Intergenerational Patterns of Maltreatment in Families at Risk for Foster Care

INTERGENERATIONAL PATTERNS OFMALTREATMENT IN FAMILIES AT RISK

FOR FOSTER CARE

Lenore M. McWeyFlorida State University

Andrea L. PazderaValdosta State University

Amber VennumKansas State University

Armeda S. WojciakFlorida State University

Few qualitative studies have investigated the process of parental efforts to break interge-nerational patterns of maltreatment. A grounded theory approach was used to understandhow 24 parents who had been identified by CPS as being at-risk of having their childrenremoved from their homes due to allegations of abuse and ⁄ or neglect, perceived and con-nected their own experiences of childhood abuse in light of their experiences as allegedperpetrators of child maltreatment. Three major categories were identified: patterns,beliefs, and behaviors. A majority of the parents stated that they recognized intergenera-tional patterns, most expressed that they wanted to be different from their own parents,yet many described parenting actions that were ‘‘destructive.’’ We suggest that it is theinterrelationship amongst patterns, beliefs, and behaviors that may offer opportunities forparents and therapists to enact change.

Child welfare agencies received referrals regarding alleged maltreatment of approximately6 million children during the federal fiscal year of 2009 (U.S. Department of Health andHuman Services, 2010). Given this statistic, it is not surprising that there has been much empir-ical interest in determining causal explanations of child maltreatment in families (Markowitz,2001; Wilkes, 2002). One predictor of child abuse and neglect is parents’ own childhood histo-ries of maltreatment (Bert, Guner, & Lanzi, 2009). Using a nationally representative datasetinvolving over 6,000 participants, results of Heyman and Smith-Slep’s (2002) quantitative studyindicate that both fathers and mothers who had childhood histories of maltreatment were at anincreased risk of parent to child violence in adulthood. Although not all abused youth grow upto abuse their own children, often parents who are reported for abuse were abused themselves(Wilkes, 2002).

Lenore M. McWey, PhD, is an Associate Professor in the Marriage and Family Therapy (MFT) Doctoral

Program in the Department of Family and Child Sciences at The Florida State University; Andrea Pazdera, PhD,

is a faculty member in the MFT program at Northcentral University; Amber Vennum, PhD, is an Associate

Professor in the MFT Program in the School of Family Studies and Human Services at Kansas State University;

Armeda Wojciak, MS, is a doctoral student in the MFT Doctoral Program in the Department of Family and

Child Sciences at The Florida State University.

This project was supported with a grant from the UK Center for Poverty Research through the U.S.

Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, grant

number 5ASPE417-03. The opinions and conclusions expressed herein are solely those of the author(s) and

should not be constructed as representing the opinions or policy of the UKCPR or any other agency of the

Federal government.

Address correspondence to Lenore McWey, 210 Sandels Bldg., Tallahasse, Florida 32306-1491; E-mail:

[email protected]

Journal of Marital and Family Therapydoi: 10.1111/j.1752-0606.2012.00289.x

JOURNAL OF MARITAL AND FAMILY THERAPY 1

Despite evidence supporting intergenerational patterns of maltreatment (Bailey, Hill,Oesterle, & Hawkins, 2009; Bert et al., 2009; Herschell & McNeil, 2005), others question thevalidity of the hypothesis that maltreatment is transmitted across generations (Belsky, 1993;Widom, 1989). Spawning continued debate in the literature, Kaufman and Zigler (1987) chal-lenged the theory of an intergenerational process, arguing that although some who were abusedas children do indeed perpetrate abuse as parents (estimates vary by study and rates have beenshown to be as low as 7% [Renner & Slack, 2006]), the majority of parents who were mal-treated as children do not later abuse their own children. Questions of the intergenerationalprocess, however, remain challenged by contemporary reviews of research demonstrating‘‘confirmation’’ that child abuse rates are consistently higher than the national average forparents who themselves were the victims of childhood abuse (Lieberman, Chu, Van Horn, &Harris, 2011, p. 401).

The general consensus in literature is that there are multiple familial and environmentalrisk factors associated with increased risk of maltreatment (e.g., Lieberman et al., 2011; Tyler,Allison, & Winsler, 2006). Familial factors include the parent’s history of abuse, substance use,psychological problems, and parental behaviors. For example, child maltreatment is more likelyto occur the younger a parent is (Kim, 2009), in single parent families (Sedlak & Broadhurst,1996), if mothers use alcohol or drugs prenatally (Smith, Johnson, Pears, Fisher, & DeGarmo,2007) or if parents use drugs or alcohol after the child is born (Kim, 2009; Smith et al., 2007),and when a parent struggles with mental health concerns (Egeland, Jacobvitz, & Sroufe, 1988;Herschell & McNeil, 2005; Kim, 2009). Interestingly, a study of 109 families in high-crime areasin a mid-sized city found that parents who were depressed were less likely to abuse their chil-dren compared to parents suffering with anxiety (Pears & Capaldi, 2001). Pears and Capaldi(2001) attribute this finding to the symptomology of depression—wanting to be alone, isolation,and withdrawing from those around you.

Specific environmental factors associated with maltreatment include socioeconomic statusand whether or not the parent has a positive social support network. In a congressionallymandated, nationally representative study, findings indicated that when comparing families withan annual income below $15,000 to those with an annual income of more than $30,000, thosewho were living below the poverty line were 22–25 times more likely to experience child mal-treatment (Sedlak & Broadhurst, 1996). Parents who are cyclically employed versus consistentlyemployed are also at higher risk (Kim, 2009), possibly due to stress associated with trying toprovide for a family with minimal finances (Egeland et al., 1988; Tyler et al., 2006). Addition-ally, the impact of negative life events on an increased risk of child maltreatment might beheightened when there is not an adequate parental support network in place (Rodrigo, Martin,Maiquez, & Rodriguez, 2006).

Although research indicates that it is often a combination of risk factors that contribute tothe occurrence of child maltreatment in a family (Goldman, Salus, Wolcott, & Kennedy, 2003),Haapasalo and Aaltonen (1999) report that a maternal history of abuse accounted for nearly30% of the variance in predicting child maltreatment, and findings from a quantitative study of213 mothers indicated that no one type of past maltreatment (i.e., physical abuse, neglect, sex-ual abuse) predicted intergenerational transmission better than another (Zuravin, McMillen,DePanfilis, & Risley-Curtis, 1996). Although there is empirical support implicating familypatterns of child maltreatment, little is known about the processes of these intergenerationalpatterns (Wilkes, 2002). More research is needed to determine characteristics of parents’ experi-ences that heighten the risk of child maltreatment. The purpose of this study was to understandthe following: how parents at-risk of losing their children because of maltreatment makeconnections between their own experiences of maltreatment and their children’s experiences ofmaltreatment; how they desire to parent differently and ⁄or similarly to their own parents; andhow these beliefs are reflected in their behaviors with their children.

