































Graduate Student Journal of Psychology          Copyright 2012 by the Department of Counseling and Clinical Psychology 
2012, Vol. 14               Teachers College, Columbia University 

45 

 
The Developmental Implications of Parentification: 

Effects on Childhood Attachment 
 

Jennifer A. Engelhardt 
Teachers College, Columbia University 

 
Parentification refers to the process through which children are assigned the role of an adult, taking 
on both emotional and functional responsibilities that typically are performed by the parent.  The 
parent, in turn, takes the dependent position of the child in the parent-child relationship.  Although 
a small degree of parentification can be beneficial to child development, this process can become 
pathological when the tasks become too burdensome or when the child feels obligated to take on 
the role of adult.  The purpose of this review is to examine the current literature concerning the 
effects of parentification on child attachment and the implications this may have for the present and 
future well-being of a child.  Methodological issues in current research as well as suggestions for 
future research are also discussed.  Research indicates that, due to the emotional unavailability of 
the caregiver, emotional parentification disrupts the development of secure attachment.  The 
consequent formation of insecure attachments to primary caregivers, particularly the mother, results 
in interpersonal deficits in the child that can carry on into adulthood.   
 

 
 The term “parentification” was first utilized in depth by 
Boszormenyi-Nagy and Spark (1973) to describe a common 
component of relationships whereby parental characteristics 
are projected onto an individual.  Within the parent-child 
relationship, this process is often seen when the child 
performs chores or occasionally offers emotional support for 
a parent, and is believed to be healthy for the child as he or 
she begins to see the potential for him or herself in an adult 
role (Boszormenyi-Nagy & Spark, 1973).  However, when 
the responsibilities become too burdensome, or when the 
child feels obligated to take on the adult position in order to 
maintain a balance in the family system, parentification can 
become pathological (Hooper, 2007a, 2007b).  This 
dysfunctional aspect of parentification is most commonly 
addressed in the literature, and is described as:  

a disturbance in the generational boundaries, such 
that evidence indicates a functional and/or emotional 
role reversal in which the child sacrifices his or her 
own needs for attention, comfort, and guidance in 
order to accommodate and care for the logistical and 
emotional needs of a parent and/or sibling.  (Hooper, 
2007b, p.  323) 

In simpler terms, the adult essentially adopts the dependent 
position in the parent-child relationship, and in turn the child 
is expected to fulfill what are typically considered to be adult 
responsibilities. 

Given the importance of childhood as a period rife with 
developmental tasks that will influence an individual 
throughout the lifespan, it is surprising to note that little 

                                                 
 Jennifer A. Engelhardt, Department of Counseling and 

Clinical Psychology, Teachers College, Columbia University. 
Correspondence regarding this article should be 

addressed to Jennifer A. Engelhardt, 49 Tennyson Place, 
Passaic, NJ 07055. Email: j.a.engelhardt@gmail.com.  

research has been performed on how parentification directly 
affects the developmental processes of the children who 
experience it.  The formation of attachment to a primary 
caregiver is considered to be one of many key tasks in child 
development (Bowlby, 1958), and any process which can 
negatively influence attachment, such as parentification, 
warrants investigation.  In actuality, the majority of research 
on parentification has examined a vast array of potential 
outcomes in adulthood (Earley & Cushway, 2002; Hooper 
2007a, 2007b, 2008; Hooper, Marotta, & Lanthier, 2008; 
Jones & Wells, 1996; Katz, Petracca, & Rabinowitz, 2009; 
Macfie, McElwain, Houts, & Cox, 2005; Mayseless, 
Bartholomew, Henderson, & Trinke, 2004), or the effects of 
parentification on the mental and behavioral well-being of 
children (Earley & Cushway, 2002; Jacobvitz, Hazen, Curran, 
& Hitchens, 2004; Macfie, Houts, McElwain, & Cox, 2005).   

In response to this lack of focus on the topic, the purpose 
of this review is to discuss the literature that addresses how 
parentification affects childhood development in particular.  
Specifically, the scope of this review is limited to the 
influence of parentification on the process of attachment 
formation and its implications for the parentified individual’s 
well-being, particularly with regard to interpersonal 
relationships.  Attachment affects a variety of outcomes in 
areas such as identity development and differentiation, 
temperament, self-esteem, and, most strongly, interpersonal 
relationships through the development of internal working 
models and the corresponding interpretations of experiences 
(Ainsworth, Blehar, Waters, & Wall, 1978; Byng-Hall, 2002).  
An understanding of how parentification affects attachment 
formation not only assists researchers and clinicians in 
understanding, preventing, and treating the problem, but also 
depicts the possible pathways through which many of the 
observed negative childhood and adult outcomes occur. 



