Parentification
Parentification happens to a child/adolescent when they are expected by their parental guardian or caretaker to take on the roles and responsibilities of an adult. This can happen as a result of the physical absence of a parent, physical/emotional neglect, a parent’s substance use, a parent’s reliance on a child for emotional support, financial hardships, or a parent being injured or disabled (Chase, 1999). In all of these scenarios, there is the potential for parents to unconsciously or expectantly place adult roles/responsibilities on their children. This form of role reversal has the potential to harm a child/adolescent’s developmental process, resulting in long-term psychological consequences (Hooper et al., 2011).
The issue of parentification of children and adolescents is a multifaceted issue. It is usually talked about and addressed by those in the mental health field with an extremely negative connotation. Surprisingly, research has found that in a sector of children, parentification has been associated with resiliency, self-efficacy, and competency (Byng-Hall, 2008). However, other researchers have addressed that the higher academic achievement and resilience in parentified children acts as a coping mechanism to overcompensate for their circumstances, often resulting in “workaholism” (Chase, 1999).
Therefore, It is important to note, that it is often these types of positive character trait developments that make the pains and wounds of parentification so deviously entrenched and hidden in many children/adolescents. In other words, because parentified children/adolescents often exhibit uncommon maturity for their age and have developed strong coping mechanisms that have driven them toward achievement, caregivers and professionals tend to overlook their need for support (Chase, 1999). Their independence and maturity mask their internal emotional distress often including anxiety and depression (Hooper et al., 2012). Parentified children may also struggle with establishing their own identity, setting boundaries with others, low self-esteem, and feelings of guilt and shame (Hooper et al., 2016). If these issues are not addressed early on, they often follow a parentified child as they grow into adulthood, affecting personal relationships and increasing the likelihood of burnout (Chase, 1999).
Parentified children/adolescents as adults, often are left with feelings of grief over their childhood which they feel they did not get to experience. This sense of loss also contributes to the negative effects and symptoms that can follow parentified children into adulthood (Chase 1999). Research has shown that parentified children as adults often benefit more from certain forms of therapy than others. For example, Narrative therapy has been found to be very effective since it provides the opportunity for an adult client who experienced parentification as a child, to integrate their childhood experiences into who they are today (White, 1990; Chase, 1999). This gives those adults the opportunity to make meaning of their non-typical childhood, and build an understanding of their identity (White,1990; Chase, 1999).
Effective Treatment Methods for Parentified Children/Adolescents
Knowing that adults have proven effective treatment options for healing their parentification wounds from childhood, it leaves the question: What can be done for children currently in a home environment that is contributing to the development of parentified tendencies? In other words, is healing still possible for these children while their ‘hand is still on the burner’ so to speak? Are attempts from therapists to aid in a child’s healing from parentification practically naught until the child is no longer subject to the dynamics of their household of origin?
Thankfully, there are a number of ways therapy can be effective for parentified children/adolescents even while their living environment remains unchanged (Chase, 1999). That being said, the effectiveness of treatment differs from person to person depending on a variety of factors- such as the treatment method/intervention used, positive adult support outside of the household, the receptiveness of parental guardians, and the child/adolescent’s motivation/willingness to actively engage in treatment (Southwick et al., 2007).
An intervention that can be effective while a child still has a challenging home environment is addressing issues in the here-and-now. Although things will continuously be going on in the child/adolescent household, therapy can address that child’s immediate emotional needs when they enter into the therapeutic space (Hooper, 2007). Any amount of experiencing emotional attunement and corrective emotional experiences would be beneficial for a child/adolescent even if they only can experience that a few hours a week. The child/adolescent having a safe space where their needs are allowed to come first can be a lot of relief.
Additionally, even if nothing in the client’s home life changes, therapy can provide them with healthier coping skills along with tools to deal with stress such as CBT techniques (Beck, 2011). CBT techniques used with adolescents and children through play therapy can help clients identify maladaptive thoughts (Knell et al., 2006). This can specifically be beneficial for parentified children/adolescents who often struggle with low self-esteem, anxiety, and guilt (O’Connor et al., 2016).
Specifically with younger children, child-centered play therapy is an effective intervention for parentified children, addressing symptoms due to their experiences (Glover & Landreth, 2006). As a non-directive form of play therapy, child-centered allows a client to have a space to restore aspects of childhood getting to participate in developmentally appropriate activities (Glover & Landreth, 2006). The child gains a space to be free of their expectations and responsibilities. With the non-directive nature of child-centered play, a child can gain autonomy skills, build confidence in decision-making skills, and advocate for their own wants/needs. Although children may not be able to use these skills in their home situation, learning these things sets a foundation in which a parentified child can lean on these skills in adulthood. At the very least, having a good experience in therapy may increase the likelihood that the child as an adult will seek therapy if they need it.
Working with Parents/Caregivers and Adult Mentors
All of the treatment methods discussed up to this point have the highest likelihood of effectiveness if the child/adolescent has positive social support (teachers, coaches, mentors, etc.) outside of the home (Carver, 1998). One of the biggest ways a caring adult can best support a parentified child is by building a secure attachment with them (Hooper, 2007). Therefore, providing stability, consistency, and emotional attunement (Hooper, 2007). Another way in which outside adults can support a parentified child is by providing practical support through school-based programs to address mental health, as well as advocating for a child’s physical needs if necessary (i.e. free school lunches if criteria are met) (Tolan et al., 2018).
