Parentification: Signs and Symptoms of a Parentified Child

Parentification creates a role reversal in the parent-teen relationship. This problematic dynamic can overwhelm teens with family caregiving roles and responsibilities, leading to issues including mental health challenges, substance use disorders, and difficulty forming or maintaining relationships.     

To explore parentification, also known as reverse parenting, we spoke to Alex Hamilton, licensed clinical professional counselor and clinical director of Lake House Academy, an Embark Behavioral Health therapeutic boarding school. This article explores the different types of parentification, parentification trauma, how to keep your teen from being parentified, and how to help them heal if it happens.   

What Is Parentification? 

Parentification occurs when a child takes on developmentally inappropriate levels of responsibility for their family’s emotional, physical, and/or mental well-being. This reverse parenting results in them becoming caregivers before they’re physically, mentally, or emotionally ready for such responsibility.   

When it comes to teenagers, it’s not unusual for a teen to clean the bathroom, hold down a job, or occasionally watch out for younger siblings. When these tasks teach them new skills or how to shoulder responsibility or give them encouragement, they can grow because their parents are the ones who bear final responsibility for the family’s well-being. When teenagers experience a complete role reversal and becomes responsible for the parents’ or younger children’s well-being, however, it can lead to them being parentified, which may lead to trauma. 

Types of Parentification 

There are two types of parentification: emotional and instrumental. 

Emotional parentification 

Emotional parentification occurs when a teen fulfills emotional and/or psychological needs for the parent, creating an unhealthy role reversal that can be very hard on teenagers, as highlighted in Columbia University research on the developmental implications of parentification. The parentified child could be expected to serve as a confidante or to provide crisis intervention if a parent is experiencing psychological distress. 

Examples and signs of emotional parentification 

Examples and signs of emotional parentification include: 

• Being relied on for emotional, physical, or mental support from parents. 
• Providing conflict resolution or mediating between parents. 

Instrumental parentification 

With instrumental parentification, the teen takes on responsibilities that usually fall within a parental role. This can happen in situations where one or both parents can’t fulfill all of the family’s needs, such as when a father leaves and the mom struggles to make ends meet. 

Divorce, loss of a parent, disability, and other life situations can lead to teens taking on more adult responsibilities. When family members provide emotional support to each other during these times, the positives of adding such responsibilities could outweigh the negative effects. 

Examples and signs of instrumental parentification 

Examples and signs of instrumental parentification include: 

• Consistently performing parental household tasks. 
• Parenting siblings. 
• Working and providing for parents, siblings, or the household. 

Effects and Symptoms of Parentification 

Several difficult mental health challenges can affect children who’ve been parentified. 

For example, teens can overcompensate by forming relationships where they don’t have to expose themselves emotionally. 

“There are some teens who are really going to have those moments where it feels like neglect or too much pressure, and that can result in symptoms of depression or self-destructive actions,” Hamilton said. “There might also be other teens who overcompensate for parentification, which can result in perfectionist tendencies.” 

Teens who face pressure from reverse parenting are more likely to show strain through: 

• Attention-deficit/hyperactivity disorder symptoms. 
• Aggressiveness. 
• Self-harm. 
• Mental illness and mental health issues such as depressive symptoms, binge eating, or substance use disorders. 
• Absenteeism in school and lower grades. 
• Dysfunction and distance in their interpersonal and romantic relationships. 
• Trauma. 

Parentification Trauma 

What’s the relationship between parentification and trauma? When teens realize they’re responsible for providing emotional and physical security for parents and other family members, they tend to repress their own developmental needs in favor of what they perceive the adults need. This reversal tends to compromise the child’s emotional, physical, and relational development.  

After several years of this reverse parenting, a parentified child may find it difficult to discern their core identity, feelings, or needs — and, most importantly, compromise their ability to trust caregivers. This could result in having poor boundaries and difficulty saying no. Teens can also internalize the belief that having personal needs and desires is not OK and become hypervigilant of others’ moods and needs, leaving them unable to relax or trust others and making developing and maintaining close, healthy relationships difficult. This can be a traumatic experience for teens as they move toward and into adulthood.  

A Parentified Child vs. a Responsible Child 

If you’re trying to determine if your teen is parentified or just responsible, take a close look at them. 

