Strain Among Caregivers of Youth Designated as Seriously Emotionally Disturbed: Do Place of Residence and Race Matter?

Abstract

To what extent might race and where one lives at service start in Monroe County, New York, influence three dimensions of caregiver strain among those caring for a youth designated as having serious emotional disturbance? We used the Caregiver Strain Questionnaire to measure our outcomes: subjective internalizing strain—negative feelings of guilt and worry associated with having a child with behavioral and emotional problems; subjective externalizing strain—negative feelings about the child such as anger or embarrassment; and objective strain—interruption of personal time, lost work time, and/or financial strain in four geographical areas (place of residence) defined by ZIP code. These places included Low Income Urban (median ZIP code household income less than $39,000), High Income Urban (median ZIP code household income greater than or equal to $39,000), Suburban, and Rural. We found that place at service start and time predicted caregiver strain levels (though time was the only predictor for externalizing strain), controlling for several factors. Race had no detectable influence. Supports can be individualized to a greater extent to address specific factors influencing the type of strain experienced by a caregiver. Providers might begin by identifying caregiver strain by type and intensity as well as identifying the specific circumstances leading to feelings and concerns associated with each type of caregiver strain.