How Parentification Impacts Teen Mental Health

In healthy parent-child relationships, parents give and children receive. The role of a parent is to provide care and unconditional love so that children are free to focus their energy on learning and growing. However, not all individuals have the stability and inner resources to be this kind of parent. Instead, they may rely on their children in inappropriate ways. The result is a phenomenon known as parentification.

What Is Parentification?

The word parentification was coined by the Hungarian-American psychiatrist Ivan Boszormenyi-Nagy, one of the founders of the field of family therapy. The word describes what happens when the roles of parent and child are reversed.

In other words, parents look to their children for emotional and/or practical support, rather than providing it. Hence, the child becomes the caregiver. As a result, parentified children are forced to assume adult responsibilities and behaviors before they are ready to do so. In addition, they do not receive acknowledgment or support for taking on these responsibilities.

Consequently, this role reversal disrupts the natural process of maturing. Therefore, in most cases, it has far-reaching negative effects on the child’s mental and physical health.

Newport Academy Resources Post Mental Health Parentification

Reasons for Parentification

In most cases of parentification, the parent is compromised in some way. Hence, it is more likely to occur when a parent

  • Has an alcohol or substance use disorder
  • Is disabled or has a serious medical condition
  • Does not have sufficient emotional support from other adults
  • Experienced neglect or abuse as a child
  • Suffers from a mental illness.

Moreover, financial hardship, divorce, or the illness of a sibling can create conditions that may lead to parentification.

“When parentification assumes pathological proportions, parents are often unwittingly replaying painful and abusive scripts from their own childhood and setting the stage for succeeding generations to do the same. In the process, their children’s intrinsic loyalty, concern, and trust are exploited.”

—Gregory J. Jurkovic, author of Lost Childhoods: The Plight of the Parentified Child

Two Types of Parentification

Experts have identified two distinct types of parentification: instrumental and emotional. In addition, it can be parent focused or sibling focused. Parent-focused parentification describes caregiving directed toward the parent or primary caregiver. Sibling-focused parentification indicates that the child or teen has taken a caregiving role toward a sibling or siblings.

In cases of instrumental parentification, children take on practical responsibilities such as

  • Taking care of siblings or other relatives because a parent is unable to
  • Assuming housekeeping duties, such as cleaning, cooking, and grocery shopping
  • Paying bills and attending to other household tasks
  • Serving as a translator in families where the parent does not speak the primary language of their resident country.

Emotional parentification involves a child

  • Listening to a parent talk about their problems
  • Offering advice to a parent
  • Mediating between a parent and another family member
  • Serving as a confidante for their parent
  • Providing emotional comfort and support to a parent.

“Children should not be serving the intimate needs of a parent, or placed in the role of secret-keeper.”

Dr. Lisa M. Hooper, researcher and expert on parentification

Newport Academy Resources Post Mental Health Parentification

The Difference Between Parentification and Healthy Communication

To be clear, it’s not always a bad thing for a parent to talk to a child or teen about what they’re feeling, in age-appropriate ways. In fact, kids may feel confused or blame themselves if they know a parent is unhappy but don’t understand what’s making them sad. But the parent should not look to the child for help in coping with their emotions.

Furthermore, it’s fine for kids to help out around the house or care for younger siblings sometimes, or even for a parent if they are briefly unwell. In fact, taking on family responsibilities—in appropriate measure—can give a child a sense of satisfaction and competence. However, helping out at home should not be at the expense of a child’s or teen’s emotional or physical health. Nor should it disrupt their academic studies, peer relationships, or the other “work” of growing up.

In summary, children should never feel that they are responsible for keeping their parents happy or keeping the family safe.

Parentified Child Symptoms

Parentification creates a state of chronic stress and relational trauma. Moreover, it is a form of parental neglect. As a result, it has both short- and long-term effects on a child’s life. And the earlier the caregiving begins, the more negative the consequences for the child.

A parentified teenager or younger child may exhibit the following symptoms:

  • Anxiety, particularly regarding caring for others
  • Depression
  • Suicidal thoughts
  • Compulsively overworking in order to fulfill responsibilities at school and at home
  • Feelings of guilt and shame
  • Unrelenting worry
  • Social isolation
  • Physical symptoms of anxiety and depression, such as stomachaches, headaches, etc.

According to the National Alliance for Caregiving, about 1.4 million children and adolescents in the United States experience emotional or instrumental parentification. However, it is often overlooked or unrecognized. Therefore, it’s possible that many more children and teens belong in this category.

Long-Term Effects of Parentification

Furthermore, the impact of parentification continues into adulthood. Research shows that having adverse childhood experiences increase the likelihood of both mental and physical health problems. The ongoing stress of such experiences actually changes the brain—shrinking the hippocampus, the part of the brain that regulates memory, emotion, and stress management.

Hence, adults who were parentified as children or teens may experience the following:

  • Inability to trust others
  • Involvement in violent or otherwise unhealthy relationships
  • Inappropriate sense of entitlement or authority
  • Difficulty functioning independently
  • Higher chance of chronic physical illness
  • Greater risk of anxiety, depression, substance use disorders, and eating disorders.

The Parentification Inventory

Over the past two decades, Dr. Hooper and her collaborators have done extensive research on parentification. Hence, they have developed a parentification scale.

Known as the Parentification Inventory, this scale is a series of statements regarding family dynamics. In response to each statement, individuals choose a number between 1 (never true) and 5 (always true) that describes their experience. The results indicate the extent to which the individual has been parentified.

Parentification Treatment Approaches

Treatment focuses on addressing the resulting trauma, neglect, and chronic stress. Therefore, modalities to address the parentified child may include the following.

Trauma-Focused Cognitive Behavioral Therapy is designed to shift unhelpful thought patterns.

Dialectical Behavioral Therapy helps clients identify and transform self-destructive behaviors. 

Eye Movement Desensitization and Reprocessing (EMDR) uses specific physical techniques to resolve and release trauma.

The Comprehensive Resource Model involves elements of psychology, spirituality, neurobiology, and body-based (somatic) techniques.

Experiential modalities, such as creative arts therapies and Equine-Assisted Therapy, allow children and teens to process emotions in nonverbal ways.

Newport Academy Resources Post Mental Health Parentification

Yoga and meditation are contemplative practices that build tools for emotion regulation and self-awareness.

In conclusion, the goal of parentification treatment is to repair the damage that arises from a disrupted childhood. Hence, the client can gradually heal from the painful consequences of those early experiences. Moreover, they can build skills for developing healthy boundaries and caring relationships—essential ingredients for a balanced, happy life.

Sources:

J Family Ther. 35:43–65.  

Family. 20:164–178.

American J Family Ther. 39(3):226–241.

J Am Acad Child Adolesc Psychiatry. 2014 Apr;53(4):417–24.

PNAS. 2012 August;109 (32):12927–12932.