The number of children diagnosed in the U. S. with autism spectrum disorder (1 in 31),[i] disabilities, mental health conditions,[ii] and chronic illnesses continues to rise. According to the Centers for Disease Control and Prevention (CDC) and the U.S. Census Bureau, currently 17.8% of U.S. children (13 million) are diagnosed with a developmental disability, and 20% of U.S. households are caring for a child with special health care needs.[iii]
Parents caring for children with chronic illnesses or disabilities experience additional and significantly more intense daily stressors than parents of children without additional needs.[iv] Chronic grief, social isolation, complex problems, and financial weight pile up, doubling the risk for these parents experiencing mental health conditions and spiritual struggles.[v] They face a one-in-three risk for developing clinical anxiety and depression[vi] and a 20% chance of suffering from posttraumatic stress disorder (PTSD).[vii]
The Skyrocketing Counseling Needs of These Parents
With the increasing number of strained parents, the need for counseling is growing. However, many caregivers don’t realize the risks to their mental health or are unwilling to seek professional treatment due to societal stigma, especially within the Christian faith community. They are also often hesitant to seek support from a therapist or pastoral counselor due to legitimate fears—that the counselor won’t be empathic about their experience, understanding of their extenuating circumstances, or knowledgeable about how to best support their unique needs.
For example, a mother riding in an ambulance rushing her daughter to the hospital called to tell her new therapist that she would not be able to come to her scheduled appointment that afternoon. The therapist replied to the mother that she intended to bill her the full amount for the session. The mother did not return for therapy.
The Unique and Additional Considerations
If a special needs parent does present for counseling, they are likely doing well to even make it to your office on a given week. These parents have to overcome multiple logistical hurdles such as balancing limited financial resources due to loss of work and added bills; finding specialized childcare; and juggling their child’s schedule of doctors and therapy appointments. And urgent situations due often arise, and they may need to cancel last minute.
Along with these special considerations, parents caring for children with additional needs all present with three common challenges and counseling needs. Let’s look at the three issues and ways you can effectively support these clients:
1. The Need to Practice Stress-Reduction Skills
To calm the body’s chronic stress response, special needs parents must use additional coping skills and use them more often than average parents.
Engaging in physical activity, organizing, and getting adequate sleep are all helpful in lowering stress levels. In addition, mindfulness practices have been shown to be especially effective for parent caregivers in reducing stress, anxiety, depression, and difficulties adjusting.[viii]
You can support parents by:
- Practicing mindfulness and deep breathing exercises during sessions
- Guiding clients in Mindfulness-Based Stress Reduction (MBSR) exercises such as body scans and progressive muscle relaxation meditations
- Discussing simple ways to practice self-care
- Helping parents plan a respite break
2. The Need to Process Chronic Grief
Special needs parents experience a unique, ongoing, and complex grief process, distinct from the classic five stages of grief.[ix]
As opposed to going through stages, special needs parents move through different states of grief and lifelong chronic sorrow. Different painful emotions can come in waves, especially with new milestones or life stages, on birthdays, or with worsening of their child’s illness or development.
Many special needs parents experience difficulty managing grief due to not understanding the process, believing their thoughts and feelings are atypical or wrong, or experiencing guilt and shame about their feelings of loss, anger, and sadness. This can lead to mental health symptoms and spiritual struggles.
Two important therapeutic goals may be learning to manage grief in healthy ways and working toward practicing acceptance.
You can support parents by:
- Normalizing their grief experience and helping them understand their unique process
- Guiding them in identifying their grief triggers, naming and validating their emotions, and grieving their loss
- Helping them process their spiritual struggles and grow closer to God through their emotional pain
- Practicing acceptance exercises such as an acceptance gaze
3. The Need to Find Social Support
Social support has been shown to be a major factor in helping special needs parents become more resilient by reducing stress levels, facilitating grief processing, improving coping, and bettering mental health.[x]
Yet, many special needs parents experience isolation, and obstacles get in the way of them being able to attend church, join a support group, or even spend time with other parents.
You can support parents by:
- Helping them address their hesitations and fears about reaching out and connecting with others
- Brainstorming how to overcome practical barriers to finding support
- Providing a list of resources of local and virtual support groups
- Offering a support group or therapy group for parent caregivers
Helping your clients develop effective stress management skills, process grief, and find social support are three of the best ways you can effectively assist special needs parents. Above all, caregiving parents need a safe place where they feel heard, supported, and cared for throughout their difficult parenting journey.
What approach have you found works well when counseling special needs parents?
Kristin Faith Evans, MA, MS, LMSW is an award-winning author, national speaker, licensed master social worker, and a special needs mom. She is passionate about empowering parents with the skills to thrive in their faith, mental health, and marriage, as well as equipping the professionals and ministry leaders who support parent caregivers. Kristin and her husband wrote their multi award-winning book, How to Build a Thriving Marriage as You Care for Children with Disabilities. Kristin has been featured on over thirty-five radio and podcast shows and published in magazines such as Focus on the Family, Exceptional Needs Today, and Christian Counseling Connection. She is experienced in couples, child and family, substance abuse, and crisis interventions, as well as church and retreat ministries. She enjoys a cup (or two) of Italian roast, dark chocolate, traveling, and authentic conversations with friends. Kristin lives with her fun-loving husband, Todd, and their two children in the suburbs of Nashville.