Families ‘‘At-Risk’’

After reports of abuse or neglect are made, investigations are conducted by child andprotective services (CPS) to determine the legitimacy of the claims. Of the millions of reports

2 JOURNAL OF MARITAL AND FAMILY THERAPY

alleging maltreatment each year, approximately 702,000 are substantiated (U.S. Department ofHealth and Human Services, 2010). Families whose cases are substantiated are often deemed‘‘at-risk’’ and are typically court ordered for postinvestigative services. Case plans are to be spe-cific to each family’s needs and often require individual and family assessments, therapy, andparent education (Child Welfare Information Gateway, 2011). Services tend to be short termwith the goal centered on preventing future maltreatment so that the child can remain safely inthe home. In cases where children have been removed and placed in foster or kinship care, thegoal of services may be to remedy threats to child safety so that reunification can occur (Curtis,1999). Reoccurrence of maltreatment is another concern. Among a national sample, 22% ofchildren who were victims of alleged abuse were again reported to CPS for a repeat allegationof maltreatment within a 24-month period (Fluke, Shusterman, Hollinshead, & Yuan, 2008).

Substantial progress has been made with regard to interventions aimed to improve out-comes of families deemed at-risk. For example, there are now a number of empirically sup-ported parent education models such as the Incredible Years (Webster-Stratton & Reid, 2003),and the Oregon Model of Parent Management Training (Forgatch, Bullock, & Patterson,2004). There also are empirically supported family therapy models such as multisystemic ther-apy (Henggeler, Melton, & Smith, 1992) and multidimensional family therapy (Liddle, 2009).Although there has been important progress in interventions aimed to promote child welfare,considering the relatively high rates of recidivism (Fluke et al., 2008) and stable rates of mal-treatment across the country (U.S. Department of Health and Human Services, 2010), muchmore remains to be learned.

Elements of interventions aimed to decrease maltreatment risk include psychoeducation(Herschell & McNeil, 2005), building empathy within the parent (e.g., Hitchcock, 1987; Tempel,2009), building a support network (Egeland et al., 1988), cognitive restructuring (Dattilio, 2006;Wilkes, 2002), and acceptance of past abuse (Fulshaw, Browne, & Hollin, 1996). Yet, previousresearch suggests that when there is an intergenerational pattern, there are important differencesin parents’ understanding of their own maltreatment (Wilkes, 2002). Therefore, what mightwork for one parent might not work for another. Many have argued that interventions need tobe tailored to the unique needs of clients (e.g., DePanfilis, 2006). Unfortunately, when it comesto understanding beliefs regarding past abuse and current parenting practices of parents whowere maltreated, little is empirically known.

Wilkes (2002) conducted a pilot quantitative investigation of the nature of change among20 parents who were abused as children but who did not later abuse their own children. Shefound that adults who were able to break the intergenerational pattern of abuse demonstratedstrong conceptual change. She suggested that this change involved three tasks. First, parents inher study were able to create categorical reassignment where they were able to move frombeliefs that their own parents did not believe that what they were doing was wrong, to apersonal belief that maltreatment in their family of procreation is wrong. Second, nonabusiveparents expressed changes in their explanatory mechanisms. Specifically, parents were able toseparate things that were in their control (how they parent their children) from things that werenot in their control (how their parents treated them). Changes in individual concepts, involvingboth positive and negative coping strategies, were the final aspect of conceptual change. Posi-tive coping strategies involved parents engaging in new activities such as parent education, andnegative coping mechanisms involving overworking, overeating, and ⁄or use of alcohol.Although Wilkes (2002) study differs from the present study in that nonabusive parents werethe focus of her investigation, she concluded that clinicians might approach intergenerationalpatterns of maltreatment by gaining a better understanding beliefs and behaviors of parents.

Symbolic interactionism, with roots in phenomenology (Oliver, 2011), could theoreticallyexplain intergenerational patterns of violence by linking the relationships between early experi-ences, meaning making, and later parenting behavior. According to Blumer (1969), ‘‘to bypassmeaning in favor of factors alleged to produce the behavior is seen as a grievous neglect of therole of meaning in the formation of behavior’’ (p. 3). Symbolic interactionism posits that peopleact toward things based on the meaning they attribute to that object, person, or event (Blumer,1969). Parents maltreated as children may have meanings (i.e., values and beliefs) that theyattach to particular behaviors and the roles of people who exhibited such behaviors. These


meanings may importantly differ from those of parents who were not maltreated as children,and these differences may help explain the increased risk of intergenerational maltreatment(Bert et al., 2009).

Symbolic interactionism explains that the use of meaning is a process of interpretation(Blumer, 1969). For example, a parent who attached a meaning of ‘‘I had a right to be pun-ished because I misbehaved’’ to his own experiences of child maltreatment might later interprethis or her own parenting behavior as giving a ‘‘punishment’’ akin to child maltreatment. Insupport of these ideas, one study found that 85% of participants who were abused in childhoodbelieved their parents were disciplining rather than abusing them (Wilkes, 2002). It is theorizedthat those parents who were able to break intergenerational patterns of maltreatment were ableto make important shifts in meaning specific to control, namely understanding that whathappened to them was not in their control, while ascribing meaning of having control overtheir own behaviors as parents (Wilkes, 2002). Certainly, some parents recognize that their ownabuse was unjust, yet they may remain at risk of maltreating their own children because theylack knowledge of other options for interacting with their children, and ⁄or they are strugglingwith important familiar or environmental risk factors associated with maltreatment. As such,although meanings may be one aspect of intergenerational processes, other important potentialmoderators may also affect risk (Lieberman et al., 2011).

Parents who are able to break the cycle of abuse are important examples of resilience(Lieberman et al., 2011). In the literature specific to maltreatment, resilience is defined as thedemonstration of competence across several domains of functioning including social andemotional functioning despite a history of maltreatment (Afifi & MacMillon, 2011). A recentsynthesis of research identified specific family-level protective factors associated with resiliencefollowing child maltreatment including a stable family environment and supportive familyrelationships. Although important individual-level characteristics, such as personality traitsand intellect, were also important, the authors concluded that proxies of intellect were lessstrongly related to resilience and call for interventions that focus on family-level factors (Afifi& MacMillon, 2011).

Aims and Objectives

By investigating parental beliefs, the association between childhood experiences of maltreat-ment and later adult perpetration of child maltreatment can be further understood. This studyasks the following questions: (a) How are parents, at-risk of losing their children because ofmaltreatment, aware of potential connections between their own experiences of maltreatmentand their children’s experiences of maltreatment? (b) How do parents at-risk of losing their chil-dren because of maltreatment desire to parent differently and ⁄or similarly to their own parents?And (c) How are parents’ beliefs reflected in their behaviors with their children?

Method

The goal of this study was to examine intergenerational patterns of maltreatment among asample of parents deemed ‘‘at-risk’’ of the removal of the children from the home and place-ment in foster care. Data for this study were collected as part of a larger research project(McWey, Humphreys, & Pazdera, 2011) aimed to identify parents’ perceptions of therapeuticservices and their experiences associated with involvement with CPS. The sample consisted of24 parents, all of whom had been identified by CPS as being at-risk of having their childrenremoved from their homes because of allegations of abuse and ⁄or neglect. It is important tonote that the sampling did not involve the preidentification of families demonstrating an inter-generational pattern of maltreatment, but rather parents who were presently involved with CPSbecause of allegations of maltreatment.

