RUNNING HEAD: PARENTAL ABUSE BY CHILDREN

Parental Abuse by Children: Overview, Etiology, and Strategies for Intervention Kevin F. McNeill California State University, Bakersfield

Authors Note Kevin F. McNeill, Social Work Department, California State University, Bakersfield. This paper was completed in partial fulfillment of the requirements for the course SW572 (Issues and Interventions in Child Maltreatment), Winter Quarter, 2010.

RUNNING HEAD: PARENTAL ABUSE BY CHILDREN

Introduction Twenty years ago, domestic violence between intimate partners and parental abuse of children was thought to be a rare occurrence. Abuse was viewed as a private matter, and few supports were available to either victims or perpetrators of violence. In fact, abuse tended to be either ignored or was silently managed by the afflicted family (Busby, 2005). Since this time, the problem of violence within families has come to public attention. There are now policies and supports in place that aim to protect adults from abusive spouses and children from abusive parents (Cottrell, 2001). Another form of family violence, however, still lies in a veil of secrecy. This is the abuse of

parents by their children. Currently there is little public awareness of parent abuse, and few supports and interventions are available (Cottrell, 2001; Paterson, Luntz, Perlesz, & Cotton, 2002). This paper will review what parent abuse is, the impact that it has on families, who the likely perpetrators and victims are, some of the theories of etiology, as well as present therapeutic techniques. What is Parent Abuse? Parent abuse can be described as any act perpetrated by a child or adolescent that causes a parent to feel threatened, intimidated and controlled (Paterson, Luntz, Perlesz, & Cotton, 2002). As with partner abuse it can include physical, psychological, emotional and financial abuse. Although the behaviors that constitute parent abuse and partner abuse may be identical, the unique relationship between a parent and their child means that there are two important distinctions between these types of abuse. First, the victim parent still has a responsibility to parent, which makes the option of leaving the relationship less appropriate. Second, even though victim parents may not necessarily be physically larger than the abusing child, they are frequently more powerful than the perpetrating child in terms of social and economical resources, even though the childs abusive behaviors are likely to maintain power over parents (Paterson, Luntz, Perlesz, & Cotton, 2002). The Prevalence of Parent Abuse Since abuse of parents by their children has not attracted great research interest, the prevalence rate of this type of abuse has yet to be determined (Jackson, 2003). Furthermore, many parents are unwilling to report their childrens abuse, feeling ashamed, guilty and/or fearing what will happen to their child if they report the abuse (Cottrell, 2001). Even when reported, accurate prevalence rates are hampered by different measurement scales and methods of data collection (Wilson, 2005). Researchers in the United States, for instance, estimate that parent abuse occurs in 7% (Peek, Fischer, & Kidwell, 1985) to 18% (Pelletier, 1992) of two-parent families and 29% (Livingston, 1986) of one-parent families (Downey, 1997). What is clear from the literature, however, is that parent abuse affects many families.

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The Impact of Parent Abuse on Families Families are affected by parent abuse in a range of ways (Micucci, 1995). The stress of dealing

