Defining and Understanding Parentification: Implications for All Counselors

Abstract

This article advances a balanced discussion of the extent to which varied outcomes are evidenced in adulthood after one has been parentified in childhood. Recommendations are provided that may help counselors avoid the potential overpathologizing of clients with a history of parentification. Suggestions for clinical practice are put forth for all counselors. Parentification is a ubiquitous phenomenon that most school, community, and family counselors as well as other human helpers face (Byng-Hall, 2002). That is, most counselors are likely to encounter both children and adults who have a history of parentification—a potential form of neglect (Boszormenyi-Nagy & Spark, 1973; Chase, 1999). What is parentification, and given its relationship with negative outcomes and behaviors, what can counselors do to avoid overpathologizing the client's signs, symptoms, and behaviors associated with parentification? This paper offers a review of what clinical practitioners and researchers have described in the literature. Subsequent to a brief review of the literature, suggestions regarding practice efforts directed toward clients who have experienced parentification are put forward.

Full text

Defining and Understanding Parentification:
Implications for All Counselors
Lisa M. Hooper
The University of Alabama
ABSTRACT
This article advances a balanced
discussion of the extent to which varied
outcomes are evidenced in adulthood
after one has been parentified in
childhood. Recommendations are
provided that may help counselors avoid
the potential overpathologizing of clients
with a history of parentification.
Suggestions for clinical practice are put
forth for all counselors.
Parentification is a ubiquitous
phenomenon that most school,
community, and family counselors as
well as other human helpers face (Byng-
Hall, 2002). That is, most counselors are
likely to encounter both children and
adults who have a history of
parentification—a potential form of
neglect (Boszormenyi-Nagy & Spark,
1973; Chase, 1999). What is
parentification, and given its relationship
with negative outcomes and behaviors,
what can counselors do to avoid
overpathologizing the client’s signs,
symptoms, and behaviors associated
with parentification? This paper offers a
review of what clinical practitioners and
researchers have described in the
literature. Subsequent to a brief review
of the literature, suggestions regarding
practice efforts directed toward clients
who have experienced parentification are
put forward.
Defining Parentification
Parentification is the distortion or lack
of boundaries between and among
family subsystems, such that children
take on roles and responsibilities usually
reserved for adults (Boszormenyi-Nagy
& Spark, 1973). That is, either explicitly
or implicitly, parents create an
environment that fosters caretaking
behaviors in their children that help
maintain homeostasis (i.e., balance) for
the family in general and the parent in
particular. Above and beyond
maintaining homeostasis for the family,
the responsibilities that are carried out
by the parentified child are traditionally
behaviors that provide the parent with
the specific emotional and instrumental
support that the parent likely did not
receive while he or she was growing up
(Boszormenyi-Nagy & Spark,1973;
Minuchin, Montalvo, Guerney, Rosman,
& Schumer, 1967). Thus, the child must
be emotionally available for the parent,
even though the parent is often
emotionally unavailable for the child,
which may engender a chronic state of
anxiety and distress in some emotionally
parentified children (Bowen, 1978;
Briere, 1992; Cicchetti, 2004). The
clinical literature has also reported that
the breakdown in the generational
hierarchy may rob the child of activities
that are developmentally appropriate; the
child instead participates in either
instrumental or emotional caregiving
behaviors directed toward parents,
siblings, or both that may go unrewarded
and unrecognized (Boszormenyi-Nagy

