How Professionals Can Implement a Two-Generation Approach

Co-authored by Sarah MacLaughlin, LSW, and Rahil Briggs, Psy.D.

Adverse Childhood Experiences (ACEs) and other traumatic experiences are often intergenerational, meaning that the children in these families (where caregivers have experienced ACEs) can be at greater risk themselves.

A crying baby and her stressed-out mother.

Source: Christinarosepix/Shutterstock

Part of the reason for this is that parents and caregivers who have experienced trauma in their childhoods, without key protective factors, may have developed an overactive stress response, which can increase their risk for physical, mental, and behavioral health concerns. These health issues can tax family resources and interfere with an adult’s ability to be a healthy buffer for the child. In addition, caregivers with an overactive stress response may have more difficulty managing stress and emotions and self-regulating in a healthy manner when engaging with their kids.

This dynamic can affect their parenting practices, create an additional vulnerability in parent-child interactions, and contribute to a higher risk of adverse outcomes. It can also perpetuate the intergenerational cycle that is particularly important as nurture (the environment) interacts with nature (genes) via gene expression—a process called epigenetics. This process can put children with ACEs and trauma histories at higher risk for disease and other harmful health conditions throughout life. This is because the biochemical effects of chronic stress, absent protective factors, can be toxic to a child’s healthy development.

Effectively addressing ACEs and trauma involves a two-generation approach to reduce the dose of adversity and enhance the ability of the caregiver to buffer their child's stress. This approach provides support for children and their caregivers, with the goal of breaking the intergenerational cycle.

Why a two-generation approach?

• Improving awareness, providing parenting education and mental health screening enhances the likelihood that caregivers will get the support they need.
• Receiving support and other needed services can improve parents’ and other caregivers’ physical, mental, and behavioral health outcomes.
• Building a positive, loving relationship with their child creates a buffer that can protect the child, interrupt the intergenerational cycle, and reduce the impact of trauma.

All caregivers hope that their children will experience a higher quality of life than they had. Research shows that a parent’s education, economic stability, and general health can have a significant impact on a child’s welfare and path in life. Without awareness, caregivers who have unaddressed ACEs can unknowingly impair their child’s life trajectory through their own behavior and parenting or via epigenetics. That is why protective factors are vital for children to thrive.

A caregiver-child approach to providing support

The entire family benefits when you address the needs of the family system. This care entails paying attention to the needs of the child, the caregivers, and the quality of their relationship. This approach recognizes that a child’s health and well-being are directly affected by that of their caregivers and that parent wellness is an integral part of assuring optimal conditions for the child to thrive. In this type of two-generation model, the quality of the attachment between the caregiver and child is continually assessed and supported.

How to implement a two-generation approach

• Identify adult mental health concerns such as anxiety or depression that may negatively impact parenting or other family dynamics.
• Assess social determinants of health, including caregiver mental health, food security, transportation, and the ACEs of the children and adults in the family.
• Inform and support caregivers around the potential impact of their social-emotional and mental health on their child.
• Share the positive effects and protective factors of a healthy caregiver-child attachment.
• Discuss the ways in which empathy and responsive care can support the healthy development of the child’s brain and body and protect them from stressful events. Note that the number one protective factor for a child’s development is the presence of a loving, caring adult to buffer the biochemical impact of the toxic stress response.
• Discuss the importance of supportive relationships, healthy nutritional choices, exercise, sleep, mindfulness, getting out in nature, and mental health support.

When parents and caregivers learn healthy ways to manage stress, develop positive problem-solving skills, build strong social connections, and learn about parenting strategies as well as the basics of child development, they have better emotional and intellectual resources to enhance their own health and well-being, as well as that of their child and family.

Behavioral health providers have an important opportunity to help caregivers better understand the critical role they play in shaping their child’s life and long-term health, and they can offer key skills and support as caregivers navigate new ways to guide and nurture their children toward a healthy, happy, and productive life.

Health Essential Reads

Is Vitamin D Supplementation an Evidence-Based Practice?

Born to Run or Born to Sit?

Sarah MacLaughlin, LSW, and the Center for Youth Wellness contributed to this post. Sarah is a social worker, parent educator, and author of the award-winning, bestselling book, What Not to Say: Tools for Talking With Young Children.