with a child who is abusive towards parents can impair the health (both physical and psychological), and vocational and recreational pursuits of all family members (Cottrell & Monk, 2004). Individual family members may also experience negative emotions such as fear, shame, guilt, or despair (Cottrell, 2001). Parents, in particular, may attribute responsibility to themselves for being unable to produce a nonviolent family, and they may feel like they are blamed when they seek help from others (Micucci, 1995). The interpersonal relationships of family members may also be strained. Members may distance themselves from others for fear that the family secret will be exposed. They often focus their attention on the abusive child, resulting in less time and energy for others. Disagreements may occur as family members have conflicting views about what should be done to reduce the parent abuse (Cottrell, 2001). Busby (1995) warned, however, that the most significant consequence of any form of abuse within a family is the teaching and reinforcing of the cycle of abuse. Other children, for instance, may learn to equate hitting with love, and may see abuse as an acceptable option when alternative methods of negotiation are unsuccessful. Who are the Likely Perpetrators and Victims of Parent Abuse? Gallagher (2004) warns that behavior is always multi-determined. To believe, therefore, that we can identify the root cause(s) of an individuals behavior is presumptive. Nevertheless, several studies have focused on identifying the typical presentation of child and adolescent perpetrators and parent victims of parent abuse. Child and Adolescent Profile Gender. Traditionally, males are more aggressive than females in both domestic violence situations and community-based gang aggression (Paulson, Coombs, & Landsverk, 1990). Accordingly, many professionals believe that males engage in more parent abuse than females (Cottrell, 2001). Research, however, has found that the incidence of parent abuse does not vary according to perpetrator gender (Paulson, Coombs, & Landsverk, 1990). The exception is Evans and Warren-Sohlberg (1988), who found that males were significantly more likely to be abusive toward their parents than were females. What has been found to differ according to the young persons gender is the type of parent abuse. While both male and female perpetrators engage in all forms of abuse (Cottrell, 2001), males are more likely to be physically abusive and females are more likely to be emotionally and verbally abusive towards their parents (Evans & Warren-Sohlberg, 1988; Nock & Kazdin, 2002). Age. In earlier studies, the peak age for onset of parent abuse among young people was estimated at 1517 years (Wilson, 2005; Evans & Sohlberg, 1988). Recently, however, a younger age group (between the ages of 12 and 14 years) has emerged (Cottrell, 2001). Despite this trend, it appears

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that parents do not identify their childs behavior as abusive until they experience it as threatening. Prior to this, parents are more likely to term their childs behavior as a tantrum. Consequently, although children as young as 5 or 6 years may exhibit abusive behaviors (Nock & Kazdin, 2002), these behaviors are often only recognized as abusive retrospectively, once the child is physically larger and a pattern of abuse has emerged (Cottrell & Monk, 2004). Overall, the incidence rate of parent abuse is positively correlated with childrens age (Agnew & Huguley, 1989; Paulson, Coombs, & Landsverk, 1990), but other than kicking behaviors (which decrease with age), no overall age differences exist in the type of parent abuse that is committed (Nock & Kazdin, 2002).. Differences have been found, however, when victim gender is also considered (Wilson, 2005), in that males are less likely to hit their mothers and more likely to hit their fathers as they age, while females are more likely to hit both their mothers and fathers as they age (Agnew & Huguley, 1989). Size and Strength. It is unclear whether the amount of physical force used against parents varies according to the child/adolescent perpetrators size and strength. On one hand Cottrell and Monk (2004) found that, compared to less powerful perpetrators, stronger perpetrators are less likely to cause injury and more likely to employ non-violent intimidation and control tactics. On the other hand, Agnew and Huguley (1989) found that the size of the child has no consistent relationship with assault. As no study controlled for the size of the children relative to their parents, it may be that some of the larger/stronger children also had larger/stronger parents, which would offset the advantage that their size afforded them. Similarly, some of the smaller/weaker children may have had particularly small/weak parents, which would create a size/strength differential between them and their parents, which would not occur in other parentchild relationships (Agnew & Huguley, 1989). Emotional Attachment to Parents. As part of a larger study investigating the prevalence rates, the sociodemographic correlates, and the etiology of parent abuse, Agnew and Huguley (1989) asked 1,395 adolescents to rate their parental attachment on a 14-item scale. High scores designated that adolescents considered themselves close to and accepted by their parents, enjoyed doing things with their mother and father, and agreed with their parents ideas. Responses were compared for adolescents who had never engaged in parent abuse and those who had assaulted their parents at least once. It was found that adolescents who engaged in parent abuse were weakly attached to their parents. The results were replicated in a study (Paulson, Coombs, & Landsverk, 1990) that compared children who did not engage in parent abuse, with children and adolescents (aged between 9 and 14 years) who perpetrated parent assault. The abusive children were significantly less likely to report that they had a close relationship with their parents, or emotionally rewarding interactions with them, and were less likely to talk to their parents about their personal problems.

