@article{ref1,
title="Disrupting intergenerational maternal maltreatment in middle childhood: therapeutic objectives and clinical translation",
journal="Frontiers in psychiatry",
year="2018",
author="Amos, Jackie and Segal, Leonie",
volume="9",
number="",
pages="e623-e623",
abstract="<b>Background:</b> 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. <b>Methods:</b> 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. <b>Findings:</b> 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. <b>Interpretation:</b> 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.<p /> <p>Language: en</p>",
language="en",
issn="1664-0640",
doi="10.3389/fpsyt.2018.00623",
url="http://dx.doi.org/10.3389/fpsyt.2018.00623"
}