Notes
[i] Centers for Disease Control and Prevention. (2025, May 27). Data and statistics on autism spectrum disorder. https://www.cdc.gov/autism/data-research/index.html
[ii] Alberto, C., Minnaert, J., Donney, J., Lebrun-Harris, L., & Ghandour, R. (2024, October). National survey of children’s health adolescent mental and behavioral health. HRSA Maternal and Child Health. https://mchb.hrsa.gov/sites/default/files/mchb/data-research/nsch-data-brief-adolescent-mental-behavioral-health-2023.pdf
National Institute of Health. (2022). 2022 National healthcare quality and disparities report. National Center for Biotechnology Information, National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK587174/
[iii] The Centers for Disease Control and Prevention. (2025, June). Developmental disability basics. https://www.cdc.gov/child-development/about/developmental-disability-basics.html?CDC_AAref_Val=
Health Resources & Services Administration. (last reviewed October 2021). Chartbooks: National survey of children’s health (NSCH) and national survey of children with special health care needs. Maternal and Child Health. https://mchb.hrsa.gov/chscn/pages/prevalence.htm
[iv] Bergman, T. H., Renhorn, E., Berg, B., Lappalainen, P., Ghaderi, A., & Hirvikoski, T. (2023). Acceptance and commitment therapy group intervention for parents of children with disabilities (Navigator ACT): An open feasibility trial. Journal of Autism and Developmental Disorders, 53(5), 1834-1849. https://doi.org/10.1007/s10803-022-05490-6
Peer, J. W., & Hillman, S. B. (2014). Stress and resilience for parents of children with intellectual and developmental disabilities: A review of key factors and recommendations for practitioners. Journal of Policy and Practice in Intellectual Disabilities, 11(2), 92-98. https://doi.org/10.1111/jppi.12072
[v] Scherer, N., Verhey, I., & Kuper, H. (2019). Depression and anxiety in parents of children with intellectual and developmental disabilities: A systematic review and meta-analysis. PLoS One, 14(7), 12. https://doi.org/10.1371/journal.pone.0219888
Brehaut, J. C., Guèvremont, A., Arim, R. G., Garner, R. E., Miller, A. R., McGrail, K. M., Brownell, M., Lach, L. M., Rosenbaum, P. L., & Kohen, D. E. (2019). Using Canadian administrative health data to examine the health of caregivers of children with and without health problems: A demonstration of feasibility. International Journal of Population Data Science, 4(1), 1-10. https://doi.org/10.23889/ijpds.v4i1.584
Smith, A. M., & Joseph G. Grzywacz. (2014). Health and well-being in midlife parents of children with special health needs. Family, Systems, & Health, 32(3), 303-312. https://doi.org/10.1037/fsh0000049
[vi] Scherer, N., Verhey, I., & Kuper, H. (2019). Depression and anxiety in parents of children with intellectual and developmental disabilities: A systematic review and meta-analysis. PLoS One, 14(7), 12. https://doi.org/10.1371/journal.pone.0219888
[vii] Corsi, M., Orsini, A., Pedrinelli, V., Santangelo, A., Bertelloni, C. A., Carli, N., Buselli, R., Peroni, D., Striano, P., Dell’Osso, L., & Carmassi, C. (2021). PTSD in parents of children with severe diseases: A systematic review to face covid-19 impact. Italian Journal of Pediatrics, 47(1), 1-7. https://doi.org/10.1186/s13052-021-00957-1
Pinquart, M. (2019). Posttraumatic stress symptoms and disorders in parents of children and adolescents with chronic physical illnesses: A meta-analysis. Journal of Traumatic Stress, 32(1), 88-96. https://doi.org/10.1002/jts.22354
[viii] Singh, N. N., Lancioni, G. E., Medvedev, O. N., Hwang, Y., Myers, R. E., & Townshend, K. (2020). Using mindfulness to improve quality of life in caregivers of individuals with intellectual disabilities and autism spectrum disorder. International Journal of Developmental Disabilities, 66(5), 370-380. https://doi.org/10.1080/20473869.2020.1827211
Benn, R., Akiva, T., Arel, S., & Roeser, R. W. (2012). Mindfulness training effects for parents and educators of children with special needs. Developmental Psychology, 48(5), 1476-1487. https://doi.org/10.1037/a0027537
Bazzano, A., Wolfe, C., Zylowska, L., Wang, S., Schuster, E., Barrett, C., & Lehrer, D. (2015). Mindfulness based stress reduction (MBSR) for parents and caregivers of individuals with developmental disabities: A community-based approach. Journal of Child and Family Studies, 24, 298-308. https://doi.org/10.1007/s10826-013-9836-9
[ix] Coughlin, M. B. & Sethares, K. A. (2017). Chronic sorrow in parents of children with a chronic illness or disability: An integrative literature review. Journal of Pediatric Nursing, 37, 108-116. https://doi.org/10.1016/j.pedn.2017.06.011
Bravo-Benítez, J., Pérez-Marfil, M. N., Román-Alegre, B., & Cruz-Quintana, F. (2019). Grief experiences in family caregivers of children with autism spectrum disorder (ASD). International Journal of Environmental Research and Public Health, 16(23), 1-18. https://doi.org/10.3390/ijerph16234821
Krishnan, R., Russell, P. S., & Russell, S. (2017). A focus group study to explore grief experiences among parents of children with autism spectrum disorder. Journal of the Indian Academy of Applied Psychology, 43(2), 267-275.
[x] Slattery, E., McMahon, J., & Gallagher, S. (2017). Optimism and benefit finding in parents of children with developmental disabilities: The role of positive reappraisal and social support. Research in Developmental Disabilities, 65, 12-22. https://doi.org/10.1016/j.ridd.2017.04.006
Park G., & Lee, O. N. (2022). The moderating effect of social support on parental stress and depression in mothers of children with disabilities. Occupational Therapy International, 1-8. https://doi.org/10.1155/2022/5162954
Disability Parenting