After human subject approval and informed consent were obtained, one researcher con-ducted the in-depth, semi-structured interviews. The interviews were completed in the partici-pants’ homes (except one interview that occurred at a neighborhood park at the participant’srequest), and parents received $20 gift cards for their participation. The interviews, which


ranged in length from one to 4.5 hr, were audio recorded and then transcribed. Intervieweeschose and were referred to only by pseudonyms throughout the duration of the study. Datacollection continued past saturation of themes. The questions asked in the original study cov-ered several content areas including parents perceptions of why CPS was involved in theirlives, perceptions of services received, questions about both family of procreation and familyof origin, as well an current parenting practices. Examples include: ‘‘Why do you think [CPS]was involved in your family’s life,’’ ‘‘What sort of discipline strategies did your parents usewhen you were growing up,’’ and ‘‘Please describe how your parenting style is similar to, ordifferent from your parents.’’ Because the interviews were semi-structured, the interviewerused additional probes throughout each interview to promote more in-depth responses toquestions (such as ‘‘Would you say that this is similar to how your parents raised you,’’ and‘‘Can you tell me more about that?’’) This study is the secondary analysis of those qualitativeinterviews. For a more detailed description of the sampling procedures and methods, pleaserefer to (McWey, et. al, 2011).

After the interview, parents were also asked to complete a series of measures, including theInventory of Parent and Peer Attachment (IPPA; Armsden & Greenberg, 1987), and a demo-graphic questionnaire. All but two participants completed the measures. The IPPA is an attach-ment assessment with strong indicators of reliability (ranging from 0.72 to 0.91) and validity(Fischer & Corcoran, 1994). Possible scores for the total scale range from 0 to 250 with higherscores representing higher levels of attachment. The IPPA also has three subscales assessingperceived levels of trust, communication, and alienation. The measure assesses attachment toone’s parents and peers. For descriptive purposes for this study, only scores regarding attach-ment to one’s mother and father were used. The integration of a quantitative component canprovide additional information to supplement what was ascertained from a qualitativeapproach (Hanson, Creswell, Plano Clark, Petska, & Creswell, 2005). For the purposes of thisstudy, we used the scores on the IPPA as a form of data triangulation.

Grounded Theory AnalysisOur aim was to analyze the qualitative data and take an initial step toward generating a

conceptualization of how parents’ own experiences of maltreatment as children are associatedwith intergenerational processes for at-risk families. Thus, grounded theory methods (GTM),involving open, axial, and selective coding methods (Strauss & Corbin, 1998), were used.Individual cases were examined, concepts in the raw data were discovered and were organizedinto themes, and then conclusions were drawn about how these data relate to intergenerationalprocesses for families involved in the child welfare system.

During open coding, the first phase of GTM analysis, transcripts were read line by line,and concepts were created. The open coding continued past saturation as an effort to verifythat the codes would continue to appear in the data (LaRossa, 2005). The concepts that sur-faced included pattern awareness, desire to be different, belief in doing the same, proactivebehaviors, and destructive behaviors. It is important to note that we did not ask questionsabout beliefs and behaviors, rather these themes resulted from the analyses. Open coding flowsinto axial coding, in which the concepts generated in open coding are related to each other andrevised through a constant comparative method (Strauss & Corbin, 1998). As suggested byLaRossa (2005), in the axial coding phase, the focus was limited to examining one centraltheme; in this case, the focus was on intergenerational processes and the interrelationshipsamong variables related to parenting behaviors and beliefs. For example, the code ‘‘beliefs’’included the concepts of desiring to be different and wanting to be the same (please see Table 1for definitions and codes). Emergent interrelated themes from the axial coding phase includedpatterns, beliefs, and behaviors within the contexts of parenting, mental health, and intimaterelationships. Selective coding, involving a careful examination the open and axial coding, wasthe next step. Selective coding ultimately leads to defining the ‘‘story line’’ of integrated catego-ries (Echevarria-Doan & Tubbs, 2005) representing the grounded theory. In this phase, wegenerated provisional hypotheses about intergenerational patterns for families deemed at-risk.We generated the hypotheses by triangulating these data with the attachment quantitative dataand carefully re-examining the open and axial coding.


The researchers coded cases and compared codes, explaining our thoughts throughout theprocess. This resulted in definitions of themes. The researchers continued to analyze at least onecase per week together throughout the coding process as an effort to ensure that the codingremained consistent. We revised the definitions as needed when there were discrepancies or differ-ences in interpretations. At least two research team members coded each case. In instances whereresearchers coded the same data differently, the team met to discuss the discrepancies, potentialbiases, and reviewed or revised the definitions. Finally, we implemented a ‘‘partner system,’’

Table 1Qualitative Coding of Categories and Themes

Theme Concept Definitions and examples

Childhood maltreatment The parent describes events that the researcherslabeled maltreatment (ex. ‘‘I never hated her for whatshe’d do to us. She’d hit us; leave us for days, being onthe streets.’’)

Intergenerationalpatterns

Patternawareness

The parent’s ability to connect how their ownbehaviors mirror the behaviors of their parents(ex. ‘‘You spank the child, I’m sorry, but that was theway I was raised, that was the way my husband wasraised. So that’s what we did.’’)

Lack ofawareness

The parent’s behavior appears similar to experiencesthey recalled as a child, yet the parent did notexpress an awareness of the similarities (ex. ‘‘Mymother would whoop me. You know, those things youcan’t do today. She would punish me.’’ and the parentwas involved with child welfare services because ofalleged physical abuse of her child.)

Beliefs Desire to bedifferent

The parent identifies how they want to behavedifferently than their parents or how they want theirchildren to have different parent–child relationshipsthan the ones they experienced (ex. ‘‘I don’t want mychildren to go through what I went through when Iwas a child. I’m trying to be different for mychildren.’’)

Belief in doingthe same

The parent expressed how they are intentionallyparenting similarly to the way they were raised(ex. ‘‘I believe in corporal punishment becauseI remember that’s what worked with me. . .’’)

Behaviors Proactive The parent identifies the ways in which they haveimproved and ⁄or added health to an aspect of theirparenting, mental health, or intimate relationship(ex. ‘‘Now I am taking a parenting class, I am goingto the domestic violence classes. I’m going to asupport group on Monday nights. Really what am Inot doing?’’)

Destructive The client identifies personal choices and ⁄orbehaviors that lead to crisis, chaos, abuse, and ⁄orthe destruction of healthy aspects of their parenting,mental health, or intimate relationship from theperspective of the coders (ex. ‘‘I was planning ongoing back to my daughter’s father and putting us indanger again.’’)


where one team member would verify the themes and subthemes identified by another teammember. This process continued throughout the study until all cases were coded and verified.