ENGELHARDT 
 

46 
 

This review begins with an overview of the concept of 
parentification, including an explanation of the process of 
parentification itself as well as a summary of associated risk 
factors and commonly observed outcomes.  This is followed 
by a description of attachment paradigms, incorporating 
parentification research to formulate an understanding of how 
these two processes are related to and influenced by one 
another.  Following a discussion of the existing literature, 
methodological and conceptual weaknesses of the empirical 
studies performed, as well as suggestions for future research, 
are provided. 

Although parentification is classified as a type of role 
reversal, an analysis of research on parentification reveals that 
researchers often utilize the terms “parentification” and “role 
reversal” interchangeably, with those who do use the term 
“role reversal” conceptualizing it in their research as similar 
to the process of parentification.  In consideration of this, for 
the sake of this review these two words will be used here 
interchangeably, in accordance with the terminology utilized 
in the studies being discussed. 

 
Parentification 

 
When occurring to a pathological degree, parentification 

is considered by some a form of child neglect as it impedes 
development through the denial of basic childhood necessities 
and experiences (Boszormenyi-Nagy & Spark, 1973; Hooper, 
2007a, 2007b).  In a relationship characterized by 
parentification, the parent is typically unwilling or unable to 
uphold his or her emotional and/or physical responsibilities as 
caregiver (Barnett & Parker, 1998).  The parentifying adult 
may relegate these duties to the child, or the child may take 
up these responsibilities voluntarily, despite the incongruence 
between the developmental requirements of these tasks and 
the developmental maturity of the child (Aldridge, 2006; 
Mechling, 2011).  Nevertheless, the child recognizes that by 
providing the physical care and emotional support that he or 
she would normally elicit from the parent, he or she can 
develop closeness with the parent and avoid feelings of loss 
and anxiety (Barnett & Parker, 1998).  The child therefore 
interprets these undertakings as necessary and sees the needs 
of the parent and family as taking precedence over all other 
needs, including their own personal needs.  As a result, the 
parentified child misses out on the developmentally 
appropriate and essential activities that typically characterize 
childhood, such as the formation of healthy interpersonal 
relationships, the development of secure attachment to 
caregivers, and the differentiation of self (Boszormenyi-Nagy 
& Spark, 1973; Bowlby, 1958, 1969; Hooper, 2007a, 2007b). 

The latest report published by the Children’s Bureau of 
the United States Department of Health and Human Services 
(2011) estimates that 9.2 per 1,000 children experienced 
maltreatment in the year 2010, totaling approximately 
695,000 children.  Of these cases, an overwhelming 78.3% 
involved neglect, in which a parent or guardian failed to 
provide appropriate care for the child, resulting in negative 
consequences.  While data on the national prevalence rate of 

parentification specifically is lacking in the literature, 
researchers have attempted to estimate the pervasiveness of 
this problem in other countries, particularly in the United 
Kingdom.  For example, Aldridge (2006) estimates that 
approximately 175,000 children serve in a caregiving role for 
a parent with an illness or disability each year in the United 
Kingdom.  A related study performed by Doran, Drever, and 
Whitehead (2003) found that 114,000 children, or 1.4% of 
children in the UK, were providing some form of care that 
was characterized as burdensome for at least one member of 
their family. The health of a significant number of these 
children was rated as “not good,” indicating that their own 
needs were being neglected in their attempts to meet the 
needs of their family.  Furthermore, the researchers reported 
that caregiving by these children ranged in depth from a few 
hours per week to more than fifty hours per week (Doran et 
al., 2003), illustrating that this problem can vary considerably 
in severity for children who experience it.   

Parentification is most commonly found within 
dysfunctional family systems in which there is a need for the 
establishment of homeostasis in order for the family to 
function adequately.  The family system characterized by 
parentification is thought to be deficient in some way (Hooper 
et al., 2008) so that a lack of boundaries exists and parental 
versus childhood roles and behaviors are not properly 
delineated (Hooper, 2007a).  Most often, one or both parents 
are incapacitated, commonly for physical, social, emotional, 
or economic reasons, and they come to depend upon the child 
to meet their needs and the needs of the family.  Specific 
parental risk factors found to be associated with the 
parentification of one or more child within the family system 
include maternal sexual abuse history, low maternal socio-
economic status, physical and mental illness, addiction, 
divorce, single-parent households, intrusive parenting styles, 
and adult attachment issues (Barnett & Parker, 1998; Earley 
& Cushway, 2002; Macfie, McElwain, et al., 2005).  In each 
of these cases, the child is more likely to take on the parental 
role, voluntarily or involuntarily and to varying degrees, in 
order to compensate for parental deficits and to allow the 
family to function as a whole.   
 
