中華心理衛生協會

 Purpose: Parental reflective functioning refers to parents' ability to understand their own and their children's mental states. Studies have shown that higher parental reflective functioning positively affects the development of children with special healthcare needs, and reduces their risk of negative mental health outcomes over time. Additionally, it can decrease the risk of anxiety, depression, stress, and post-traumatic stress of parents caring for children with special healthcare needs. Research on this topic has primarily focused on parents from individualistic cultures; there is limited research on Chinese cultures, where family values and filial piety strongly influence parenting practices. The purpose of this topical review is to integrate and synthesize the literature, and to discuss cultural considerations in parental reflective functioning with a particular focus on parents of children with special healthcare needs within Chinese cultures. Methods: First, we reviewed studies on parental reflective functioning and its application for parents of children with special healthcare needs in individualistic cultures. Next, we provided an overview of how family values strongly influence parenting practices in Chinese families by focusing on Yeh and Bedford's (2003) dual filial piety model, which highlights 2 types of renlun (human relations): reciprocal (emphasizing empathy and respect) and authoritarian (emphasizing hierarchy and obedience). Finally, we analyzed the ways in which these cultural norms interact with parental reflective functioning, and specified why this understanding is crucial for supporting Chinese families with children who have special healthcare needs. Results: We found that although the concept of parental reflective functioning is generally applicable to Chinese parents, adjustments in theory, assessment, and intervention are required to align with Chinese cultural beliefs and for the development of appropriate assessment tools and interventions. We discussed how individuals from Chinese cultures may practice parental reflective functioning in ways that both align with Chinese cultural beliefs and also promote caregiver well-being, and we identified specific ways that parental reflective functioning could be applied to Chinese children with special healthcare needs. Conclusion: We expect that the effectiveness of parental reflective functioning on the mental health outcomes of children with special healthcare needs and the promotion of caregiver well-being in Chinese contexts is likely to be moderated by the strength of parents' reciprocal filial piety beliefs. Future research should examine how differences in children's conditions affect how parental reflective functioning is expressed and functions within Chinese families.