Parent and Child Therapy (PACT) In Action: An Attachment‐Based Intervention for a Six‐Year‐Old With a Dual Diagnosis

This case study explores Parent and Child Therapy (PACT), an attachment‐based intervention for mothers and children experiencing intractable relationship distress originally developed by Heather Chambers (a Child Psychotherapist and Family Therapist working in New Zealand). We describe the use of PACT with a mother—child dyad presenting a history of severe abuse and neglect. The child had been diagnosed with Conduct Disorder and co‐morbid Attention Deficit Hyperactivity Disorder. We consider the themes arising in the therapy, the emotional process experienced by the mother and child, the initial outcome and 10‐month follow up. The case study indicates that PACT can be learned and used by practitioners outside of the team that conceptualised and developed it. The case highlights the links between externalising difficulties and attachment disorganisation and points to PACT as a promising treatment for the chronic sequelae of early interpersonal childhood trauma. The need for research and possible directions of this research are discussed.     

Establishing a Parenting Program for Fathers in Substance Abuse Treatment

This paper describes a systemic, trauma and attachment model for a parenting program for fathers in residential substance abuse treatment. It emphasises the complex nature of delivering parenting programs in this context and the importance of going beyond simple linear principles of reward and punishment, upon which many other parenting programs are predicated.     

Mastery or Misery: Conflict Between Separated Parents a Psychological Burden for Children

This qualitative research examined parenting, parental conflict, and parent–child relationships following separation in the context of Australian government reform in 2006 and subsequent changes to the Family Law Act (1975). Participants were English-speaking men and women, age 16 to 27 years. The research was guided by attachment theory and social conflict theory, and embedded in grounded theory. The Cooperative Competitive Parental Conflict model emerged from the data. Two factors moderated the parent–child relationship: emotional security and responsive parenting. The research found it was not parental conflict, but how parental conflict was handled, that created the psychological burden for a child.     

Mitigating Intergenerational Trauma Within the Parent‐Child Attachment

Nine‐year‐old Ben was said to hate women. His mother was terrified he'd ‘grow up a woman basher’. This paper describes the work done with Ben and his family at the Hobart Child and Adolescent Mental Health Service. We drew predominantly on three therapeutic modalities: Theraplay, Family Attachment Narrative Therapy and Dyadic Developmental Psychotherapy. Our work enabled Ben's mother to navigate the aftermath of her own trauma history in order to heal Ben's attachment trauma.     

Attachment and Divorce

In this paper, recent efforts to integrate attachment theory and family systems theory are reviewed and extended to the context of therapy with families coping with the divorce process. Family members' global working models of attachment, rather than the spousal attachment alone, are proposed as the point of intervention, with the goal of helping families reestablish an "attachment equilibrium" during and after divorce, thus addressing potentially problematic expressions of attachment behavior that could interfere with resolution of the divorce, causing difficulties in future co-parenting and other family functioning.     

An Assessment of Two Parenting Training Manuals Used in Swedish Parenting Interventions

In Sweden, all parents of children aged 0–18 years are entitled to attend free parenting courses as part of a national strategy presented by the Government in 2009. This broad parental support welfare strategy is expected to fulfil the intentions of the UN Convention on the Rights of the Child. In this study, two parenting training manuals were analysed: the Canadian Connect program, based on attachment theory, and the Swedish ABC program, based on social learning theory. The results indicate that the manuals use strategies that can both hinder and support children's rights, regardless of rhetoric of children's best interests.     

Relationships Between Parental Attachment,Work and Family Roles,and Life Satisfaction

The purpose of this study was to examine the relationship between parental attachment and satisfaction with work and family roles, as well as the relationship of these variables to life satisfaction. Results from a multiple regression analysis indicated that satisfaction with work and marriage, but not parenting satisfaction or parental attachment, was significantly related to life satisfaction. Responses to open‐ended questions indicated that parental attachment relationships affected participants' career, marriage, parenting, and life satisfaction in varied and complex ways. Implications for counselors and directions for future research are discussed.     

Trauma adapted family connections: reducing developmental and complex trauma symptomatology to prevent child abuse and neglect

Families living in urban poverty, enduring chronic and complex traumatic stress, and having difficulty meeting their children's basic needs have significant child maltreatment risk factors. There is a paucity of family focused, trauma-informed evidence-based interventions aimed to alleviate trauma symptomatology, strengthen family functioning, and prevent child abuse and neglect. Trauma Adapted Family Connections (TA-FC) is a manualized trauma-focused practice rooted in the principles of Family Connections (FC), an evidence supported preventive intervention developed to address the glaring gap in services for this specific, growing, and underserved population. This paper describes the science based development of TA-FC, its phases and essential components, which are based on theories of attachment, neglect, trauma, and family interaction within a comprehensive community-based family focused intervention framework.     