RUNNING HEAD: PARENTAL ABUSE BY CHILDREN

Peek et al. (1985) also found that parent abuse was associated with adolescents emotional attachment to their parents. In a study of 1,545 white male high school students, adolescents who reported that they were more emotionally attached to their parents, and those who exhibited more agreement with their parents were less likely to state that they had engaged in parent abuse. Race/Ethnicity. Some researchers have found that there is no difference in the prevalence of

parent abuse across race/ethnic groups (Cornell & Gelles, 1982; Paulson, Coombs, & Landsverk, 1990). Others report that the rates of parent abuse are higher within White populations than in Black populations (Agnew & Huguley, 1989; Charles, 1986). More specifically, White children and adolescents are more likely than Blacks to assault their mothers. The rate of father assault, however, does not differ according to race or ethnic group (Agnew & Huguley, 1989). Previous Deviant Behavior. Children and adolescents who engage in parent abuse have been found to display lower frustration tolerance, more oppositional and aggressive behaviors, and to be more demanding when compared to both the general population and children and adolescents who have identified conduct problems (Cottrell & Monk, 2004; Nock & Kazdin, 2002). Pagani et al. (2004) found, for instance, that children who were described as chronically aggressive by their primary school teachers were 9 times as likely to engage in verbal aggression towards their mothers, and 4 times as likely to engage in physical aggression toward their mothers as adolescents, when compared to peers who were described as persistently non-aggressive by their primary school teachers. Children and adolescents who engage in physical aggression towards their parents are also typically more bored in class, place less value on school learning, and are more likely to be truant when compared to children and adolescents who do not engage in such behaviors (Paulson, Coombs, & Landsverk, 1990). In contrast, children and adolescents who engage in parent abuse do not differ from nonaggressive children on measures of conduct disorder symptoms, non-aggressive antisocial behaviors, general externalizing problems, or overall psychological functioning. These findings are consistent across settings (i.e., both home and school situations) and continue even after demographic characteristics and overall levels of oppositionality and aggressiveness are controlled for (Nock & Kazdin, 2002). Exposure to Abuse. A large proportion of children and adolescents who perpetrate parent abuse have been physically or sexually abused by their parents, or have witnessed domestic violence (e.g., Livingston, 1986). Cottrell and Monk (2004) found that perpetrators of parent abuse often start to abuse the victimized parent (typically mother) soon after the violent parent (typically father) leaves the family home. Additionally, they report that this behavior seems to be influenced by a combination of direct male role modeling, idealization of the abuser, and anger at the mother for failing to protect the family

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(Cottrell & Monk, 2004, p. 1082). Less commonly, in an effort to protect the victimized parent, perpetrators become violent towards the abusive parent while the abuse is current. Substance Abuse. There is a high correlation between substance abuse and family violence (Busby, 2005). Consequently, it is not surprising that several researchers have found a strong link between substance use and parent abuse (Cottrell & Monk, 2004). In Cottrell and Monks (2004) study, when asked about the possible connection between their substance use and parent abuse, perpetrators (aged between 10 and 18 years) often denied abusing their parents when they were high or coming down. Instead they typically reported that the abuse was precipitated by a dispute between themselves and their parent(s) over issues that were associated with the substance misuse. These reports are consistent with Evans and Warren-Sohlbergs (1988) finding that approximately 20% of parent assaults occur in the context of a dispute about substance use. It

