Disrupting Intergenerational Maternal Maltreatment in Middle Childhood

Background: Child Maltreatment is a concerning worldwide problem. The population of distressed mothers with their highly disturbed children, in middle-childhood, often present to child and adolescent mental health services (CAMHS). Finding effective therapies for this population has proved elusive. This led the authors to undertake a theory-driven research program to better understand intergenerational child maltreatment from a clinical perspective, in order to determine how best to treat the entrenched distressing and destructive behaviors. Methods: The model describing the mechanisms of the intergenerational transmission of maternal maltreatment is briefly described, from which the objectives of any effective treatment for these mothers and children are derived. A clinical model for achieving the therapeutic objectives is then elucidated. Findings: Core objectives of therapy are; first to support the mother and child to develop differentiated senses of self and, second to disrupt a relationship style built on a competitive dominance and submission hierarchy, replacing it with a hedonic (cooperative and compassionate relationship style). This requires a deep healing of the mother and child's trauma histories. A clinical operationalization of these objectives, through a novel dyadic psychotherapeutic protocol, Parallel Parent and Child Therapy is described, which addresses the therapeutic objectives while attending to the safety of mother and child. Interpretation: This research contributes to a better understanding of the components of effective treatment in what is a notoriously hard to treat population. It also illustrates the value of clinically informed theory development in understanding and refining treatment strategies for highly distressed and distressing populations

Child abuse · Developmental psychology · Mental health · Operationalization · Poison control · Population · Psychiatry · Psychotherapist · Suicide prevention · Child Abuse and Trauma · Child and Adolescent Psychosocial and Emotional Development · Clinical Psychology · Maternal Mental Health During Pregnancy and Postpartum · Medicine · Psychology

• Addressing Intergenerational Trauma in an Adolescent Reunification Program

  Open Access•Catia Malvaso, Paul H Delfabbro et al.•Journal of Child & Adolescent…•2021

  Incluir item

• Description and evaluation of a trial program aimed at reunifying adolescents in statutory long-term out-of-home care with their birth families

  Open Access•Catia Malvaso, Catia G Malvaso et al.•Children and Youth Services Review•2020

  Incluir item

• Infant Intersubjectivity

  Open Access•Colwyn Trevarthen, Kenneth J Aitken•Journal of Child Psychology and…•2001

  Incluir item

• The Circle of Security project

  Robert S Marvin, Robert Marvin et al.•Attachment & Human Development•2002

  Incluir item

• Child abuse

  Open Access•Donna Della Femina, Catherine A Yeager et al.•Child Abuse & Neglect•1990

  Incluir item

• The Current State of Cognitive Therapy

  Aaron T Beck•Archives of General Psychiatry•2005

  Incluir item

• The origins of 12-month attachment

  Beatrice Beebe, Joseph Jaffe et al.•Attachment & Human Development•2010

  Incluir item

• Experiential avoidance and behavioral disorders

  Steven C Hayes, Kelly G Wilson et al.•Journal of Consulting and…•1996

  Incluir item

• Ghosts in the Nursery

  Open Access•Selma Fraiberg, Edna Adelson et al.•Journal of the American Academy…•1975

  Incluir item

• Chapter IV. Maternal Frightened, Frightening, or Atypical Behavior and Disorganized Infant Attachment Patterns

  Open Access•Karlen Lyons-Ruth, Karlen Lyons‐Ruth et al.•Monographs of the Society for…•2003

  Incluir item

• Burden and consequences of child maltreatment in high-income countries

  Open Access•Ruth Gilbert, Cathy Spatz Widom et al.•The Lancet•2009

  Incluir item

• Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults

  Open Access•Vincent J Felitti, Robert F Anda et al.•American Journal of Preventive…•1998

  Incluir item

• New approaches to understanding unconscious processes

  Mauricio Cortina, Giovanni Liotti•International Forum of…•2007

  Incluir item

• The capacity for understanding mental states

  Open Access•P Fonagy, M Steele et al.•Infant Mental Health Journal•1991

  Incluir item

• Watch, wait, and wonder

  Open Access•Nancy J Cohen, Elisabeth Muir et al.•Infant Mental Health Journal•1999

  Incluir item

• Categories of response to reunion with the parent at age 6

  Mary Main, Jude Cassidy•Developmental Psychology•1988

  Incluir item

• Emotional processing of fear

  Edna B Foa, Michael J Kozak•Psychological Bulletin•1986

  Incluir item