Defining and Understanding Parentification
& Spark,1973; Jurkovic, 1997; Kerig,
2005; Minuchin et al.,1967). Some
research and practitioners contend that to
fully understand the aftereffects of
parentification, the type of
parentification (i.e., emotional and
instrumental) experienced in the family
must be assessed (Jurkovic, 1997).
Emotional parentification is the
participation in the “socioemotional
needs of family members and the family
as a whole” (Jurkovic, Morrell, &
Thirkield, 1999, p. 94). Behaviors
described by Jurkovic and colleagues
include, “serving as a confidant,
companion, or mate-like figure,
mediating family conflict, and providing
nurturance and support” (p. 94).
Instrumental parentification is the
participation in the “physical
maintenance and sustenance of the
family” (Jurkovic et al., 1999, p. 94).
Behaviors described by Jurkovic and
colleagues include, grocery shopping,
cooking, housecleaning, and
performance of daily duties that involve
caring for parents and siblings” (p. 94).
Of significance to counselors and other
mental health practitioners, not all
children who are parentified will
experience negative aftereffects (Byng-
Hall, 2002; DiCaccavo, 2006; Earley &
Cushway, 2002; Tompkins, 2007). In
fact, approximately only one-fourth of
all children who experience neglect will
go on to experience negative aftereffects
(Alexander, 1992; Cicchetti & Toth,
1995; Golden, 1999; Toth & Cicchetti,
1996; West & Keller, 1991). The next
section takes a less myopic view of the
potential aftereffects of parentification
often reported in the literature. The
following section includes a brief review
of the research base of both negative and
positive outcomes associated with
parentification.
Understanding Parentification: The
Negative and Positive Effects of
Parentification
Established Negative Effects. Studies in
the last 30 years have established a
relationship between parentification and
later maladjustment. Researchers have
found linkages from early childhood
stress/trauma to child and parent factors
such as divorce (Wallerstein, 1985),
parental alcohol and drug use (Bekir,
McLellan, Childress, & Gariti, 1993),
disruption in attachment (Zeanah &
Zeanah, 1989), family discord, low
socioeconomic status (Boszormenyi-
Nagy & Spark, 1973; Minuchin et al.,
1967), depression, and attachment and
relational difficulties (Jones & Wells,
1996).
The effects of childhood parentification
can be long-lasting, multigenerational,
and deleterious, presenting over the
course of a lifetime (Chase, 1999;
Karpel, 1976; West & Keller, 1991). For
young adults, parentification can impede
“normal” development related to
relationship building, personality
formation, and other developmentally
critical processes (Burt, 1992; Goglia,
Jurkovic, Burt, & Burge-Callaway,
1992; Sessions & Jurkovic, 1986;
Wolkin, 1984). Valleau, Bergner, and
Horton (1995) found that children who
are parentified have significantly more
“caretaker characteristics” in adulthood
than do those children who are not
parentified. Similarly, Jones and Wells
(1996) found an association between
personality characteristics such as
“people pleasing” and adults who had
been parentified. Further, their study,
comprising 208 undergraduate students
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Defining and Understanding Parentification
from a large Midwestern university,
found that participants who were
destructively parentified as children
often relate to others in problematic,
overfunctioning, caretaking ways.
Domains like separating from the family
of origin, participating in age-
appropriate behaviors (Olson & Gariti,
1993), engaging in academic pursuits,
and developing self-esteem can also be
affected (Bekir et al., 1993; Chase,
Demming, & Wells, 1998). Other
aftereffects may include mental illness in
general, and depression, anxiety,
substance abuse, and dependence
disorders in particular. For example,
Chase et al. (1998) found relationships
between high levels of parentification
and academic achievement and parental
use of alcohol. These findings are
consistent with multiple studies that
have established a relationship between
parentification and alcohol use by at
least one parent or guardian (Bekir et
al.,1993; Goglia et al., 1992). Bekir et al.
concluded that adults who abuse alcohol
or drugs are often unable to perform
their parental duties and that, therefore,
the parentified child is often left to care
for self, siblings, and parents. Bekir et al.
also found that the parentified child is
often inclined to repeat the same
behaviors as an adult with his or her own
children. Borderline personality and
dissociative disorders, although rare, can
be evidenced in extreme cases of this
phenomenon (Cicchetti, 2004; Liotti,
1992; Wells & Jones, 2000; Widom,
1999).
As previously mentioned, neglect
such as parentification can be and often
is traumatic for a child as well as for the
adult he or she becomes (Aldridge,
2006; Alexander, 1992; Chase, 1999;
Jurkovic, 1998). Trauma is often
experienced when a situation or
environment is perceived as being
overwhelming, threatening, and too
much for the individual (Briere, 1992;
Lazarus & Folkman, 1984), or when a
chronically stressful situation becomes
unrelenting and the individual is unable
to adapt and cope with the experience in
a healthy functional way (Brewin,
Andrews, & Gotlib, 1993; Werner,
1990).
Parentification can therefore be
characterized as a traumatic event and an
adverse process, in accord with the
definitions and criteria put forward in the
family and trauma literature, that have
long-lasting effects experienced in
adulthood (Belsky, 1990; Briere, 1992;
Chase, 1999; Cicchetti, 2004). Further,