should be noted however, that while there may be a correlation between substance use and parent abuse, this correlation is not directional. That is, one cannot conclude whether the substance use preceded the parent abuse, or whether the substance use occurred in response to the parent abuse (Wilson, 2005). Peer Influence. Peer influence has been reported by perpetrators, victims and service providers to contribute and to reinforce parent abuse in three ways First, perpetrators of parent abuse often socialize with peers who display similarly violent behaviors in the home and use aggression to achieve power and control (Cottrell & Monk, 2004). Consistent with these reports, Agnew and Huguley (1989) found that adolescent perpetrators of parent abuse reported that their friends engaged in parent abuse, endorsed delinquent acts and, perceived the likelihood of sanction for assault as low. Second, perpetrators often engage in abusive behaviors against their parents as a means compensating for (i.e., displace) the feelings of powerlessness and anger that they experience as a results of victimization by their peers. Finally, peer based prohibited behaviors (e.g., stealing and truancy) often result in disputes within the home that precipitate parent abuse in much the same way as substance abuse, as described in the previous section (Cottrell & Monk, 2004). Parent Profile Gender . Mothers and female careers, in both single and two-parent families, are normally the targets of parent abuse (Agnew & Huguley, 1989; Cornell & Gelles, 1982; Paulson, Coombs, & Landsverk, 1990). This pattern has been reported by service providers to be related to several factors. First, a number of female children perceive their mothers as weak and powerless and aim their abusive behavior at their mothers as a means of separating themselves from this image of female vulnerability. Second, many male children are given the message, through a variety of social means, that it is acceptable to control and dominate females. Third, fathers are often viewed by young people as physically powerful, which reduces the likelihood of abuse against them. Lastly, many families are

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parented exclusively or primarily by females who are more likely to have abuse directed at them merely because they are more accessible (Cottrell, 2001; Cottrell & Monk, 2004). It should be noted that not all researchers agree that females are the victims of parent abuse more often than males. Peek et al. (1985) found that fathers were more likely to be assaulted. This contrary finding could be accounted for by the fact that their research concentrated on older adolescent males. Perhaps a more accurate conclusion, therefore, is that mothers are more likely to be assaulted than fathers, but that this finding is reversed as male adolescents grow older. Parenting Structure. While parent abuse does occur in two-parent families (Cottrell, 2001), it is more common (although not always statistically more common) in single parent families (Kumagai, 1981; Livingston, 1986; Cottrell & Monk, 2004). Parenting Style. Young people are more likely to engage in parent abuse when their parents are overly permissive, or displaying inconsistent rules and consequences (Agnew & Huguley, 1989; Charles, 1986; Micucci, 1995). When interviewed about their experience of adolescent perpetrators, service providers and parents reported that adolescents who were parented by overly permissive parents frequently engaged in a cost/benefit analysis in which the advantages of their abusive behaviors were thought to outweigh the costs. Eventually, a pattern developed whereby young people learned that their abusive behaviors could be used to coerce their parents into compliance (Cottrell & Monk, 2004). Similarly, Wilson (2005) states that parent abuse occurs when there is a change of authoritarian roles within a family (i.e., with children becoming more authoritarian than their parents). This exchange of roles, however, is not reported to occur because the child desires control, but because they think that someone ought to be in charge, and recognize that their parents are unable or unwilling to do so. In contrast to the preceding accounts, service providers also report that parent abuse occurs when parents are excessively controlling (Cottrell & Monk, 2004). In such circumstances parents often apply the same level of rigid control that they applied when their children were younger. While this control was formerly perceived as adaptive, tension is now created as the young person, particularly in accordance with the developmental stage of adolescence, has an increased need for autonomy. The result is often that the child/adolescent engages in abusive behaviors in an attempt to acquire a sense of control over their lives (Cottrell & Monk, 2004). Service providers report that parent abuse also occurs when one parent is more lenient than the other (i.e., where inconsistent parenting takes place). When this occurs, two common responses may be observed. First, youth become resentful and angry, directing abuse towards the firm parent (a pattern that is often either overtly or covertly encouraged by the more lenient parent). Alternatively, the young