Opioid Use Disorder,Attachment, and Parenting: Key Concerns for Practitioners

In the United States, the current epidemic of opioid use disorders impacts many parents and their children. Historically, interventions for parents with substance use disorders have focused on two separate areas, achieving and maintaining abstinence and learning parenting skills. These interventions do not address the parent/child relationship, and the impact of parental opioid use disorder on attachment. Insecure attachment, particularly disorganized attachment, negatively affects the child’s development and safety. Attachment should always be considered when doing a safety assessment or planning an intervention for parents with opioid use disorders. This conceptual paper describes the impact of parental opioid use on attachment across the developmental span of childhood, highlighting research about opioid use disorder, parenting, and attachment which is relevant for practitioners working with parents with opioid use disorders, as child protection workers, substance abuse counselors, or therapists. Identification, attachment assessment tools, and empirical research on attachment-based interventions are discussed.     

Cultural and Contextual Influences on Parenting in Mexican American Families

Family stress theory can explain associations between contextual stressors and parenting. The theory, however, has not been tested among Mexican Americans or expanded to include cultural‐contextual risks. This study examined associations between neighborhood, economic, and acculturative stressors and parenting behaviors in a sample of 570 two‐parent Mexican American families. Results support the negative impact of economic stress on parenting through parental depressive symptoms. Neighborhood stress influenced fathers’ depressive symptoms and parenting, but not mothers’. The effects of acculturative stress were inconsistent. Results suggest that contextual stressors common to Mexican American families impact parenting behaviors through parental depression.     

Theoretical Perspectives of Male Sexual Abuse: Conceptualization of a Case Study

The purpose of this article is to demonstrate the traumatic impact that sexual abuse can have on a young male's development by addressing mediating dispositions that can render a child vulnerable to the effects of sexual abuse. Consideration is given to three different theoretical perspectives that are not exclusive to male victims but shed light on the impact that sexual abuse can have on the development of a young boy. These perspectives include early family relationships and attachment theory, developmental psychopathology, and trauma theory. These theoretical lenses provide a conceptual understanding into why some victims are vulnerable to the effects of sexual abuse. Each theoretical view is applied to a case study of an adolescent male with a history of early trauma and sexual abuse. Clinical implications are discussed.     

‘Riding the Wave’: Working Systemically with Traumatised Families

This paper draws on the authors’ clinical experience as family therapists, working predominantly with families who have experienced trauma such as sexual abuse, physical abuse and neglect, to demonstrate that taking a systemic trauma‐informed approach is a powerful therapeutic modality that can facilitate positive outcomes for all family members. The paper discusses the impact of trauma on relationships, and then outlines a rationale for a trauma‐informed, systemic approach with those traumatised families who are, at times, challenged by excessively heightened behaviour and emotional dysregulation. Drawing from parenting research, it includes a discussion of the place of parent work and how this can be integrated with systemic family work. Key constraints and considerations are highlighted followed by a discussion of key interventions the authors have found useful in building a clinical framework for this work, including what is critical for the therapeutic process. While working with traumatised families is complex and challenging, offering a safe place for families to be in the presence of each other's pain and ‘ride the wave’ of emotions can be a powerful path to recovery.     

Complex Couples: Multi‐Theoretical Couples Counselling with Traumatised Adults Who have a History of Child Sexual Abuse

One of the major ways child sexual abuse can have an impact on individuals is in their later ability to have and maintain fulfilling couple relationships. Survivors may experience avoidance behaviours that become problematic in their adult intimate relationships. If couple therapists fail to focus on these traumatic imprints, the therapy may founder. This paper proposes that a multi‐theoretical approach enables the couple therapist to deal with the complex problems such couples present including sexuality and intimacy concerns. Such an approach integrates trauma theory, attachment theory, feminist principles, body‐oriented psychotherapy, and systemic couple therapy.     

Oyate Ptayela: Rebuilding the Lakota Nation Through Addressing Historical Trauma Among Lakota Parents

SUMMARY

This article presents evidence to suggest that historical trauma has affected Lakota parents and children by changing parenting behavior and placing children at risk for alcohol and other substance abuse. The theoretical explanation of the Lakota historical trauma response is described and used as a framework for the design of a parenting skills curriculum. This intervention focuses on (1) facilitating parental awareness of life span and communal trauma across generations and (2) a re-cathexis or re-attachment to traditional Lakota values.

The experimental curriculum intervention was delivered to a group of ten Lakota parents and two Lakota parent facilitators on a Lakota reservation. Qualitative study results revealed that parents experienced the curriculum as effective, particularly the focus on both historical trauma and the reconnection with traditional Lakota mores. The curriculum's emphasis on traditional protective factors for alcohol and other substance abuse prevention for Lakota children presents implications for other parenting curricula. The article concludes with recommendations for future research in the area of Indian parenting and historical trauma.     

