Helping Parentified Children
A Guide For Counselors
Family Work
After establishing trust with the child, family sessions can begin alongside the individual work. It is better to have the child practice and experience confidence with their emotional regulation before more intense family sessions are conducted.
Assessment
Family sessions will highlight the parent-child dynamics. Interactive games are a fun way to help the family feel more at ease. As part of the assessment, take note of the following, as it can help shed light on their dynamics:
-
how the parent is talking to the child.
-
if the child speaks first on behalf of the family.
-
if the child remains quiet throughout the session.
-
if the parent shares information that may not be developmentally appropriate for the child to hear.
These observations will help to inform family interventions.
Interventions
In looking at the various interventions that can help to support parentified children, it is important to incorporate family work. The family environment will need to be addressed, as the cause of parentification is within the family dynamics.
Some parents may consciously or unconsciously be creating an environment that elicits the caregiving response in their own child because of their own parentification when they were children. If applicable, helping parents to understand this intergenerational transmission is crucial in breaking the cycle.
At the root level you will need to address the families' boundaries and roles. This can only be done when there is trust between you and the family. Once trust has been established, family sessions can include education on parentification, using non-judgmental language. Using a strengths-based approach, you can acknowledge the family's strengths and ways that family members have been working together to maintain the household. It will be essential to explore role clarification and boundaries. One way to accomplish this would be to use Minuchin's structural family model that suggests family roles are heavily influenced by the family's structure.
A central clinical goal is to realign family roles by supporting the child’s movement out of the parental subsystem and restoring clear generational boundaries. This involves assessing and restructuring patterns of interaction that have led to parentification.
Interventions may include working with caregivers to address unresolved relational or emotional needs that have been displaced onto the child, strengthening the parental subsystem so that adults can more effectively meet those needs within appropriate adult relationships, and reducing the child’s responsibility for caregiving or emotional regulation within the family. Clinicians can facilitate boundary-setting, clarify roles, and coach parents in reclaiming developmentally appropriate responsibility.
Additionally, it is important to connect families with external supports (e.g., extended family, community resources, or individual services for caregivers) that reduce reliance on the child. Throughout the process, the therapist should help the family develop new interaction patterns that support the child’s return to a developmentally appropriate role.
As a counselor, you will:
6
Gently discuss with the parents your observations regarding their developmentally inappropriate interactions with their child. These interactions include speaking to their child in an oversharing and adult manner.
Give the parents follow-up assignments, such as noticing how they speak to their child at home to reinforce the insights that are developed during the sessions.
Be generous and specific in giving praise and affirmations to the family when they do their follow-up assignments. This promotes confidence in their abilities to stay with the work, as some of the follow-up assignments may get harder, based upon the family's needs.
Key Points:
-
Look to assess family dynamics in ways that are interactive and fun.
-
The family environment will need to be addressed, as the root cause of parentification is found within the family roles and boundaries.
Returning to Casey: Interventions
In working with the family, it was apparent that work around boundaries and communications needed to be developed between Casey and her mother. Casey's mother was also dealing with her own unresolved grief related to her husband's and mother's deaths. Casey's mother was provided with psychoeducation on anxiety and how to help support Casey when she was experiencing anxiety and anger. She was also given information on parentification and how it impacted her children, especially Casey. Casey's mother sought therapy for her own unresolved traumas. Through family sessions, they learned how to communicate more effectively, while respecting roles and boundaries. Casey's mother was encouraged to speak to Casey, sharing information that would be developmentally appropriate. Casey's mother was encouraged to expand her support system, re-connecting to family members and friends so that she would not rely on Casey as her emotional support person.