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person may utilize abuse to intimidate the more lenient parent into changing rules that had been set by the firm parent (Cottrell & Monk, 2004). Socioeconomic Status. The relationship between socioeconomic status and parent abuse is

unclear (Cottrell & Monk, 2004). Some researchers have found that the rates of parent assault are higher in middle and upper class families (Charles, 1986; Paulson, Coombs, & Landsverk, 1990), while others report that the incident rates are higher in lower class families (Cottrell & Monk, 2004). Other researchers have been unable to establish any relationship between parent assault and socioeconomic status (Agnew & Huguley, 1989; Cornell & Gelles, 1982). What is clear though is that parent abuse occurs across all socioeconomic groups (Cottrell & Monk, 2004). Family Stress. The parents of children and adolescents who engage in parent abuse report that they experience significantly more parenting stress than other parents (Nock & Kazdin, 2002). It is unclear, however, whether abusive behavior predates the heightened stress, or vice versa. Cottrell and Monk (2004) report that with these heightened stress levels, parent abuse occurs as parents often have less energy to react effectively to conflictual circumstances. Moreover, in these environments children and adolescents are likely to feel alienated and are, therefore, likely to become abusive as they express their frustration and anger. Family stress levels may also contribute to the reported increase in parent abuse in other demographics that have already been discussed above (e.g., under the headings of substance abuse, socioeconomic status, parenting structure, and exposure to abuse). In summary, numerous factors have been associated with parent abuse, ranging across child, parent, sociodemographic and family domains. Although patterns are observed, they are not always consistent. Parent Abuse Etiology Among the various theoretical frameworks that attempt to explain parent abuse are the Culture of Violence Theory, Stress Theory, Social Learning Theory and Nested Ecological Theory (Cottrell & Monk, 2004; Downey, 1997; Kratcoski, 1985). The cultural explanation of violence purports that parent abuse is part of the norm and a learned response in many demographics. Males, for example, (especially those in female-headed households in Black or lower-class neighborhoods) may attempt to achieve status through parent abuse that they were unable to achieve through other mechanisms, such as material wealth (Kratcoski, 1985). Stress Theory states that parent abuse occurs when children/adolescents have inadequate natural defenses to cope with excessive stress (irrespective of whether that stress occurs as a result of a single event or whether it accumulates from a series of events) (Kratcoski, 1985). Abuse occurs as the stressed child/adolescent attempts to maintain intense physical and emotional contact with their parent victim.

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The abuse is often unplanned, and unintended, occurring in a very confused, stressful emotional relationship (Kratcoski, 1985).

Social Learning Theory reports that early childhood experiences and parentchild relationships, such as witnessing abuse and the effects of different parenting styles and abuse within the home, influence later behavior patterns (Downey, 1997). If, for example, a young person was raised in a family environment with excessive levels of stress and inadequate coping mechanisms, their parents might have sought a solution through violence and this behavior could have been learned via modeling. Similarly, if a young person has been raised in a family that is overly controlled and characterized by intense relationships that involve the use of violence as a means of discipline, the young person could have learned that abuse is an acceptable means of influencing others (Cottrell & Monk, 2004). Nested Ecological Theory proposes that parent abuse arises when macrosystemic, exosystemic, microsystemic, and ontogenetic factors interact. Within the macrosystem are cultural values and belief systems, such as gender inequality and media violence, that justify violence towards others. Exosystem factors include social structures, such as poverty, family stress, negative peer influence, and lack of social supports, which produce environments in which abuse is more likely to occur. Microsystemic factors incorporate family interaction patterns, such as negative or ineffective parenting styles and parenting conflict, which contribute to abuse. Lastly, ontogenetic factors comprise the individual characteristics and experiences, such as poor attachment history, drug and alcohol abuse, childhood victimization and mental health issues, which the perpetrator brings to the relationship with their parents (Cottrell & Monk, 2004). Although no direct test of these theories on the etiology of parent abuse has been made, they are consistent in varying ways with some of the research findings to date. However, further, more sophisticated, research is required to determine the degree to which the correlational research linking various characteristics of perpetrators and victims with parent abuse supports the various etiological approaches. Interventions for Parent Abuse While therapists and researchers are becoming more aware of the existence of parent abuse, research has tended to focus on explaining the abuse, rather than on identifying options for interventions (Downey, 1997). Consequently, very few descriptions or evaluations of treatment programs for parent abuse exist (Paterson, Luntz, Perlesz, & Cotton, 2002), and no literature is currently available that compares the effectiveness of treatment approaches. Despite this, family therapy is generally regarded as the treatment of choice for parent abuse (Wilson, 2005). While there are many different schools of family therapy, what is common to all is the core belief that the problem does not belong exclusively to one member or part of the system, but should be addressed by the entire system (Sheehan, 1997).

