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Disrupting Intergenerational Maternal Maltreatment in Middle Childhood: Therapeutic Objectives and Clinical Translation

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....

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Autores principales: Amos, Jackie, Segal, Leonie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277472/
https://www.ncbi.nlm.nih.gov/pubmed/30538646
http://dx.doi.org/10.3389/fpsyt.2018.00623
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author Amos, Jackie
Segal, Leonie
author_facet Amos, Jackie
Segal, Leonie
author_sort Amos, Jackie
collection PubMed
description 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.
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spelling pubmed-62774722018-12-11 Disrupting Intergenerational Maternal Maltreatment in Middle Childhood: Therapeutic Objectives and Clinical Translation Amos, Jackie Segal, Leonie Front Psychiatry Psychiatry 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. Frontiers Media S.A. 2018-11-27 /pmc/articles/PMC6277472/ /pubmed/30538646 http://dx.doi.org/10.3389/fpsyt.2018.00623 Text en Copyright © 2018 Amos and Segal. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Amos, Jackie
Segal, Leonie
Disrupting Intergenerational Maternal Maltreatment in Middle Childhood: Therapeutic Objectives and Clinical Translation
title Disrupting Intergenerational Maternal Maltreatment in Middle Childhood: Therapeutic Objectives and Clinical Translation
title_full Disrupting Intergenerational Maternal Maltreatment in Middle Childhood: Therapeutic Objectives and Clinical Translation
title_fullStr Disrupting Intergenerational Maternal Maltreatment in Middle Childhood: Therapeutic Objectives and Clinical Translation
title_full_unstemmed Disrupting Intergenerational Maternal Maltreatment in Middle Childhood: Therapeutic Objectives and Clinical Translation
title_short Disrupting Intergenerational Maternal Maltreatment in Middle Childhood: Therapeutic Objectives and Clinical Translation
title_sort disrupting intergenerational maternal maltreatment in middle childhood: therapeutic objectives and clinical translation
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277472/
https://www.ncbi.nlm.nih.gov/pubmed/30538646
http://dx.doi.org/10.3389/fpsyt.2018.00623
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