Mothers’ Parenting Stress and Engagement: Mediating Role of Parental Competence

ABSTRACT

Guided by role-strain theory and the spillover hypothesis, this study used data (n = 2,637) from the Fragile Families and Child Wellbeing Study to examine the link between mothers’ parenting stress, perceived parental competence, and parental engagement when the child was age 1, 3, and 5, respectively. Analyses were based on a multiple-sample path analysis that tested direct and indirect effects for mothers of biologically intact and nonintact families. Mothers who reported higher levels of parenting stress at child age 1 experienced lower levels of perceived parental competence at child age 3. Higher levels of perceived parental competence at child age 3 predicted increased mother–child engagement levels at child age 5. Test of indirect effects confirmed that perceived parental competence mediated the relationship between parenting stress and parental engagement for mothers of intact and nonintact families. Implications are discussed.     

Intergenerational Processes,Attachment and Unexplained Medical Symptoms

Children organise self‐protectively in response to anxiety‐provoking or dangerous parental behaviours. When children's self‐protective responses are extreme and persist over time, they may come to the attention of health professionals in the guise of emotional, behavioural or somatic symptoms. A parallel phenomenon is that harmful parental behaviours may be embedded in the emotional processes of the inter‐generational family unit, reflecting the parents' own experiences of comfort and danger, as well as the particular manner in which these experiences have been integrated into the parents' current functioning. Using a case study of a three‐year‐old girl with medically unexplained urinary retention, the article explores how information about attachment relationships and unresolved parental loss or trauma can inform our understanding of implicit, anxiety‐driven processes within the family, and to facilitate family interventions and symptom alleviation. The case shows that the Dynamic‐Maturational Model of attachment has significant applications in the areas of family therapy theory and practice, psychosomatic medicine and consult‐liaison psychiatry.     

Understanding Chinese American Adolescents' Developmental Outcomes: Insights From the Family Stress Model

In this brief report, we investigated whether the Family Stress Model could be replicated with a sample of Chinese American families. Path analyses with 444 adolescents and their parents provided support for the model's generalizability. Specifically, mothers' and fathers' reports of economic status (i.e., income, financial, and job instability) were associated with parents' economic stress. Economic stress and economic status were related to parental depressive symptoms, which, in turn, were associated with more hostile and coercive parenting, less nurturing and involved parenting, and greater interparental hostility. Finally, mothers' hostile and coercive parenting was directly related to both adolescents' academic and sociobehavioral outcomes, whereas fathers' nurturing and involved parenting was related to academic but not sociobehavioral outcomes.     

Is There a Primary Mom? Parental Perceptions of Attachment Bond Hierarchies Within Lesbian Adoptive Families

Basic tenets of attachment theory were evaluated in a qualitative study of 15 lesbian couples with internationally adopted children, focusing on parental perceptions of a primary mother-child attachment within the families. Interviews with 30 mothers examined variables affecting the hierarchy of parenting bonds, including division of labor, time with the child, and parental legal status. All children developed attachments to both mothers, but 12 of the 15 had primary bonds to one mother despite shared parenting and division of labor between the partners. Quality of maternal caretaking was a salient contributing factor; no significant relationship existed between primary parenting and parental legal status.     

Nonmaternal Care's Association With Mother's Parenting Sensitivity: A Case of Self‐Selection Bias?

Although attachment theory posits that the use of nonmaternal care undermines quality of mothers' parenting, empirical evidence for this link is inconclusive. Using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (N = 1,233), the authors examined the associations between nonmaternal care characteristics and maternal sensitivity during the first 3 years of children's lives, with special attention to selection effects and moderation by resource levels. Findings from fixed‐effects regression models suggested that, on average, there is little relationship between nonmaternal care characteristics and maternal sensitivity, once selection factors are held constant. Some evidence of moderation effects was found, however. Excellent‐quality care is related to more sensitivity for mothers with lower family income. Poor‐quality care is related to lower sensitivity for single mothers, but not partnered mothers. In sum, nonmaternal care characteristics do not seem to have as much influence on mothers' parenting as attachment theory claims.     

Familism, Interparental Conflict, and Parenting in Mexican-Origin Families: A Cultural-Contextual Framework

The present investigation examined the relations between the cultural belief of familism and various aspects of family functioning and child adjustment, including interparental conflict, parenting, and children's attachment to school, in a sample of 549 two-parent Mexican-origin families. The results indicated that parents' familistic values were negatively associated with interparental conflict for both mothers and fathers. Parents' familistic values were also indirectly associated with parenting through the marital relationship. Interparental conflict was negatively associated with nurturant-involved parenting for both parents, but particularly for fathers. Interparental conflict had an indirect negative effect on children's attachment to school via mothers' and fathers' nurturant-involved parenting. Both paternal and maternal nurturant-involved parenting behaviors were positively associated with children's attachment to school across two time points. Child gender differences are also discussed.