RUNNING HEAD: PARENTAL ABUSE BY CHILDREN

In line with family therapy (particularly systemic family therapy, which aims to identify repetitive patterns of interaction among family members that produce and maintain symptomatic

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behavior), Micucci (1995) has identified four key therapeutic strategies for treating parent abuse. These are: supporting parental authority, repairing dislocated relationships, containing conflicts, and discovering and supporting competence. While research that outlines the effectiveness of these strategies is lacking, Micucci (1995) suggests that they help the family break free from symptomatic patterns, end the violence, repair broken relationships, and facilitate the development of each others strengths and talents. Micucci (1995) further reports that as parents of families in which parent abuse occurs frequently feel powerless and helpless, it is imperative for the therapist to support parental authority and to install in the parents more self-confidence. He proposes that one way of achieving this is to insist that parents assume complete responsibility (both within therapy sessions and external to therapy sessions) for decisions affecting their household. Price (1996) adds that therapists regularly make the mistake of taking on an instructional role prematurely in therapy. He states that when this occurs, the therapists instructions convey to the parents that they dont have what is required to solve their own problems. Micucci (1995) states that discussions regarding the ways in which family members can help to re-establish trust in each other may help to repair their dislocated relationships. As family members often experience difficulty in listening non-reactively to each other, Micucci suggests that family members be instructed by the therapist to listen without feeling compelled to defend themselves. As extra-familial systems often become embroiled in conflicts, Micucci (1995) also suggests that therapists schedule meetings together with parents and members from extra familial systems. He proposes that such meetings will help to contain conflicts across systems and will assist members to work more collaboratively in addressing the parent abuse. It may be necessary to involve the police in this process. Parents should, where possible, speak with the police outside of the abusive situation to be clear about what the criminal justice system can and cannot do (Cottrell, 2001). Where parent abuse occurs, all family members are prone to feeling helpless and incompetent (Cottrell, 2001). To interrupt this cycle, Micucci (1995) states that therapists should help the family to identify and support competence in all family members. Assistance should particularly be given to help the family members (including the perpetrator themself) to develop an expanded definition of the perpetrator of abuse (i.e., so that they are not only viewed as the perpetrator of abuse). Parent Training Therapy Gallagher (2004) warns that, just as it is widely recognized that it is usually inappropriate to see both the perpetrator and victim together in initial treatment sessions for spouse abuse, seeing the young perpetrator and parent victim and/or family members of parent abuse together can be problematic. He

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cautions that the child/adolescent may disrupt conjoint sessions by making derogatory statements towards their parents, storming out, and/or withdrawing, and that the remainder of the family may scapegoat the young person. Furthermore, as therapists endeavor to engage the whole family, they regularly collude with family members in playing down the violence and abuse. In the absence of conjoint sessions, it is preferable for therapists to work separately with both