“The biggest challenge is that sometimes you have to dig to find parentification because it can be hidden in really positive working behaviors,” Hamilton said. “A lot of parentification can be masked in perfectionism and overcompensation, so a lot of what they’re doing is perceived as positive.” 

Hamilton noted that while there are gains and losses to parentification, “It’s really important for us to notice that, yeah, this may look great, but teens are missing out on nurturing developmental moments that help them have positive relationships in adulthood. A nurturing moment can be as simple as preparing a favorite snack and bringing it to your teen all the way to providing hygiene guidance and products. Anything that consistently provides emotional and physical safety can be seen as nurturing.” 

How Can You Keep Your Child From Being Parentified? 

To keep parentification from creeping in, Hamilton recommended you understand and adhere to what’s developmentally appropriate for your child. Remain in the role of caregiver. To that end, she said, you should establish and follow boundaries based in emotional and physical safety. 

Provide emotional safety

“Emotional safety can be defined as the ability to feel unconditional acceptance from the parent, paired with the ability to share feelings appropriately and freely ask questions,” Hamilton said. 

Boundaries based in emotional safety include using respectful and appropriate language and positive communication, which includes being aware of the tone you’re using as well as avoiding profanity, putting others down, blaming, and oversharing. It’s important to keep in mind that boundaries like these are for the entire family. 

“If the boundary is to have respectful language, that should be abided by everyone,” Hamilton said. “If that doesn’t happen, then repair work such as apologizing needs to be done.” 

Provide physical safety 

“Physical safety leans heavily on meeting basic needs like food, shelter, and health as well as practicing safe touch, such as a handshake, pat on the back, or hug with a trusted person,” Hamilton said. 

Boundaries based in physical safety that can help prevent reverse parenting include maintaining a clean and safe house.  

Addressing Parentification and Helping Your Child Heal 

When it comes to addressing parentification and helping a parentified child heal from challenges, Hamilton has recommended that parents of teens attending Lake House Academy for the school year use parenting support groups, find their own therapists, and practice co-regulation. 

Use parenting support groups 

Parenting support groups can provide needed empathy and help you strategize about how to address reverse parenting. 

“It’s really an opportunity for the parent to work on their individual self — and work on that with other parents who are experiencing the same thing,” Hamilton said. 

For Lake House Academy parents whose teens come home to visit from time to time, she noted, “Being part of a parent support group provides that connection of ‘I had a really hard home visit too, let’s talk about it as parents … ‘Having that peer support is really helpful in those moments where parents can empathize with one another.” 

Find a therapist 

If you’re struggling with parentification and the role reversal that comes with it, a therapist can help create moments and assignments where you, the parent, take on the role of the parent so it becomes rewired in your brain and begins feeling natural. 

“Those moments can look as simple as having the parent cook the meal and just having the child there. Or at bedtime, you can rub your child’s back,” Hamilton said. “A 14-year-old may not want you to sit and rub their back or brush their hair, but it can be really nurturing. Having some of those assignments can help developmentally, and eventually, they become organic and helpful — and it doesn’t feel awkward. Creating and cultivating these homework assignments in therapy is where it starts.” 

Types of therapy you — and your teen — can explore are: 

• Trauma-focused cognitive behavioral therapy (TF-CBT). 
• Dialectical behavior therapy (DBT). 
• Experiential therapy. 

Practice co-regulation 

“I think it’s the therapist’s duty to create moments of co-regulation, or moments to facilitate role reversal,” Hamilton said. 

She explained that co-regulation is consistently providing commitment to, acceptance of, and security for your child. It involves putting empathy into action and understanding what the child needs. 

“It’s the experience of healthy intimacy between the caregiver and child,” Hamilton said. 

Parentification: Wrapup 

If the parent-child roles in your family are not functioning as they should, there are ways to fix it. Besides working with your own therapist, work together in family therapy too. Your teen may also benefit from counseling. Reaching out to a mental health professional could be just what your child needs to heal from parentification and the issues that can result from it, like trauma. 

Embark is the most trusted name in teen and young adult mental health treatment. We’re driven to find the help your family needs. If you’re looking for support, contact us today.