We took a number of steps to help control for researcher bias or the assumptions, posi-tions, and interpretations of the researchers. We each made explicit our own opinions aboutwhat we were reading and the codes we were creating, and made efforts to call attention toinstances where our individual biases may have influenced our interpretation of the data. Forexample, when creating the code ‘‘destructive behaviors,’’ we had multiple conversations aboutour choice of language and the inherent bias associated with calling actions ‘‘destructive.’’ Wealso attempted to present the methods and results using thick description. Doing so aidesothers in having a sense of perspective from which they can judge the decisions made by theresearchers (Chenail, 1995). As one additional effort to help reduce investigator bias, we pro-vide frequencies of patterns so that the reader can assess the commonalities and differences inparticipant responses and themes (Miles & Huberman, 1994).

Description of SampleThe mean age of the parents was 34.3 years (range 18–62), the majority self-identified as

Caucasian (n = 11), followed by African American (n = 10) and Hispanic (n = 3). Of thoseemployed, the average family income was $19,066. The average number of children was 2(range 1–6; SD = 1.4), and the majority of the participants identified themselves as ‘‘single par-ents’’ (n = 18; 75%). The leading allegation placing families at-risk was physical abuse(n = 15), followed by domestic violence (n = 9), neglect (n = 6), drug or alcohol abuse(n = 3), parental mental health issues (n = 2), and abandonment (n = 1). Some parents hadmore than one allegation; therefore, the preceding numbers exceed the sample size.

Results

Every parent who completed the IPPA (n = 22) had relatively low scores on every dimen-sion of the measure. Specifically, the IPPA possible scores range from 0 to 125 for mothers’and fathers’ total attachment scores. For parents in this study, the average score for motherswas 59.54 (SD = 28.59) and fathers was 49.95 (SD = 28.49), meaning that parents generallyperceived low levels of trust, communication, and higher levels of alienation with their ownmothers and fathers. Of the three subscales (trust, communication, and alienation), parentsreported the lowest scores for the communication subscale for both mothers (M = 15.29;SD = 8.03) and fathers (M = 10.92, SD = 7.64). Scores regarding relationships with fatherswere consistently lower than scores for relationships with mothers. We included these descrip-tive quantitative findings as one means of demonstrating intergenerational relationships, and weinterpreted these data as providing tentative support of qualitative data indicating strains infamily of origin relationships.

Qualitatively, themes emerged from parents’ descriptions of their experiences growing upand how they currently parent their children. Consistent with the low level of attachment toone’s parents, there was one universal theme expressed by every participant (n = 24, 100%): areflection of a childhood in which they too experienced abuse or neglect. We labeled this child-hood maltreatment. It is important to reiterate that the sampling did not involve identifyingfamilies demonstrating an intergenerational pattern of maltreatment, but rather parents whowere presently involved with CPS because of allegations of maltreatment. Yet, when parentsreflected upon their own childhoods, each parent described a childhood that was ‘‘worse’’ thanwhat they perceived their children experiencing. However, there seemed to be varying degreesof parental family of origin maltreatment experienced. On one end of the spectrum, three par-ticipants were placed in foster care because of physical abuse and two parents described sexualabuse they suffered as children. Importantly, however, some parents did not label their pastexperiences as abusive or neglectful, yet the researchers coded parents’ reflections of past experi-ences as maltreatment. For example, ‘‘I never hated her for what she’d do to us. She’d hit us;leave us for days, being on the streets. But now we are close.’’

In addition to the universal theme representing childhood maltreatment, three majorintegrated categories were also identified: Intergenerational patterns, beliefs, and behaviors. The


intergenerational patterns category consisted both of intergenerational patterns that the partici-pants were aware of, and those in which they did not suggest awareness. Beliefs consisted oftwo opposing sentiments: a desire to be different and belief in doing the same. Additionally,behaviors included proactive and destructive behaviors parents described when trying to makethe desired differences in their families.

Intergenerational PatternsParticipants were asked to reflect on their childhood and identify ways in which their

parenting styles and interactions with their children are similar or dissimilar to their interactionswith their parents. Some participants expressed awareness that patterns were being repeated,whereas in other instances the parenting behaviors described seemed similar to experiences theyrecalled from their childhood, yet the parents did not express an awareness of the similarities.These were coded as ‘‘awareness’’ or ‘‘lack of awareness’’ of intergenerational, respectively. Eachis discussed below.

Awareness. Fifteen (63%) of the parents interviewed recognized intergenerational patternsin their own interactions with their children. Examples include, ‘‘You spank the child, I’msorry, but that was the way I was raised, that was the way my husband was raised. So that’swhat we did;’’ ‘‘Sure, I am not as mean as [my mother], but I raise my kids right. You don’tsee them running all over me, disrespecting me. My momma wouldn’t tolerate that either. Nogood parent would;’’ and ‘‘I believe that a lot of stuff comes from generational stuff. And Ibelieve now that my mom was the way she was because of her own childhood.’’ This awarenessof intergenerational patterns was also associated with parents articulating aspects of their rela-tionship with their children that they are trying to change: ‘‘Me and my mom, we never talked.And if I just talk to my kids like friends, we can tell each other anything, then that’s nice,’’ and‘‘I could have easily been like my mother. But I didn’t, and I think that needs to be recognized.It takes someone who is so strong to break the cycle.’’ These statements suggest that it may beimportant, while exploring family history, also to recognize the effort and difficulty that parentsmay experience as they try to intentionally break intergenerational cycles within their currentfamily.

Lack of awareness. While parents identified some patterns, it appeared as though therewere other patterns in which they did not express awareness of intergenerational parallels(n = 23; 96%). Most parents expressed that they were mistreated by their parents when theywere children, but attributed it to parents doing the ‘‘best they can.’’ As an example, one parentstated, ‘‘My momma, she alright, we aren’t close or nothing, but I don’t hold no grudge. Shejust did the best she could, and that’s all anyone can do.’’

Some parents also expressed confusion regarding which actions warrant an abuse report.For example, one parent stated, ‘‘She [the therapist] said ‘you know I have to report that tochild services’ and I said ‘You do?’ and she said ‘Yes, I have to report this because I heard thesituation’ and I’m required to by law and blah blah blah.’’ Several parents (n = 3) mentionedhow CPS involvement could help promote awareness when that awareness was previously lack-ing, as expressed by a parent: ‘‘When [CPS] took my sister’s kids it was like a light went on.And she started getting herself together, and they gave her a huge case plan, huge, with a lot ofstuff she had to do and she did it. She did it.’’

Still others felt that if it were a different time, the type of treatment or discipline they exhi-bit in their families would not result in CPS involvement. For example, ‘‘My mother wouldwhoop me. You know, those things you can’t do today. She would punish me.’’ Similarly,another parent stated, ‘‘I was spanked! Yes. You know those things they don’t want you togive. That’s discipline.’’ Another client stated, ‘‘I used to get a lot of whippings. Me and mycousins too. But they say it’s best if we get a whipping now because when we get older we’llknow it was just an act of love.’’ It appears as though, for some parents, there was ambiguityin meaning regarding discipline, abuse, and love.

BeliefsThe intergenerational beliefs expressed by parents fell into one of two categories: desire to

be different and belief in doing the same. Each is described below.


