{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T11:05:09Z","timestamp":1771844709475,"version":"3.50.1"},"reference-count":42,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T00:00:00Z","timestamp":1771632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Children with emotional disturbance (ED) frequently display highly unpredictable behaviors compared to other children. The magnitude and unpredictability of childhood ED make finding effective management strategies difficult for parents. Prior research has examined parents\u2019 stress and the children\u2019s behaviors in schools, but we know very little about how parents manage at home. Methods: This qualitative study used Naturalistic Inquiry to explore how parents respond to the challenges which arise at home due to childhood ED. Eight mothers raising 10 children with ED were recruited nationally. Data were gathered through semi-structured, individual interviews. Results: Consequences-based parenting strategies were unsuccessful, but mothers achieved greater success with pre-planned, intentional responses and adapting the child\u2019s environment. Mothers learned their child\u2019s world view was very different than their own. This realization caused mothers\u2019 perspective toward their child to change. Mothers saw their child as struggling with a problem, instead of simply being defiant. The perception shift allowed mothers to approach situations with greater compassion and inner peace. Conclusions: The findings provide suggestions for pediatric healthcare providers who work with such parents seeking assistance and advice.<\/jats:p>","DOI":"10.3390\/children13020300","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T10:00:52Z","timestamp":1771840852000},"page":"300","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adapting Instead of Reacting: A Qualitative Study Exploring Parenting Strategies for Childhood Emotional Disturbance"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1525-9712","authenticated-orcid":false,"given":"Michelle L.","family":"Nighswander","sequence":"first","affiliation":[{"name":"St. David\u2019s School of Nursing, Texas State University, Round Rock, TX 78665, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,21]]},"reference":[{"key":"ref_1","unstructured":"National Center for Special Education Research (2017). Future Directions for Research to Improve Outcomes for Students with Emotional and Behavioral Disorders: Technical Working Group Meeting Summary, Institute of Education Sciences."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1690091","DOI":"10.1080\/17482631.2019.1690091","article-title":"Experience of stress in parents of children with ADHD: A qualitative study","volume":"14","author":"Leitch","year":"2019","journal-title":"Int. J. Qual. Stud. Health Well-Being"},{"key":"ref_3","unstructured":"Nighswander, M. (2024). Searching for Their Path: Understanding Parents of Children with Emotional Disturbance. [Ph.D. Thesis, University of Texas Medical Branch]. Available online: https:\/\/utmb-ir.tdl.org\/items\/e79beb6a-2668-4780-b4b4-cedba276bf02."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1080\/0886571X.2010.500956","article-title":"Families of children with Serious Emotional Disorder: Maternal reports on the decision and impact of their child\u2019s placement in residential treatment","volume":"27","author":"Tahhan","year":"2010","journal-title":"Resid. Treat. Child. Youth"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1176\/appi.ps.201700145","article-title":"Prevalence of Serious Emotional Disturbance among U.S. Children: A meta-analysis","volume":"69","author":"Williams","year":"2018","journal-title":"Psychiatr. Serv."},{"key":"ref_6","unstructured":"Center for Behavioral Health Statistics and Quality (2016). 2014 National Survey on Drug Use and Health: DMS-5 Changes: Implications for Child Serious Emotional Disturbance, Center for Behavioral Health Statistics and Quality."},{"key":"ref_7","unstructured":"US Department of Education (2021, November 18). Individuals with Disabilities Education Act. A History of the Individuals with Disabilities Education Act, Available online: https:\/\/sites.ed.gov\/idea\/IDEA-History#1975."},{"key":"ref_8","unstructured":"Zionts, P., Zionts, L., and Simpson, R.L. (2016). Emotional and Behavioral Problems: A Handbook for Understanding and Handling Students, Corwin Press, Inc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1177\/0145445518762398","article-title":"The Responsible inclusion of students receiving Special Education services for Emotional Disturbance: Unraveling the practice to research gap","volume":"43","author":"McKenna","year":"2019","journal-title":"Behav. Modif."