If a parent is able and willing to become involved in the child’s healing/therapy process Theraplay and Filial Therapy provide two great ways to work with parents and directly address the parent-child relationship (O’Connor et al., 2016). That being said, Theraplay or Filial therapy should only be used as an intervention/modality when a caretaker/guardian has the emotional/intellectual capabilities to effectively engage in the therapy as well as safely/healthily engage with their child. Theraplay and Filial Therapy can also be beneficial for building a secure attachment between a child and their foster or adoptive parent. A child/adolescent should never engage in one of these modalities with their abuser (VanderGriend, 2024).
Filial therapy utilizes psychoeducation that teaches parents how to conduct child-centered play therapy sessions with their child (VanderGriend, 2024). Therefore, Filial therapy is both a child and family therapy that operates with the goal of creating change in the family system while employing parent-child play (O’Connor et al., 2016). Filial Therapy has the potential to cultivate a supportive environment between parent and child that can counteract some of the negative effects of parentification (O’Connor et al., 2016). This is all done under the guidance and supervision of the therapist.
Similarly, Theraplay can effectively be used to improve parent-child relationships through structured play. Specifically, Theraplay can be a useful intervention/modality for children who have disrupted attachment with their caregiver by relying on direct here-and-now interaction to increase self-regulation and joyful engagement between parent and child (O’Connor et al., 2016). The goal is to empower parents to continue pursuing healthy interactions with their child outside of the therapeutic space (O’Connor et al., 2016).
Although parentification is a prominent and saddening process that many children experience, it is reassuring to know there are options for treatment and many ways to help. Staying updated as clinicians is imperative to provide the best and most effective services to clients and their specific presenting issues. It is important to remember the concept of post-traumatic growth and resiliency which provides hope for clients and those who work in the helping fields. Therapists and mental health providers have the beautiful opportunity to engage with clients in their journey toward healing.
References:
Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond. Guilford Press.
Byng-Hall, J. (2008). The significance of children fulfilling parental roles: implications for family therapy. Journal of Family Therapy, 30(2), 147–162. https://doi.org/10.1111/j.1467-6427.2008.00423.x
Carver, C. S. (1998). Resilience and Thriving: Issues, Models, and Linkages. Journal of Social Issues, 54(2), 245–266. https://doi.org/10.1111/j.1540-4560.1998.tb01217.x
Chase, N. D. (Ed.) (1999). Burdened children: Theory, research, and treatment of parentification. SAGE Publications, Inc. https://doi.org/10.4135/9781452220604
Glover, G., & Landreth, G. L. (2016). Child-centered play therapy. In K. J. O’Connor, C. E. Schaefer, & L. D. Braverman (Eds.), Handbook of play therapy (2nd ed., pp. 93–118). John Wiley & Sons, Inc.
Hooper, L. M. (2007). The application of attachment theory and family systems theory to the phenomena of parentification. The Family Journal, 15(3), 217–223. https://doi.org/10.1177/1066480707301290
Hooper, L. M., DeCoster, J., White, N., & Voltz, M. L. (2011). Characterizing the magnitude of the relation between self-reported childhood parentification and adult psychopathology: A meta-analysis. Journal of Clinical Psychology, 67(12), 1028–1043. https://doi.org/10.1002/jclp.20807
Hooper, L. M., Doehler, K., Jankowski, P. J., & Tomek, S. E. (2012). Patterns of self-reported alcohol use, depressive symptoms, and body mass index in a family sample: The buffering effects of parentification. The Family Journal: Counseling and Therapy for Couples and Families, 20(2), 164–178. https://doi.org/10.1177/1066480711435320
Hooper, L. M., L’Abate, L., Sweeney, L. G., Gianesini, G., & Jankowski, P. J. (2016). Models of psychopathology: Generational processes and relational roles. Springer.
Knell, S. M., & Dasari, M. (2006). Cognitive-behavioral play therapy for children with anxiety and phobias. In H. G. Kaduson (Ed.) & C. E. Schaefer (Ed.), Short-term play therapy for children (2nd ed., pp. 22–50). The Guilford Press.
O’Connor, K. J., Schaefer, C. E., & Braverman, L. D. (Eds.). (2016). Handbook of play therapy (2nd ed.). Wiley.
Southwick, S. M., Morgan, C. A., Vythilingam, M., & Charney, D. (2007). Mentors enhance resilience in at-risk children and adolescents. Psychoanalytic Inquiry, 26(4), 577–584. https://doi.org/10.1080/07351690701310631
Tolan, Patrick H, and Kenneth A Dodge. “Children’s mental health as a primary care and concern: a system for comprehensive support and service.” The American psychologist vol. 60,6 (2005): 601-14. https://doi.org/10.1037/0003-066X.60.6.601
White, Michael (2007). Maps of Narrative Practice. New York: W. W. Norton & Company. p. 139. ISBN 9780393705164. OCLC 76792066. http://www.worldcat.org/oclc/76792066