extant literature on parentification has
shown that the process is in fact adverse
for most children and that it can later be
linked to poor adult functioning. The
process of childhood parentification can,
in the adults those children become,
produce a fear of having children and/or
lead to the transmission of
parentification across many generations
(Boszormenyi-Nagy & Spark, 1973;
Bowen, 1978; Chase et al., 1998).
Potential Positive Effects
Because of the trauma often related to
the parentification process (e.g.,
significant distress, adversity,
dissociation, and even suicide [Jurkovic,
1997; Markowitz, 1994), research has
tended to focus on psychopathology and
other negative outcomes (Barnett &
Parker, 1998; Walker & Lee, 1998).
There is a dearth of research discussing
positive outcomes after childhood
parentification. One of the few studies to
do so, conducted by Jurkovic and Casey
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Defining and Understanding Parentification
(2000), reported on the linkage between
emotional parentification and
interpersonal competence among Latino
adolescents. That study’s findings
suggested that higher levels of emotional
parentification are predictive of higher
levels of interpersonal competence. On
the other hand, adolescents who
experience low levels of emotional
parentification—in a family system in
which they perceive the parentification
process (i.e., the assignment of and the
responsibility to carry out parent like
duties) to be unfair—also experience
low levels of competence. Jurkovic and
Casey concluded that parentification has
the potential to promote competence.
Additionally, they suggested that
potentially critical to positive outcomes
after parentification is the degree to
which the child perceived the process to
be fair. In the context of a family system
where children have reported that the
parentification process was “fair” also
reported that their parent-like behaviors
and responsibilities did not go unnoticed
and they carried out those
responsibilities for brief periods of time.
Of significance, a family system absent
of parentification may prevent some
children of the skills and abilities they
could use across domains and
throughout their lives—although more
research is needed to clarify and support
this assertion. Towards this end, in
Thirkield’s (2002) study examining the
relationship between instrumental
parentification in childhood and
interpersonal competence in adulthood, a
significant positive linear relationship
was obtained. Thirkield also found a
positive relationship between age,
positive outcomes (operationalized as
interpersonal competence), and
instrumental parentification. Findings
from these studies (Jurkovic &
Casey,2000; Thirkield,2002) provide
preliminary support showing that (a)
benefits may be engendered by the
parentification process, and (b) benefits
may last over time.
In a more recent study conducted by
Walsh, Zvulun, Bar-On, & Tsur (2006)
they examined the extent to which the
parentification process may be
associated with positive factors among
adolescent immigrants. In their study
they found parentification was related to
positive outcomes such as high levels of
individuation and differentiation from
the family system. They also found
when adolescent immigrants and non-
immigrants perceived their roles and
responsibilities as fair and age
appropriate the outcome was positive:
sense of mastery and competence. Thus
they concluded the provision of parent-
like roles and responsibilities among the
study sample engendered individual
autonomy, self-mastery, and family
cohesion. McMahon and Luthar (2007)
also found a relationship between
psychosocial adjustment and
parentification. Of significance, and in
support of divergent findings related to
childhood parentification and adult
outcomes, McMahon and Luthar
contend this process and its associated
outcomes are multidetermined and
multifactorial, even in the context of
severe, long-standing levels of
parentification. For example, among
their study sample of children living in
poverty, the researchers failed to find a
significant, stable relationship between
parentification and poor outcomes.
Discussion
Given the overwhelming findings
regarding negative outcomes, counselors
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Defining and Understanding Parentification
may be inclined to delimit their
therapeutic encounters to investigations
that look for the negative outcomes often
seen among this population (DiCaccavo,
2006; Earley & Cushway, 2002; Kerig,
2005). This potential overpathologizing
among counselors (Barnett & Parker,
1998; Hooper, 2007) could result in
missed opportunities to uncover
exceptions, that is, when positive skills
and coping strategies are experienced.
Consistent with a wellness, strength-
based counseling framework, counselors
should assess for clients’ strengths—if
any—derived from the parentification
process and infuse them into the
counseling and treatment planning
process. Therefore, the advantage of the
application of the counseling wellness
framework—as compared to a deficit or
medical model framework—is that it
allows for the explication of differential
outcomes—both negative and positive—
associated with parentification
(DiCaccavo,2006; Hooper,2007;
Jurkovic, 1997; Mayseless , et al.,
2004).
In the case of potential neglect, such as
parentification, many factors, as
previously described, may contribute to
the same event or process leading to
divergent outcomes. For example,
parentification can be perceived as
traumatic, as stressful but not traumatic,
or as a regular, even an anticipated
cultural event in the course of daily
living (Walsh, et al., 2006). To this end,