},{"key":"ref_10","unstructured":"Lipscomb, S., Lacoe, J., Liu, A.Y., and Haimson, J. (2023, December 01). Preparing for Life after High School: The Characteristics and Experiences of Youth in Special Education. A Summary of Key Findings from The National Longitudinal Transition Study 2012. NCEE Evaluation Brief. National Center for Education Evaluation and Regional Assistance, Available online: https:\/\/ies.ed.gov\/use-work\/resource-library\/report\/evaluation-brief\/preparing-life-after-high-school-characteristics-and-experiences-youth-special-education-summary-key."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"551","DOI":"10.3102\/0034654313497517","article-title":"Educational accommodations for students with behavioral challenges: A systematic review of the literature","volume":"83","author":"Harrison","year":"2013","journal-title":"Rev. Educ. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"199","DOI":"10.2975\/35.3.2012.199.208","article-title":"Longitudinal transition outcomes of youth with emotional disturbances","volume":"35","author":"Wagner","year":"2012","journal-title":"Psychiatr. Rehabil. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1177\/1063426616649163","article-title":"Using caregiver strain to predict participation in a peer-support intervention for parents of children with emotional or behavioral needs","volume":"25","author":"January","year":"2017","journal-title":"J. Emot. Behav. Disord."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1007\/s10826-019-01626-y","article-title":"Understanding Caregiver Strain and Related Constructs in Caregivers of Youth with Emotional and Behavioral Disorders","volume":"29","author":"Green","year":"2020","journal-title":"J. Child Fam. Stud."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2810","DOI":"10.1007\/s12671-021-01744-z","article-title":"Parenting a child with mental health problems: The role of self-compassion","volume":"12","author":"Wald","year":"2021","journal-title":"Mindfulness"},{"key":"ref_16","unstructured":"Council for Exceptional Children (2021, October 12). Behavioral Disorders. Available online: https:\/\/debh.exceptionalchildren.org\/behavior-disorders-definitions-characteristics-related-information."},{"key":"ref_17","first-page":"46","article-title":"Understanding parents\u2019 perspectives on the transition to kindergarten","volume":"7","author":"Malsch","year":"2011","journal-title":"Best Pract. Ment. Health Int. J."},{"key":"ref_18","unstructured":"US Department of Health and Human Services (1999). Mental Health: A Report of the Surgeon General\u2014Executive Summary."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s10567-022-00378-4","article-title":"Conceptualizing emotion regulation and coregulation as family-level phenomena","volume":"25","author":"Paley","year":"2022","journal-title":"Clin. Child Fam. Psychol. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1002\/nur.22066","article-title":"Family resilience and flourishment: Well-being among children with mental, emotional, and behavioral disorders","volume":"43","author":"Herbell","year":"2020","journal-title":"Res. Nurs. Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1111\/eip.12934","article-title":"Development of an early intervention programme for adolescents with emotion dysregulation and their families: Actions for the treatment of adolescent personality (ATraPA)","volume":"14","author":"Mayoral","year":"2020","journal-title":"Early Interv. Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"33","DOI":"10.2989\/17280583.2015.1135804","article-title":"A first-level evaluation of a family intervention for adolescent social, emotional and behavioural difficulties in child and adolescent mental health services","volume":"28","author":"Wynne","year":"2016","journal-title":"J. Child Adolesc. Ment. Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.brat.2018.02.001","article-title":"The effect of adding Coping Power Program\u2014Sweden to Parent Management Training -effects and moderators in a randomized controlled trial","volume":"103","author":"Helander","year":"2018","journal-title":"Behav. Res. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1001\/jamapsychiatry.2015.3411","article-title":"Internet-assisted parent training intervention for disruptive behavior in 4-year-old children: A Randomized clinical trial","volume":"73","author":"Sourander","year":"2016","journal-title":"JAMA Psychiatry"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1007\/s10488-023-01275-w","article-title":"Implementing integrated early childhood mental health services in primary care: Relationships, vision, and sustainability","volume":"50","author":"Nayak","year":"2023","journal-title":"Adm. Policy Ment. Health Ment. Health Serv. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1002\/mpr.1477","article-title":"Changes in mental health outcomes with the intensive in-home child and adolescent psychiatric service: A multi-informant, latent consensus approach","volume":"25","author":"Barbot","year":"2016","journal-title":"Int. J. Methods Psychiatr. