n = 31), data were collected at baseline/pre-intervention (T1), post-intervention (T2), and at 3-month follow-up; for the waitlist control group (n = 23), data were collected at baseline (T1), pre-intervention (T2), post-intervention, and 3-month follow-up. While participants in the treatment group received immediate intervention, participants in the waitlist control group received intervention after the completion of T2 data collection. Intrapersonal impacts were measured by Kessler Psychological Distress Scale; and interpersonal impacts were measured by Parent-Child Relationship Scale and Parental Bonding Inventory. A series of 2 × 2 mixed design ANOVA was conducted to evaluate the intrapersonal and interpersonal outcomes of MFNT. Paired-sample t-tests were then used to examine the sustainability of MFNT.

Results. Compared to the waitlist control group, parents in the treatment group experienced a significant reduction in psychological distress (Cohen’s d = 1.24), while no significant improvement in ratings of parent-child relationship for both groups. Conversely, children in both groups reported no significant reduction in their psychological distress but children in the treatment group demonstrated significant drops in their ratings of parental overprotection (Cohen’s d = 0.84) and indifference (Cohen’s d = 0.68). The effects for parents’ psychological distress and parental overprotection were sustained at 3-month follow-up.

Conclusions. The present study was one of the first attempts to explore the effectiveness of MFNT. Our results suggested that MFNT has differential effects on parents and children at intrapersonal and interpersonal level, specifically a beneficial effect in psychological distress among parents and perceived parental bonding among children. Such a non-alignment in parent-child perspectives highlights the importance of considering multi-informant perspectives and the inclusion of children’s voice in evaluating the outcomes of family-based intervention, especially when the intervention takes place at their schools. Take Hong Kong as an example, MFNT recognizes the impact of disempowering dominant discourses prevalent in society, particularly in relation to academic excellence, diagnostic culture, stigmatization and expectation of parental involvement in education. By countering these oppressive narratives and promoting positive collective narratives about children with dyslexia, MFNT offers a promising approach to alleviate parental psychological burden and enhance the parent-child bond.