Desire to be different. The majority of parents stated they wanted to raise their childrendifferently than the way they were raised (n = 18; 75%). As one parent succinctly summarized,‘‘I want things with my family to be different, very different.’’ Some reflections were generalstatements, such as, ‘‘I don’t want my children to go through what I went through when I wasa child. I’m trying to be different for my children’’ and ‘‘My parents taught me how to not tobe, and what I don’t need to do as a parent. I don’t want to be like them.’’

Many parents, however, were more specific, reflecting upon painful childhood memoriesand how they are trying to create different experiences for their children. As one parent stated,‘‘My childhood was not happy, it was miserable. I will not let my children go through the life Iwent through wondering what the hell life’s worth. That’s not fair to them.’’ Another parentcautioned: ‘‘I don’t want anyone to end up like me. . .I don’t want her to be in a foster home.No matter what, don’t let them go into foster care.’’

Reflecting upon physical punishment specifically, parents discussed how they do not resortto the same practices as their parents. For example, one parent stated as follows:

I used to get a lot of whippings. I used to get back handed from my mom right acrossthe face. I told [my children] that they’ve got it easy, popping your child in the mouthis not right. I won’t do that.

Paradoxically, although each of these parents expressed desires to be different, it is note-worthy that each has been deemed as ‘‘at-risk’’ for the removal of their children from theirhomes due to allegations of abuse and ⁄or neglect.

Belief in doing the same. Whereas most of the parents overtly stated they wanted to bedifferent, a minority of parents (n = 6, 25%) expressed intentionally ‘‘doing the same.’’ Inevery instance, the behaviors were specific to spanking. An exemplar quote representing thissubtheme summarizes: ‘‘I believe in corporal punishment because I remember that’s whatworked with me. And when I did something or I lied, I got a whippin’, and I’m sorry but itworked, and it works with my son.’’ Possibly expressing helplessness to change, one father sta-ted, ‘‘I’m following in my dad’s footsteps. That’s all I can do.’’

BehaviorsParticipants described different parenting behaviors. Congruent with wanting to be ‘‘differ-

ent,’’ parents expressed how they are intentionally doing things in an attempt to afford betterrelationships with their children; we categorized these as ‘‘proactive behaviors.’’ Conversely,despite wanting to be different, some parents also described actions that did not seem helpful,particularly considering the context of CPS involvement. We termed these ‘‘destructive behav-iors.’’ We recognize that this is a value laden categorization, and we discussed this throughoutthe coding process; however, given that these families were involved with CPS owing to allega-tions of maltreatment, we believed it appropriately captured this grouping of behaviors. Wedescribe both proactive and destructive behaviors below.

Proactive behaviors. Every parent in the sample (n = 24, 100%) noted at least one spe-cific action they were taking to try to promote better parent–child relationships. Most fre-quently, parents stated that they were taking specific classes and ⁄or participating in therapy:‘‘Now I am taking a parenting class, I am going to the domestic violence classes. I’m going toa support group on Monday nights. Really what am I not doing?’’ A number of parents notedthat they were not required by CPS to take all the actions they were taking. For example,‘‘CPS is not making me do anything. I’m volunteering for everything because there’s alwayssomething I don’t know, and I might be doing something wrong and if I am I want to knowabout it.’’ Further, parents discussed implementing the things they were learning in their clas-ses, such as one father who stated, ‘‘when I come home, I use what I learned on the kids.’’

Destructive behaviors. Despite 100% of the sample reporting specific proactive behaviors,71% (n = 17) of the sample described other actions that were coded as ‘‘destructive.’’ Themajority of the parents (15 of the 17 cases in this category) described actions specific to punish-ment. Statements exemplifying this include: ‘‘We, as parents, have the right to hit our children.Sometimes you need that attitude adjustment real quick to say ‘I am still in control. You arethe child, I am the adult. I’m taking care of business.’’’ Contrasting current behaviors to family


of origin experiences, parents often stated things such as ‘‘Sure, I pop my kids, but I wasbeat!’’

The remaining two parents, of the 17 who had responses coded in this category, discussedintimate partner relationships. Specifically one parent stated, ‘‘I was planning on going back tomy daughter’s father and putting us in danger again.’’ Whereas the former parent was aware ofpotential danger, another parent seemed to minimize her situation, stating: ‘‘It was nothingreally. It was between me and my boyfriend. . . They just said it was domestic violence and thatwe can’t do that in front of the kids.’’ With only two parents citing this subtheme however, thiscode did not reach saturation.

Discussion

In this study, we examined intergenerational patterns of maltreatment among a sample ofparents deemed ‘‘at-risk’’ by child protective services. We identified a universal theme of child-hood maltreatment and three additional categories: patterns, beliefs, and behaviors. The parentsin this study reported low levels of trust, communication, and higher levels of alienation withtheir own mothers and fathers. A majority of the parents (63%) stated that they recognizedintergenerational patterns, most (75%) expressed that they wanted to be different from theirown parents, yet 71% described parenting actions that were ‘‘destructive,’’ and all (100%) ofthe parents were deemed ‘‘at-risk’’ by CPS for removal of their children from the home. Thedifferences in parental awareness of intergenerational patterns of abuse, participant desires toparent differently in relation to their own experience of being parented, and the degree to whichtheir behavior is congruent with the abusive behavior of their own parents have implicationsfor clinical interventions with at-risk parents.

A Grounded Theory of TypologiesAlthough there seem to be clear trends in the data, when looking at the themes in relation

to one another, potential typologies emerge that may represent a process associated with inter-generational patterns of maltreatment in families. We suggest that it is the interrelationshipamong these categories that may offer opportunities for parents and therapists to enact change.Please see Table 2 for a description of the possible typologies. For example, it is possible for aparent to express awareness of intergenerational patterns, want to be different, yet still havebehaviors that are congruent with their family of origin (an A, 1, Z typology); whereas anotherparent may express awareness of intergenerational patterns, want to be the same as theirparent, and exhibit behaviors congruent with their family of origin (an A, 2, Z typology). Wepropose that the course of therapy could look notably different for these two parents (and anyother configuration of typologies). Below we present 2 case examples to demonstrate theseideas. Both examples involve an intergenerational continuity of physical abuse; however, theparents in each case ascribe different meanings to past abuse and present behaviors. We arguethat, consistent with symbolic interactionism, differences in meaning are important for inform-ing intervention.

Table 2Possible Typologies

Patterns Beliefs Parents’ descriptions of behavior

Expresses awarenessof intergenerationalpatterns (‘‘A’’)

Wants to bedifferent (‘‘1’’)

Behavior incongruentwith family of origin (‘‘X’’)

Does not expressawareness ofintergenerationalpatterns (‘‘B’’)

Wants to bethe same (‘‘2’’)

Behavior congruent withfamily of origin (‘‘Z’’)


Two Divergent Case ExamplesThe following case examples are derived from the research; names and other identifying

information have been changed, but the information presented comes directly from the inter-views.

Case example one. Elaine is a single mother of three children. Elaine states that she wassexually abused by her stepfather and physically abused by her mother. She ascribed the follow-ing meaning to her mother’s actions:

When I was little we got spanked! We got whippings! My mom didn’t play. It was justher and she had to take care of eight of us. . .she didn’t talk to us much. I guessbecause she’s like her mom, which is my grandma, who wasn’t really involved with hereither. So she didn’t know how to talk with us, but we got a whipping for everythingand anything! Really, we did. (Typology A).

