Helping Parentified Children
A Guide For Counselors
Individual Work With the Child
As a counselor, it may be helpful to conceptualize the work as:
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assessing for emotional and behavioral dysregulation.
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intervening to help affective regulation, behavioral managment, and cognitive reframing.
Assessment
Assessment is an important first step. In assessing the parentified child's needs, it is helpful to conceptualize within a Maslow's hierarchy of needs and Bronfenbrenner's bioecological framework. This is to ensure that basic needs are addressed prior to working on more difficult areas. Viewing the issues through a bioecological framework helps to establish interventions that acknowledge the various environments that have shaped the child's experience of being parentified. Parentification does not always look the same on every child. Children will present with different struggles due to many variables, such as how the child is parentified, as well as the reason behind the parentification.
Identifying parentified children can be done formally or informally. Formal parentification assessments are available, but most are not in the public domain. For more information on some of the parentification assessments, please select:
If you are curious and would like to take a quiz to determine if the child you are working with may be parentified, you can complete an informal
Screenings do not necessarily have to be focused on parentification itelf. Rather, it can focus on emotional and/or behavioral issues that the child presents with. Using assessments to help identify the areas that the child struggles with will help to identify a more targeted treatment. A free screening tool, the Strengths and Difficulties Questionnaire (SDQ), created by Robert N. Goodman is a behavioral and emotional screening questionnaire geared for struggling children and young people.
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Intervention
Teaching Coping Skills
Upon completion of an assessment and determination that the child is destructively parentified and exhibiting mental health struggles, there are different ways to approach with them. Different approaches are recommended depending on which issues are most urgent.
In helping to develop good coping skills, it may be helpful to categorize the interventions as affective, behavioral, or cognitive.
Affective
Studies have shown that some destructively parentified children may experience anxiety (generalized, separation, or social) as well as depression. Teaching various grounding techniques to show them how to center themselves so that they do not feel engulfed and overwhelmed by their own emotions is helpful. Mindfulness interventions have shown promising outcomes in working with anxious children. Teaching mindfulness can help them become more attuned to where they store their feelings in their bodies so that they can sense early warning signs and effectively respond to those feelings earlier.
Being able to attend to stress and anxiety as it is happening or before it becomes too overwhelming helps to counter the instability and disorganization they experience internally. One helpful method is teaching them how to breathe, such as deep belly breathing. Various techniques can be used to help make learning more fun, such as blowing bubbles through a bubble wand at arm's length to help reinforce the proper deep breathing needed.
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Behavioral
For destructively parentified children, anger may be an area with which they struggle. While anger is a normal response to certain situations that happen at home, the expression of the anger can be intense and uncontrolled. For behaviors that impact the household, it is critically important to pull in the parent to provide support in helping the child adopt healthier means of expression for negative emotions. You will need to collaborate with the parent and other potential family members to come up with a positive reinforcement system to help shape behaviors at home. Encourage parents to use positive reinforcement as opposed to punishment to help shape more adaptive behaviors. Work with parents who feel overwhelmed and frustrated with their child to manage their own stress so that they can approach their child with more patience. Behavioral strategies for parents and their child can include quick mindful body scans or box breathing.
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Cognitive
It is important to help children recognize the relationship between their:
By helping them to see the connection, they understand that they can influence their own feelings and behaviors. A common belief that some parentified children have is the idea that they are incapable. Parentified children experiencing overwhelming fears and anxieties having to be the “perfect child” will benefit from being able to manage their emotions so that they do not feel overwhelmed and shut down. Cognitive re-framing can help them identify and challenge the thoughts that perpetuate and maintain their anxieties, leading to healthier, more balanced beliefs.
In working with a parentified child, it is important to acknowledge that they may have some positive feelings, such as a sense of pride that they have been "in charge". This pride may be due to them having the opportunity to master skills that their peers do not possess. Still, this pride can act as an impediment in asking for help from others. This pride may also mask a deeper fear of failing their family. It is therefore helpful to explore how this pride serves them - does it promote resiliency or impede the child's ability to ask for help.
Feelings
Thoughts
Behaviors
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Additionally, it is important to note that some researchers believe that destructive parentification can be traumatic to some children. They compare being destructively parentified as emotional neglect because the child's own needs are not being met. Neglect is a form of abuse, and abuse is a type of trauma. Furthermore, most parentification appear in households where there have been negative life experiences and/or trauma, which further exacerbates the impact of parentification. Some work addressing these negative life events and losses will need to be done. Various methods such as Eye Movement Desensitization and Reprocessing (EMDR) can be helpful to facilitate processing of these adverse experiences and challenge these negative beliefs.
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Key Points:
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Parentification does not look the same in every child,.
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Screening does not always have to be specific to parentification. Assessing and identifying emotional and behavioral areas that the child is struggling with can be a great starting point.
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It is essential for the counselor to recognize that there may be some positive association that the child has with being tasked with adult responsibilities, and that will need to be acknowledged.
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In working with the individual child, the counselor will need to help the child learn good coping skills that can be organized as affective, behavioral, and cognitive interventions.
Returning to Casey: Assessment and Interventions
A measurement tool is used to assess Casey's level of anxiety. She is diagnosed with generalized anxiety disorder. Her mother contributes to the assessment by providing collateral information on observations she has made at home and reports from the school. At this point, it is not necessarily clear that Casey is parentified, so the focus is helping with her anxiety and sometimes, anger issues.
As part of therapy, Casey was taught how to identify emotions and thoughts that contributed to her big feelings. She learned a wide range of words other than the basic "glad", "mad" and "sad" to better describe feelings she experienced. Casey learned how to identify early warning signs of anxiety and anger, and how to use belly breathing to help manage those early warning signs. Trauma work was also done around her father's and grandmother's deaths to help her process unresolved grief.