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the child/adolescent perpetrator and their parents (Gallagher, 2004). Once again, however, this is often not possible. Child perpetrators are often difficult to engage in therapy and rarely acknowledge that their behavior is problematic (Paterson, Luntz, Perlesz, & Cotton, 2002; Jenkins, 1990). Gallagher, therefore, suggests that if one has to make a choice, work with the parent is probably more important. He has proposed nineteen steps that parents should undertake to regain control over their abusive child. A fundamental goal of individual parent work is for parents to develop clear rules about their childs behavior and to establish logical consequences for all violent, abusive or destructive acts (Gallagher, 2004). Rule clarity involves the parents being specific about the unacceptable aspects of their childs behavior. The parents should be specific about the behaviors they would like their child to change, and ought to avoid confusing and ambiguous terminology. Rather than stating that they want their child to change their attitude, for example, parents should be specific about what it is about their childs attitude that they would like altered (e.g., stating that they would like their childs voice to become less angry and more calm). As it is difficult to be consistent when there are multiple rules, parents should be encouraged to prioritize the aspects of their childs behavior that they wish to shape (Gallagher, 2004). For example, initially safety concerns should be addressed in favor of other less pressing aspects of the childs behavior. Occasionally parents may need to employ physical management techniques to restrain their child. According to Price (1996), such techniques aim to protect the child and others around the child from harm, and to demonstrate to the child that their abusive behavior (typically violence) will not be tolerated. Parents should be educated that even though restraint often precipitates a response of aggression in the child/adolescent, this aggression is generally followed by submission when the adult doing the restraining demonstrates that they will not relent when threatened. Parents should also be educated that it is critical that restraint is not instigated when they are angry and unable to contain of their own anger and are likely to act in a harmful manner. As becoming physical may be dangerous, Price warns that it is only recommended when there are no other options. Parents are likely to benefit from enrolment in a physical management course that will educate them on how to restrain their child without causing harm (Price, 1996). For a few families, removing the abusive child from the home will help. Removal may occur for a few hours per week (e.g., to another family members or friends house) or may continue in an

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enduring fashion (e.g., placing the child in a residential care program). Such removal alleviates the

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immediate threat of abuse and provides parents with the time and space to start addressing the long-term issues related to the abuse (Cottrell, 2002). The risk of removing the abusive child from the home, however, is that the child will perceive that they have been abandoned. Further, the risk of intergenerational abuse remains if the underlying abusive behaviors are not addressed (Price, 1996). Individual Therapy Even though it is often not regarded as being effective on its own (since it is more difficult to address interpersonal relationships between parents and their children and few youths will be honest about their abusive behavior when seen alone), several authors advocate individual therapy for the youth perpetrator of parent abuse (e.g., Downey, 1997). This therapy typically occurs either as a concurrent therapy or post initial treatment. The goal of individual therapy with the child/adolescent perpetrator of parent abuse is typically to improve emotional awareness, to advance the expression of feelings, to develop more insight into the level of control and, therefore, control over abusive behaviors, to challenge maladaptive attitudes about gender roles, and to motivate the young person not to be abusive (Downey, 1997; Gallagher, 2004). This may include discussing any diagnosis, such as ADHD or Oppositional Defiant Disorder, which the young person mistakenly interprets as implying that they are not in control of themselves and their abusive behavior. As many young perpetrators of abuse are difficult to engage in therapy, Gallagher (2004) offers three suggestions for encouraging them to attend at least the first session. First, he suggests that the therapist phone, text, or e-mail the child/adolescent and request a trial meeting (e.g., just once, so the young person can recount their side of the story). Second, the therapist could make arrangements to see the young person in an alternative setting (e.g., at their home or at school). Third, the therapist could assist the parents to identify suitable consequences that could be employed to encourage the young person to attend (e.g., rewarding attendance). Once the young person has agreed to attend therapy, working with the young perpetrator is a balancing act. On one hand the child/adolescent might refuse to attend further sessions if challenged too soon, while on the other, they might refuse to attend further sessions if they are not challenged soon enough (i.e., viewing the session as a waste of time). While it is necessary to build as much rapport as possible before focusing on the abusive behaviors, the child/perpetrator is likely to either become bored or they will stop taking the therapist seriously if the abuse is not addressed or is not addressed early enough. Furthermore, if the young person views the therapist solely as a confidante, they are likely to feel betrayed when the therapist finally gets around to discussing the topic of abusive behavior (Gallagher, 2004).