She further describes how this ‘‘spanking kept [her] out of trouble’’ when she was younger, andhow a ‘‘good parent spanks their child’’ (Typology 2).

She became involved with CPS because of allegations of physical abuse. When asked bythe interviewer about those allegations, she reported:

I will spank his butt and he knows it. He only gets a whipping when he does some-thing crazy because I refuse to let him go to jail, be a murderer, be stealing, and sellingdrugs. No! No way (Typology Z).

Therapy with Elaine may include several key interventions: exploring and challengingmeaning making; identifying and expanding her support network; and psychoeducation. Pro-moting the three aspects of conceptual change, as suggested in Wilkes (2002) study, involvescategorical reassignment, changes in explanatory mechanisms, and changes in individual con-cepts and ⁄or coping. Therefore, it may be useful to explore Elaine’s beliefs about her own par-ents’ actions and distinguishing between ‘‘I deserved for my parent to hit me because Imisbehaved’’ and ‘‘I cannot control what my parents did but I can control how I treat my chil-dren.’’ During the course of therapy, it also would be important explore meanings regardingthe ways in which a past history of childhood abuse might be related to current at-risk parent-ing. Challenging statements that qualify abusive parenting behaviors as positive parenting, orwhat a ‘‘good parent’’ does, may help Elaine better distinguish between effective discipline andpunishment.

As Marriage and Family Therapists (MFTs), it also would be beneficial to include Elaine’schildren in therapy. Doing so could help the therapist garner a better understanding of theinteractions and relationships among Elaine and her children. The addition of her children mayalso help the therapist identify, with Elaine, meanings she associates with her children’s behav-iors, as they may be depicted in session. Further, the literature suggests that having childrenundergo conceptual change regarding their own past, in an age appropriate manner, can helpchildren better understand intergenerational patterns and be more likely to break the cycle(Dattilio, 2006).

It is important to recognize that a change in meaning, however, may not be enough toreduce a longitudinal risk of maltreatment. Assessing for other risk factors during the course oftherapy would be central. For example, in the case of Elaine, it would also be important toidentify and work with her in expanding her support network to help her manage stress associ-ated with being a single mother of three, involved with CPS. If Elaine identifies resources orpotential interests in networks that might provide this outlet, it would be important to trackand reinforce her efforts to enhance these supports throughout the course of therapy. Ifpotential support is limited, referrals to appropriate resources may help connect Elaine withprospective supportive networks available in the community.

Lastly, psychoeducation regarding parenting techniques may be beneficial as it could equipElaine with additional ideas about how to guide and discipline her children without resortingto physical abuse. We suggest, though, that the value of psychoeducation may rest uponElaine’s meanings and beliefs. For example, if Elaine believes that ‘‘good parents’’ spank theirchildren when they misbehave, and if the parent education component promotes nonphysical


punishment, Elaine may not find the information valuable or relevant. To us, this underscoresthe importance of incorporating an intergenerational focus on meaning during the course oftherapy.

Case example two. Tammy is also a single mother of three children. She lives below thepoverty level and works two jobs trying to make ends meet. She states that she was temporarilyremoved from the care of her mother because of physical abuse when she was an adolescent,but did return home after a ‘‘short’’ period of time. Despite being removed from the care ofher mother, her meaning making of past abuse includes: ‘‘My mom did the best she could withwhat she had, which wasn’t much. I can see now how similar we are’’ (Typology A).

Tammy asserts that she wants a different life for her children than the life she experienced;a life where the parent–child relationship was often riddled with physical abuse (Typology 1).She describes herself as a hard-working woman who tries to do the best she can for her chil-dren with limited support and even fewer financial resources. Similar to Elaine, Tammy wasalso deemed ‘‘at-risk’’ because of allegations of physical abuse (Typology Z). According toTammy, CPS investigated a teacher’s report of bruising on her son’s face. CPS visited the childat school, asked him what happened and ‘‘he told them the truth.’’ Tammy discussed the mean-ing she ascribes to the incident in following way:

I just snapped. . .what I did was wrong and I take responsibility for that. I teach myboys to take responsibility for what you do whether it’s a good thing or a bad thing.And I can’t tell them that if, when it falls on me, I play the blame game. . .so when[CPS] got involved I had to sit [my children] down and I told them ‘this is on me.’ And Itold my baby, ‘you didn’t do anything wrong, I was wrong. You did what you had todo. They asked you questions and you told them the truth. This is my fault, I’m the rea-son [CPS] came to your school.’ I took all the blame for it. I didn’t make excuses. Youknow it was embarrassing for me too. . .but as long as I do my part they’ll still look atme and see that I’m a good example, that I took responsibility for my actions.

Therapy with Tammy might be importantly different from Elaine. Tammy already recog-nizes the cycle of abuse and the role that she is playing in perpetuating the cycle; she assumedresponsibility for her actions and used it as an opportunity to model healthy behavior. There-fore, Tammy already seems to have achieved two of the three aspects of conceptual changeindentified by Wilkes (2002). Specifically, there seems to be categorical reassignment or anunderstanding that although her own childhood history involved maltreatment, she does notwant to perpetuate that with her own children. In addition, Tammy’s explanatory mechanismsseem to involve her taking responsibility for things within her control. The only aspect ofcategorical reassignment that seems limited in Tammy’s case involves changes in individualconcepts or coping.

In Tammy’s situation, then, the course of therapy may include processing current parentalself-care, increasing awareness of parenting vulnerabilities and indications of the need to self-soothe prior to discipline, and expanding her support network. Helping expand Tammy’s sup-port system may reduce feelings of isolation and provide a network to which she could turn ifshe needed help. Additionally, to help ease some of the financial pressure Tammy is under,connecting her with specific social services agencies can help her access community resourcesthat may be available to her and her family. Mitigating these pressures and increasing self-caremay allow Tammy to act out her desired behaviors with her children.

Implications for Family TherapistsIt is often not just one, but rather a combination of risk factors that contribute to families

being deemed ‘‘at-risk.’’ Such factors include familial and environmental stressors such as a his-tory of abuse or neglect, lack of social support, and financial strain. When CPS becomesinvolved with families, parents often participate in family therapy to fulfill case plan require-ments and ⁄or because of a court order. In such instances, therapy is often short term and thegoal of preventing future maltreatment is often prescribed by CPS (Curtis, 1999). Our resultsindicate that, consistent with symbolic interactionism, therapeutic interventions could vary sig-nificantly depending on clients’ awareness of patterns, beliefs about childhood abuse, and the


degree to which behaviors are congruent between parenting generations. As the case examplesdemonstrate, it may be useful for family therapists to assess for a history of maltreatmentwithin the parent’s family of origin. Upon assessment, it would be important to explore concep-tual change with the client, with therapeutic attention to the client’s awareness of patterns,beliefs, and behavioral goals.