a large body of trauma literature has
suggested that the number of stressors
has more to do with the outcome or
aftereffects than does a particular
stressor itself (Waller, 2001). Thus, in
the case of parentification, the number of
stressors may influence the outcome
exhibited in both childhood and
adulthood.
Also, as asserted in the parentification
literature (Chase, 1999; Jurkovic, 1997,
1998; Minuchin et al., 1967), how long
the stressor was related to providing
caregiving to the parent and sibling is
also a contributing factor for those
children who carry out the parentified
role in their family of origin. Those who
perform this role for short periods of
time may perceive the role as less
overwhelming, stressful, or traumatic
than will others (Byng-Hall, 2002;
Saakvitne & Tennen, 1998; Tedeschi &
Calhoun, 1995). Finally, from a
developmental perspective, older
children are likely to feel more equipped
to take on the caregiving role than
younger children, thereby influencing
growth or distress outcomes associated
to the parentification process.
All counselors should consider the
following points when working with
clients who have a history of
parentification.
1. First, consider that not all clients who
are parentified experience negative
sequlae that are often reported in the
clinical and research literature (Barnett
& Parker, 1998; Byng-Hall, 2002;
Jurkovic, 1997; Jurkovic & Casey, 2000;
McMahon & Luthar, 2007; Thirkield,
2002; Tompkins, 2007).
2.Consider how long the parentification
process has been going on. The resultant
aftereffects may be different for clients
for whom the process is brief and
temporary as compared to long and
chronic (DiCaccavo, 2006; Tompkins,
2007). Shorter brief episodes of
parentification may foster competency
and self-efficacy in the client rather than
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Defining and Understanding Parentification
pathological, poor outcomes (McMahon
& Luthar, 2007).
3.Consider the age of the client. The
aftereffects are likely to be different for
a younger child who is parentified as
compared to an older adolescent
(Kaplow & Widon, 2007; Walsh et al.,
2006).
4.Determine if the parentification
process is delimited to instrumental,
emotional, or both. The research
suggests emotional parentification may
be more deleterious than instrumental
parentification (Hooper, 2007;
McMahon & Luthar, 2007; Tompkins,
2007).
5.Consider the cultural and familial
context in which the client is embedded.
For example, how do the family and
people who adopt the client’s culture
perceive the parentification process
(Jurkovic, et al., 2001; Walsh, et al.,
2006)? Is the parentification process
culturally expected and valued?
6.Consider using a questionnaire to
capture the level, type, and perceived
fairness of parentification (e.g., Jurkovic
& Thirkield, 1998, for child and adult
instruments).
7.Examine to what extent the client feels
the parentification process is “fair.”
Again, research suggests if the process is
perceived to be “fair” then it is often
associated with fewer negative outcomes
(Jurkovic, et al., 1999).
8.There may be strengths engendered by
the parentification process (Hooper,
2007; Tompkins, 2007). Thus it may be
helpful to explore both positive and
negative aspects of the parentification
process.
9.Involve the family if possible.
Education may be all the family needs to
help the client and family restore or
reestablish the appropriate boundaries
where the child (if working with a child
or adolescent) has a safe, appropriate
context to grow, learn, differentiate, and
thrive (Walsh et al., 2006).
10.Consider a referral. Depending on the
context in which a counselor works, and
the extent and level of adversity
associated with the parentification
process, specific trauma-based
counseling (Calhoun & Tedeschi, 1999)
may be indicated.
Summary
Counselors and researchers have long
demonstrated a clear awareness of the
deleterious effects of parentification in
general (Chase, 1999; Jurkovic, 1997;
Mayseless, Bartholomew, Henderson, &
Trinke, 2004). On the other hand, and at
the same time, Barnett and Parker
(1998) concurred with Boszormenyi-
Nagy and Spark (1973) that it may in
fact be maladaptive to avoid or miss out
on any parental roles in the family of
origin—in that many lessons for
adulthood and parenthood are derived
from family-related roles and
responsibilities (i.e., parentification)
during childhood. Recently, Barnett and
Parker (1998) have questioned whether
parentification leads to early competence
or childhood deprivation. Similarly, one
of the “founding fathers” (Boszormenyi-
Nagy) of the construct of parentification
reminded counselors, theorists,
researchers, and the like that “the term
describes a ubiquitous and important
aspect of most human relationships. It is
suggested that parentification should not
be unconditionally ascribed to the realm
of ‘pathology’ or relational dysfunction.
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39 Defining and Understanding Parentification

Defining and Understanding Parentification
It [parentification] is a component of the
regressive core of even balanced,
sufficiently reciprocal relationships”
(Boszormenyi-Nagy & Spark, 1973, p.
151)

AUTHOR NOTE
Correspondence regarding the
manuscript should be directed to: Lisa
M. Hooper, Ph.D., Department of
Educational Studies in Psychology,
Research Methodology, and Counseling,
The University of Alabama, Box
870231, Tuscaloosa, Alabama 35487-
0231. Email: lhooper@bamaed.ua.edu
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The Alabama Counseling Association Journal, Volume 34, Number1, Spring 2008
43 Defining and Understanding Parentification