which has appeared to be of particular importance to outcomes of therapy and especially to women’s well-being.
The support received from family members strengthens parental coping abilities (Nabors et al., 2013). A partner’s support is particularly meaningful in the crises represented by the child’s illness. For example, a high-quality intimate relationship is related to mental health in parents of children with cancer (Salvador et al., 2019). Dyadic coping is associated with parents’ well- being and experience of family adjustment soon after the diagnosis and over time (van Schoors, de Paepe, et al., 2019; van Schoors, Loeys, et al., 2019). Parents who have poorer relationship adjustment abilities following a diagnosis have more depressive symptoms, and their child and siblings have more emotional and behavioral problems (Alba-Suarez et al., 2020).
Consequently, couple resilience is central to both individual coping and family dynamics when a child is seriously ill. The couple resilience of the parents also has impacts on the child’s and siblings’ well-being and mental health.
2.4 The connections of a child’s serious illness to the
et al., 2018). In a study by Yi et al. (2021), mothers reported that their child’s illness considerably affected their relationship with their spouse, and that they had tried to find solutions to marital conflicts.
The nature and intensity of the distress among parents varies according to the treatment phase. Wiener et al. (2017) found that parents experience relapses of the illness as stressful phases both for themselves and their relationship. In addition, the diagnosis is experienced as an individually stressful phase and hospital stays cause additional relationship stress (Wiener et al., 2017). In a qualitative study by Arruda-Colli et al. (2018), the factors affecting spousal relationships are related to the relationship, experience of illness, and external factors. The relationship is challenged most by physical and emotional distance and strengthened most by dyadic strategies, empathic interaction, and supportive behavior. Lavee et al. (2005) found that the negative change in the marital quality of the parents of children with cancer is associated with psychological stress of the fathers but not with the mothers’
distress. General social support relieves the psychological anxiety of mothers, but fathers rely primarily on their spouse and therefore feel less anxiety in proportion to the strength of their intimate relationship (Lavee et al., 2005).
2.4.2 Parents’ couple resilience
In recent years, the concept of resilience has also been applied to relationship dyads, and particularly to the resilience that appears in intimate relationships.
Skerrett (2015) defines the resilience as a couple phenomenon, which includes its own unique processes with their own features that differ from the combined personal resilience of partners. Sanford et al. (2016, p. 1243) define couple resilience as “as a process in which a couple engages in relationship behaviors that help each member adapt and maintain high well-being during stressful life situations”. In this process the partners can jointly assimilate and accommodate to varying conditions in a way that maintains and enhances the integrity of their relationship (Reid & Ahmad, 2015). According to Lepore and Revenson (2006), resilience is no longer seen as a permanent personality feature, but as a dynamic process in which individuals and couples adapt to adversities in different ways at different times. Stressful or potentially traumatic experiences can either strengthen or weaken an intimate
relationship, depending on many key processes (Fergus & Skerrett, 2015).
These include mutual empathy, compassion, and respect; awareness of the relationship, thoughtfulness, and priority; construction of shared meanings of a challenging situation; a joint effort to strengthen a positive relationship;
safety and trust; and the wisdom of shared life experiences. The conditions for resilient adaptation of couples exist before encountering the adversity, during the adversity, and afterwards (Fergus & Skerrett, 2015).
According to Walsh (2003a), the key process of interpersonal resilience is the creation of a meaningful and positive belief system for the stressful event.
Creating meanings—understanding where a couple has come from and where they are going—is the key task and part of couple resilience (Walsh, 2011).
Couples who find a common meaning for adversity—especially in determining it to be “our problem”— consider the meaning as conducive to a common feeling of coherence, providing direction, and helping couples to manage cumulative stress factors and disease-related requirements (Skerrett, 1998). Over the last decade, we-ness has risen to a key process of couple resilience. We-ness refers to a couple’s ability to face life challenges from a shared perspective, which co-ordinates the use of couple’s common and unique resources. Singer et al.
(2015, p. 124) define we-ness as “an understanding within the partners that they exist within the larger entity that transcends either of their individual selves, and entails feelings, cognitions and behaviors that seek to promote the welfare and best interests of the relationship while maintaining a simultaneous awareness of each partner’s individual concerns”. We-ness promotes a couple’s ability to adapt and cope dyadically and facilitates the individual growth of the partners offering a protective resource (Fergus, 2011; Singer & Skerrett, 2014; Skerrett, 1998).
Thus, resilience is nowadays considered as a dynamic and interactional process in which individuals, couples, and families adapt, recover, and grow by facing adversities together (Ungar, 2015; Walsh, 2003b). Couple resilience is conceptualized as a multidimensional process, which is affected by the meanings constructed for adversity, experienced and expressed emotions, reciprocal support, and the we-ness of partners. According to Skerrett (2015, p. 10), the key components of couple resilience are “self/other and relationship awareness; empathy and respect; mutual vulnerability; the joint creation of meaning, skill sets to support relational positivity, and the reintegration
of relational wisdom.” The concept of we-ness may help to understand the differences of resilience in individuals and couples.
Several researchers have stated that the dyadic perspective and we-ness in relation to long-term illnesses reflects couple resilience and adaptability (Badr et al., 2010, Berg et al., 2008; Fergus, 2011; Skerrett, 1998). Troy and Mauss (2011) see emotion regulation as a critically important factor in determining resilience. Parents of seriously ill children can help each other to regulate the challenging emotions evoked by the situation. Dyadic emotion regulation can be an indication of a couple’s resilience, support their coping both individually and relationally, and can even strengthen them by facing adversity together.
Dyadic emotion regulation may also help them support the ill child and their siblings in coping and adjustment. Understanding dyadic coping and developing interventions that support it is essential, considering the strong impacts that a child’s serious illness has on the parent’s relationship and the adaptation of parents, the child, and the whole family (Porter et al., 2019).
2.5 Couple interventions for the parents of seriously ill