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1093\/cs\/27.2.111","article-title":"The Promise of school-based psychoeducation for parents of children with Emotional Disorders","volume":"27","author":"Pollio","year":"2005","journal-title":"Child. Sch."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2770","DOI":"10.1007\/s10803-021-04893-1","article-title":"The effect of mindfulness-based and acceptance commitment therapy-based interventions to improve the mental well-being among parents of children with developmental disabilities: A Systematic review and meta-analysis","volume":"52","author":"Chua","year":"2022","journal-title":"J. Autism Dev. Disord."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/s10488-010-0329-5","article-title":"Supporting parents who have youth with Emotional Disturbances through a parent-to-parent support program: A proof-of-concept study using random assignment","volume":"38","author":"Kutash","year":"2011","journal-title":"Adm. Policy Ment. Health Ment. Health Serv. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1177\/1039856212475327","article-title":"Time-in\u2019 and \u2018time-out\u2019 for severe emotional dysregulation in children","volume":"21","author":"Johns","year":"2013","journal-title":"Australas. Psychiatry"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1111\/1440-1630.12681","article-title":"Making sense of it together: Youth & families co-create sensory modulation assessment and intervention in community mental health settings to optimise daily life","volume":"67","author":"Williamson","year":"2020","journal-title":"Aust. Occup. Ther. J."},{"key":"ref_32","unstructured":"Miller, D.L. (2026, January 15). Core Therapist Skills Supporting Implementation of Evidence-Based Practices with Serious Emotionally Disturbed Children in Community Mental Health Settings: A Modified Mixed Methods Delphi Study. Dissertation Abstracts International: Section B: The Sciences and Engineering. Available online: https:\/\/research.ebsco.com\/linkprocessor\/plink?id=8705860f-4001-3d8e-bf92-b0806842b0ad."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1471-3802.2005.00033.x","article-title":"Stress and coping in primary caregivers of children with a disability: A qualitative study using the Lazarus and Folkman Process Model of Coping","volume":"5","author":"Kelson","year":"2005","journal-title":"J. Res. Spec. Educ. Needs"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e20193548","DOI":"10.1542\/peds.2019-3548","article-title":"Parenting interventions in pediatric primary care: A systematic review","volume":"146","author":"Smith","year":"2020","journal-title":"Pediatrics"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1542\/peds.2014-3716","article-title":"Promoting Optimal Development: Screening for Behavioral and Emotional Problems","volume":"135","author":"Weitzman","year":"2015","journal-title":"Pediatrics"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Lincoln, Y.S., and Guba, E.G. (1985). Naturalistic Inquiry, Sage Publications.","DOI":"10.1016\/0147-1767(85)90062-8"},{"key":"ref_37","unstructured":"Erlandson, D.A., Harris, E.L., Skipper, B.L., and Allen, S.D. (1993). Doing Naturalistic Inquiry: A Guide to Methods, Sage Publishing."},{"key":"ref_38","unstructured":"Gallup (2026, January 15). Nurses Continue to Lead in Honesty and Ethics Ratings. Available online: https:\/\/news.gallup.com\/poll\/700736\/nurses-continue-lead-honesty-ethics-ratings.aspx."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1177\/089431848900200308","article-title":"An Interpretation of family within Orem\u2019s General Theory of Nursing","volume":"2","author":"Taylor","year":"1989","journal-title":"Nurs. Sci. Q."},{"key":"ref_40","unstructured":"Orenstein, G.A., and Lewis, L. (2023, December 15). Erikson\u2019s States of Psychosocial Development, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK556096\/."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Christou, A.I., and Bacopoulou, F. (2025). Emotion and feeling in parent\u2013child dyads: Neurocognitive and psychophysiological pathways of development. Children, 12.","DOI":"10.3390\/children12111478"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"515","DOI":"10.3102\/0013189X221111337","article-title":"\u201cYou Need to Be More Responsible\u201d: The Myth of Meritocracy and Teachers\u2019 Accounts of Homework Inequalities","volume":"51","author":"Horn","year":"2022","journal-title":"Educ. Res."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/2\/300\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T10:24:46Z","timestamp":1771842286000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/2\/300"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,21]]},"references-count":42,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["children13020300"],"URL":"https:\/\/doi.org\/10.3390\/children13020300","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,21]]}}}