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Therapists should be particularly mindful of the strategies that they typically employ when developing rapport with clients. Keeping the conversation light, avoiding challenging inappropriate behaviors, and avoiding taking the moral position on anything, for instance, should be avoided when working with young perpetrators of parent abuse. Such techniques risk undermining parents, reinforce excuses, and imply approval for behavior that is unacceptable. Group Therapy

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While little attention has been afforded to group work (separate to family work) as a treatment option for parents who are experiencing parent abuse, group therapy has been demonstrated to be beneficial to women survivors of domestic violence (Jackson & Dilger, 1995; Tutty, Bidgood, & Rothery, 1993) and parent education groups have been demonstrated to be popular and effective as a means of supporting parents (Paulson, Coombs, & Landsverk, 1990). Group work (whether it is group therapy, parent education or support groups) offers victims of abuse the chance to recognize that they are not alone in their struggles, and provides an opportunity to assist others in similar circumstances. This is valuable for parents who feel helpless in their own abusive situation, as being a source of support for others reduces their feelings of helplessness (Cottrell, 2002). Paterson et al. (2002) report the positive impact of such programs. Additionally, twelve-step models of treatment have become more prevalent recently, particularly in the fields of addiction. One in particular, developed by Patrick Carnes (2001), focuses primarily on sexual addiction, and seems to show some promise. While little research has been done to assess the viability of these models for the treatment of family violence, their apparent viability in other areas seems to indicate a oppressing need for research. Though speculative at this time, it appears that strategies such as these warrant exploration. Summary of Interventions for Parent Abuse While limitations in the current literature mean that no conclusion can be drawn as to which form of therapy is most effective in treating parent abuse, several commonalities exist across the presented approaches. According to the above studies the components of an effective treatment package targeting parent abuse include: psycho education (e.g., challenging adverse depictions of violence and highlighting that the child is not intrinsically bad, but is a good child who displays bad behaviors); monitoring of prosocial and antisocial behavior targets; behavioral parent training with a focus on parents regaining control (e.g., via logical consequences and rewards about which all careers are in agreement); family-based communication and problem solving training; and the development of trust between family members and towards therapists. In addition, families may benefit from home-school liaison meetings and remedial tuition, child-based social problem solving skills training, parent

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counseling for personal or marital difficulties, removal of the abusive child from the home, and interprofessional and interagency coordination meetings. Most importantly, while many of the reviewed approaches acknowledge that it is difficult to engage all members of the family in therapy, each highlights that the problem does not belong exclusively to one family member. Micucci (1995) advised that therapy (irrespective of which type or therapy is being employed) should not cease once the parent abuse has been disrupted. He stated that following the initial therapy other unresolved issues, which have been masked by the symptomatic cycle, ought to be addressed. Therapy may, for instance, assist the adolescent to attend to normal developmental tasks (such as developing adaptive social problem solving skills) and attending to

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educational needs that are likely to be delayed due to previous preoccupation with the abuse (Brendler, Silver, Haber, & Sargent, 1991). Similarly, parents often benefit from marital therapy to address conflicts that have been masked by the abuse or that have developed due to the stress of the abuse (Micucci, 1995). Evaluation of the Parent Abuse Research and Future Directions Research on parent abuse is limited in volume and scope, and is marred by inconclusive findings. Although research indicates that a number of factors are associated with a higher rate of parent abuse, the correlation between parent abuse and other factors are less clear. The impact of race/ethnicity, for instance, is inconclusive. Similarly, it is unclear whether mothers or fathers are more likely to be the victims of parent abuse. These conflictual findings add support to Gallaghers (2004) warning that behavior is multi-determined. That is, perhaps race/ethnic groups and parent gender are linked to parent abuse in combination with other factors (such as exposure to abuse). Further research is required to examine the interactions between combinations of factors in order to more fully understand the characteristics of perpetrators and victims of parent abuse. The limited research that is available on parent abuse is also fraught with methodological flaws. Small sample sizes, and a lack of follow-up periods, for instance, limit the conclusions that can be drawn about the effectiveness of parent abuse treatment programs. It is particularly striking that to date no research has compared the effectiveness of treatment approaches (i.e., family therapy versus parent training, individual therapy and group therapy). To deepen our understanding of parent abuse and to gain further insight into treatment more work on this issue is required.

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