On the basis of the risk factors present in a family, parents may also have to participate in anumber of other case plan activities such as attending parent education classes, domestic violenceeducation, substance use treatment, and anger management. Thus, there are often multiple pro-viders involved with families simultaneously. It may be important for therapists to initiate collab-oration between the multiple systems involved. Understanding the meaning may be potentiallyuseful, not only for the process of therapy, but for other interventions as well. For example,Elaine described abusive practices in her family of origin but viewed these behaviors as ‘‘how agood parent’’ acts. Given the meaning she ascribed to both past and present behaviors, therapyand other interventions—such as parent education—may not be impactful if the techniquestaught differ from Elaine’s view of how a ‘‘good parent’’ behaves. Encouraging insight into theways in which in their family-of-origin parent–child relationship may be related to current at-riskparenting, and challenging beliefs associated with experiences of maltreatment could produceboth attitudinal and behavioral change. If, however, parents are further along in the process ofconceptual change, such as Tammy, perhaps less time can be spent exploring meaning making.Rather, it may be more worthwhile to explore the multiple stressors she faces and work withTammy to determine what can be performed to diminish stressors and strengthen her resources.

Limitations and Implications for Future ResearchThere are several limitations of this study. First, qualitative interviews lack neutrality and

are inherently biased (Weiss, 1994). Additionally, bias can be introduced in the interpretationof data (Weiss). We have attempted to account for this bias via reflexivity regarding our experi-ence as clinicians who have worked with ‘‘at risk’’ parents. Nevertheless, data gathered frominterviews should not be interpreted as categorical fact, but rather presentations of participants’perspectives at a single point in time. Additionally, the use of a convenience sample was a limi-tation of this study. A primary weakness associated with convenience sampling is the potentialfor a nongeneralizable sample. Further, given that every participant was paid $20 for their par-ticipation in the study, the sample may be predisposed to include families most in need of thefinancial incentive. Because of the absence of comparison group, we cannot affirm that theseexperiences are unique to parents at-risk. Lastly, all participants received therapeutic servicesfrom one family therapy agency; therefore, their responses may be influenced by therapeuticintervention prior to the interview.

Future research is needed to understand intergenerational patterns of maltreatment, andboth quantitative and qualitative inquiries could strengthen this body of research. For example,researchers could assess intergenerational patterns using standardized measures of familydynamics. Longitudinal research also would greatly strengthen this body of research. Qualita-tively, future researchers could interview parents from multiple generations, rather than one ascarried out in this study. Including multiple perspectives may provide greater richness to thedata and would offer a more systemic perspective. In addition, it is important to conduct clini-cal trials of family therapy models to demonstrate family therapy effectiveness in reducing therisk of future maltreatment.

Conclusions

Wilkes (2002) study found that parents who were abused as children were able to ‘‘sponta-neously, without intervention. . .change their cognitive and behavioral patterns’’ (p. 261). Thesechanges were associated with parents breaking the cycle of abuse. While many parents whowere abused as children do not later perpetrate abuse upon their own children, every year mil-lions of children are brought to the attention of CPS because of allegations of abuse or neglect.These parents may not have been able to ‘‘spontaneously’’ change and instead may be referredto MFTs for family therapy. Each parent in this study was deemed at-risk by CPS because of


maltreatment, and upon investigation these patterns seemed to be intergenerational. If concep-tual change is associated with behavioral outcomes as Wilkes (2002) study indicates, MFTsseem particularly well suited to work with parents deemed at-risk to promote an awareness andunderstanding of intergenerational patterns and systemic change. Assessing the degree to whichchanges in meaning are associated with outcomes, such a long-term nonreoccurrence of abuse,would be critically important to continuing to improve services offered to the families we serve.

References

Afifi, T. O., & MacMillon, H. L. (2011). Resilience following child maltreatment: A review of protective factors.

The Canadian Journal of Psychiatry, 56, 266–272.

Armsden, G. C., & Greenberg, M. T. (1987). The inventory of parent and peer attachment: Individual differences

and their relationships to psychological well-being in adolescence. Journal of Youth Adolescence, 16,

427–454. doi: 10.1007/BF02202939.

Bailey, J. A., Hill, K. G., Oesterle, S., & Hawkins, J. D. (2009). Parenting practices and problem behavior across

three generations: Monitoring, harsh discipline, and drug use in the intergenerational transmission of

externalizing behavior. Developmental Psychology, 45, 1214–1226. doi: 10.1037/a0016129.

Belsky, J. (1993). Etiology of child maltreatment: A developmental-ecological analysis. Psychological Bulletin, 114,

413–434.

Bert, S. C., Guner, B. M., & Lanzi, R. G. (2009). The influence of maternal history of abuse on parenting knowl-

edge and behavior. Family Relations, 58, 176–187. doi: 10.1111/j.1741-3729.2008.00545.x.

Blumer, H. (1969). Symbolic interactionism: Perspective and method. New Jersey: Prentice-Hall.

Chenail, R. J. (1995). Presenting qualitative data. The qualitative report, 2. Retrieved from http://www.nova.edu/

ssss/QR/QR2-3/presenting.html.

Child Welfare Information Gateway. (2011). Case planning for families involved with child welfare agencies.

Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau. Retrieved November

11, 2011, from http://www.childwelfare.gov/systemwide/laws_policies/statutes/caseplanning.pdf#Page=

1&view=Fit.

Curtis, P. A. (1999). Introduction: The chronic nature of the foster care crisis. In. P. A. Curtis, G. Dale, Jr. &

J. C. Kendall (Eds.), The foster care crisis: Translating research into policy and practice (pp. 1–14).

Nebraska: University of Nebraska Press.

Dattilio, F. M. (2006). A cognitive-behavioral approach to reconstructing intergenerational family schemas.

Contemporary Family Therapy, 28, 191–200. doi: 10.1007/s10591-006-9005-z.

DePanfilis, D. (2006). Child neglect: A guide for prevention, assessment, and intervention. Washington, DC: U.S.

Department of Health and Human Services. Retrieved November 11, 2011, from: http://www.childwelfare.

gov/pubs/usermanuals/neglect/neglect.pdf.

Echevarria-Doan, S., & Tubbs, C. Y. (2005). Let’s get grounded: Family therapy research and grounded theory.

In F. Piercy & D. Sprenkle (Eds.), Research methods in family therapy (pp. 41–62). New York: Guilford

Press.

Egeland, B., Jacobvitz, D., & Sroufe, A. L. (1988). Breaking the cycle of abuse. Child Development, 59, 1080–

1088. doi: 10.2307/1130274.

Fischer, J., & Corcoran, K. (1994). Measures for clinical practice: A sourcebook. (2nd ed.). New York: Free Press.

Fluke, J., Shusterman, G., Hollinshead, D., & Yuan, Y. T. (2008). Longitudinal analysis of repeated child abuse

reporting and victimization: Multistate analysis of associated factors. Child Maltreatment, 13, 76–88. doi:

10.1177/1077559507311517.

Forgatch, M. S., Bullock, B. M., & Patterson, G. R. (2004). From theory to practice: Increasing effective parent-

ing through role-play. The Oregon Model of Parent Management Training (PMTO). In H. Steiner (ed.),

Handbook of mental health interventions in children and adolescents: An integrated developmental approach

(pp. 782–814). San Francisco: Jossey-Bass.

