PARENTING PRACTICES AS POTENTIAL MECHANISMS FOR CHILD ADJUSTMENT FOLLOWING MASS TRAUMA

Journal of Marital and Family Therapy, Apr 2008 by Gewirtz, Abigail, Forgatch, Marion, Wieling, Elizabeth

Trauma research has identified a link between parental adjustment and children's functioning and the sometimes ensuing intergenerational impact of traumatic events. The effects of traumatic events on children have been demonstrated to be mediated through their impact on children's parents. However, until now, little consideration has been given to the separate and more proximal mechanism of parenting practices as potential mediators between children's adjustment and traumatic events. To shed some light in this arena, we review literature on trauma, adversity, and resilience, and discuss how parenting practices may mediate trauma and adverse environmental contexts. Using a social interaction learning perspective (Forgatch & Knutson, 2002; Patterson, 2005), we propose a prevention research framework to examine the role that parenting practices may play in influencing children's adjustment in the wake of trauma exposure. The article concludes by providing a specific model and role for evidence-based parenting interventions for children exposed to mass trauma.

To date, research on the consequences for children of mass trauma events, such as war, widespread violence, and natural disasters, has been overwhelmingly directed toward the individual level and is often psychopathological in its orientation (Garmezy, Masten, & Tellegen, 1984; Macksound, Dyregrow, & Raundalen, 1993; Perry, 1994; Pynoos, Steinberg, & Goenjian, 1996; Terr, 1991). However, researchers working in the field of trauma (Garbarino, Kostelny, & Dubrow, 1991; Wickrama & Kaspar, 2007) increasingly recognize the limitations of such approaches and now advocate for the development of family-based interventions, using the rationale that the family is the most proximal social environment in which children learn patterns of adjustment. Working with trauma using a lens focused on social interactional relationships, however, is a relatively new field of study with few studies and no evidence-based interventions for promoting children's adaptive functioning and preventing adverse outcomes when confronted with mass trauma.

Exposure to mass trauma typically disrupts the social system of care, protection, and meaning that surrounds individuals. Family relationships are often impaired, leaving family members feeling isolated, depressed, and incompetent to manage the many adversities facing them. It is increasingly emphasized that recovery after trauma is a process connected to the family, social, and cultural contexts in which people live (National Institute of Mental Health, 2002). What has received little attention is the direct impact of the parent-child relationship on the sequel of trauma. We postulate that interventions that strengthen parents' capacity to draw on available resources and promote healthy social interactions within the family will lead to better adjustment for all family members, including children and parents. Although the importance of the social and cultural climate following traumatic events has been well documented, the interrelationship among multiple adversities, social interactional patterns within the family system, and short- and long-term adjustment to these families' new life circumstances and contextual setting is not well understood.

In this article, we provide a rationale and vision for a research agenda to develop a comprehensive, multicomponent, parenting and family intervention to enhance child adjustment following exposure to traumatic events. More specifically, the focus of this article is to elaborate on the parenting component of this broader multicomponent approach, which is embedded within a social interaction learning perspective (Patterson, 2005) and within an ecological framework. A core aim of this parenting-level intervention is to promote effective social interaction strategies within families and communities to provide protective processes for children's resilience after exposure to mass trauma. The authors propose that parenting practices are potentially the most salient target of intervention in promoting children's resilience posttrauma.

The following sections will review the literature on trauma and child functioning in the context of the broader developmental literature on risk and resilience in adverse contexts. Following that, we focus on the impact of parenting practices on child functioning in the context of stressful circumstances, a largely neglected topic within the trauma literature. We summarize research documenting successful interventions to change parenting practices among families under stress. While much evidence exists for the impact of parenting on children's externalizing symptoms, far less has been gathered regarding the relationship of parenting practices to children's distress and internalizing symptoms following traumatic events. We review the extant literature on parenting and children's posttrauma adjustment and conclude by introducing a prevention research framework which applies a relational lens to address children's functioning following exposure to mass trauma.