Fulshaw, L., Browne, K. D., & Hollin, C. R. (1996). Victim to offender: A review. Aggression and Violent Behav-

ior, 1, 389–404. doi: 10.1016/S1359-1789(96)00005-5.

Goldman, J., Salus, M. K., Wolcott, D., & Kennedy, K. Y. (2003). A coordinated response to child abuse and

neglect: The foundation for practice. Washington, DC: Office on Child Abuse and Neglect (HHS) Retrieved

November 11, 2011, from Child Welfare Information Gateway, http://www.childwelfare.gov/pubs/usermanuals/

foundation/foundationl.cfm.

Haapasalo, J., & Aaltonen, T. (1999). Mothers’ abusive childhood predicts child abuse. Child Abuse Review, 8,

231–250. doi: 10.1002/(SICI)1099-0852(199907/08)8:4 \lt 231::AID-CAR547 \gt 3.0.CO;2-C.

Hanson, W. E., Creswell, J. W., Plano Clark, V. L., Petska, K. S., & Creswell, J. D. (2005). Mixed methods

research designs in counseling psychology. Journal of Counseling Psychology, 52, 224–235.


Henggeler, S. W., Melton, G. B., & Smith, L. A. (1992). Family preservation using multisystemic therapy: An

effective alternative to incarcerating serious juvenile offenders. Journal of Consulting and Clinical Psychology,

60, 953–961. doi: 10.1037/0022-006X.60.6.953.

Herschell, A. D., & McNeil, C. B. (2005). Theoretical and empirical underpinnings of parent child interaction

therapy with child physical abuse populations. Education and Treatment of Children, 28, 142–162.

Heyman, R. E., & Smith-Slep, A. M. (2002). Do childhood abuse and interparental violence lead to adulthood

family violence? Journal of Marriage and Family, 64, 864–870. doi: 10.1111/j.1741-3737.2002.00864.x.

Hitchcock, R. A. (1987). Understanding physical abuse as a life-style. Individual Psychology, 43, 50–55.

Kaufman, J., & Zigler, E. (1987). Do abused children become abusive parents? American Journal of Orthopsychiatry,

57, 186–192 doi:10.1016/j.chiabu.2005.12.005.

Kim, J. (2009). Type-specific intergenerational transmission of neglectful and physically abusive parenting behav-

iors among young parents. Child and Youth Services Review, 31, 761–767. doi: 10.1016/j.childyouth.2009.

02.002.

LaRossa, R. (2005). Grounded theory methods in qualitative family research. Journal of Marriage and Family, 67,

837–857. doi: 10.1111/j.1741-3737.2005.00179.x.

Liddle, H. A. (2009). Multidimensional family therapy: A science-based treatment system for adolescent drug and

behavior problems. In J. Bray & M. Stanton (Eds.), Blackwell handbook of family psychology (pp. 128–163).

London: Blackwell.

Lieberman, A. F., Chu, A., Van Horn, P., & Harris, W. W. (2011). Trauma in early childhood empirical evidence

and clinical implications. Development and Psychopathology, 23, 397–410. doi:10.1017/S0954579411000137.

Markowitz, F. E. (2001). Attitudes and family violence: Linking intergenerational and cultural theories. Journal

of Family Violence, 16, 205–215. doi: 10.1023/A:1011115104282.

McWey, L. M., Humphreys, J., & Pazdera, A. L. (2011). Action-oriented evaluation of an in- home family ther-

apy program for families at-risk for foster care placement. Journal of Marital and Family Therapy, 37, 137–

152.

Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis (2nd ed.) . Thousand Oaks, CA: Sage.

Oliver, C. (2011). The relationships between symbolic interactionism and interpretive description. Qualitative

Health Research, 45, 839–846. doi: 10.1177/1049732311421177.

Pears, K. C., & Capaldi, D. M. (2001). Intergenerational transmission of abuse: A two-generational prospective

study of an at-risk sample. Child Abuse and Neglect, 25, 1439–1461. doi: 10.1016/S0145-2134(01)00286-1.

Renner, L. M., & Slack, K. S. (2006). Intimate partner violence and child maltreatment: Understanding intra-

and intergenerational connections. Child Abuse and Neglect, 30, 599–617. doi: 10.1016/j.chiabu.2005.12.005.

Rodrigo, M. J., Martin, J. C., Maiquez, M. L., & Rodriguez, G. (2006). Informal and formal supports and

maternal child-rearing practices in at-risk and non at-risk psychosocial contexts. Child and Youth Services

Review, 29, 329–347. doi: 10.1016/j.childyouth.2006.03.010.

Sedlak, A., & Broadhurst, D. (1996). Third national incidence study of child abuse and neglect: Final report.

Washington, DC: US Department of Health and Human Services.

Smith, D. K., Johnson, A. B., Pears, K. C., Fisher, P. A., & DeGarmo, D. S. (2007). Child maltreatment and

foster care: Unpacking the effects of prenatal and postnatal parental substance use. Child Maltreatment, 12,

150–160. doi: 10.1177/1077559507300129.

Strauss, A., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded

theory (2nd ed.) . Thousand Oaks, CA: Sage.

Tempel, L. R. (2009). Loosening the soil of their thinking: A theoretical integration for contracting with

low-income single mothers to stop physical aggression toward their children. Child Adolescent Social Work

Journal, 26, 39–48. doi: 10.1007/s10560-008-0161-x.

Tyler, S., Allison, K., & Winsler, A. (2006). Child neglect: Developmental consequences, intervention, and policy

implications. Child & Youth Care Forum, 35, 1–19. doi: 10.1007/s10566-005-9000-9.

U.S. Department of Health and Human Services, Administration for Children and Families, Administration on

Children, Youth and Families, Children’s Bureau. (2010). Child Maltreatment 2009.Retrieved November 11,

2011, from: http://www.acf.hhs.gov/programs/cb/stats_research/index.htm#can.

Webster-Stratton, C., & Reid, M. J. (2003). The incredible years parent, teacher, and child training series: A

multifaceted teaching approach for young children with conduct problems. In A. Kazdin & J. Weiss (Eds.),

Evidenced-based psychotherapies for children and adolescents (pp. 224–240). New York: Guilford Press.

Weiss, R. S. (1994). Learning from strangers: The art and method of qualitative interviewing. New York: Free Press.

Widom, C. S. (1989). Child abuse, neglect, and violent criminal behavior. Criminology, 27, 251–271. doi: 10.1111/

j.1745-9125.1989.tb01032.x.

Wilkes, G. (2002). Abused child to nonabusive parent: Resilience and conceptual change. Journal of Clinical

Psychology, 58, 261–276. doi: 10.1002/jclp.10024.

Zuravin, S., McMillen, C., DePanfilis, D., & Risley-Curtis, C. (1996). The intergenerational cycle of child

maltreatment. Journal of Interpersonal Violence, 11, 315–334. doi: 10.1177/088626096011003001.


Documents

Intergenerational Patterns of Maltreatment in Families at Risk for Foster Care