Instrumental versus Emotional Parentification 

When discussing parentification, it is important to note 
that there are two subtypes of the phenomenon, each of which 
may be associated with differing consequences for child 
development and, ultimately, adult outcomes (Aldridge, 2006; 
Hooper, 2007a; Hooper et al., 2008; Katz et al., 2009).  The 
first subtype, instrumental parentification, refers to the 
parentification of children through the assignment of 
functional responsibilities, such as shopping, paying bills, 
cooking meals for the family, and taking care of the general 
logistics of running a household.  This subtype, when 
occurring in isolation, is commonly observed in family 
systems in which one or both parents are incapacitated in 
such a way that they require daily care or are unable to fulfill 
these logistical responsibilities due to illness or other factors, 
such as having to work in order to keep the family financially 



PARENTIFICATION AND ATTACHMENT 
 

47 
 

afloat (Hooper, 2007a).  Instrumental parentification is 
believed to be the less deleterious of the two subtypes for 
child development, as it can foster in the child a sense of 
accomplishment and competence when regular parental 
support and acknowledgement is available (Aldridge, 2006; 
Hooper, 2007a).   

In contrast, emotional parentification requires the child to 
fulfill specific emotional and/or psychological needs of a 
parent and is more often destructive for child development 
than instrumental parentification (Hooper, 2007a).  For 
example, the emotionally parentified child may be expected 
to gauge and respond to the emotional needs of the parent, 
serve as confidante and an unwavering source of support, and 
provide crisis intervention during times of psychological 
distress (Aldridge, 2006; Hooper, 2007b; Katz et al., 2009).  
This subtype, which often occurs in concert with instrumental 
parentification, is most often found within family systems in 
which a parent suffers from mental illness or adult attachment 
issues (Aldridge, 2006).  In order to deal with his or her own 
deficits, which likely arose in childhood, the parent expects 
emotional or psychological support from the child without 
reciprocation (Hooper, 2007b).  As a result of the 
incongruence between these parental expectations and the 
child’s developmental age, level of maturity, and degree of 
understanding, emotional parentification is more strongly 
associated with a number of negative consequences for the 
parentified individual (Hooper, 2007a). 
 
Outcomes of Parentification 

With regard to potential outcomes, research that has 
examined the experiences of parentified children during 
childhood reveals that these individuals report a vast array of 
adverse effects in response to adopting the parentified role.  
These children are more likely to report internalizing 
problems such as depressive symptoms and anxiety, as well 
as somatic symptoms like headaches and stomachaches 
(Earley & Cushway, 2002; Mechling, 2011).  Parentified 
children are also more likely to exhibit externalizing 
behaviors such as aggressiveness and disruptive behavior 
(Macfie, Houts, et al., 2005), substance use, self-harm, and 
attention-deficit/hyperactivity disorder (Jacobvitz et al., 2004; 
Mechling, 2011).  Furthermore, parentification is also linked 
to social difficulties, particularly lower competency in 
interpersonal relationships (Hooper, 2007a; Macfie, Houts, et 
al., 2005), as well as academic problems such as high 
absenteeism and poor grades (Mechling, 2011).  If left 
unresolved, these symptoms of maladjustment can continue 
into adulthood, causing further dysfunction throughout the 
parentified individual’s lifespan. 

Despite the fact that there are known effects of 
parentification on individuals during childhood, such as those 
listed above, currently there has been limited research in this 
area.  Instead, the majority of research conducted has focused 
solely on the effects of childhood parentification on 
individual characteristics in adulthood.  Specifically, 
parentification has been shown to impede identity 
development and personality formation and to affect 

interpersonal relationships, including those with one’s own 
children.  It has also been found to be associated with later 
attachment issues, mental illness, psychological distress, 
masochistic and narcissistic personality disorders, substance 
abuse, and one’s academic and career choices (Earley & 
Cushway, 2002; Hooper, 2007a, 2008; Hooper et al., 2008; 
Jones & Wells, 1996; Katz et al., 2009; Macfie, McElwain, et 
al., 2005).  However, researchers have speculated that in 
some instances, emotional and instrumental parentification 
may prove beneficial for individuals in adulthood.  
Specifically, parentification can lead to greater interpersonal 
competence and stronger family cohesion, as well as higher 
levels of individuation, differentiation from family, and self-
mastery and autonomy when the child experiences a low level 
of parentification and when the efforts of the child are 
recognized and rewarded by adult figures (Hooper, 2007b, 
2008). 
 

Attachment 
 

Attachment theory was developed through the work of 
Bowlby (1958, 1969), who emphasized the importance of 
interpersonal bonds early in life – particularly with primary 
caregivers – as predictors of future well-being.  The theory 
was expanded upon by Ainsworth et al. (1978) who, through 
observation of parent-child interactions, classified infant 
behavior according to one of three attachment styles.  The 
first of these types, insecure-avoidant attachment, is typically 
observed in children whose caregivers are emotionally 
unavailable and unresponsive to the child’s needs.  These 
children often appear prematurely independent and 
consistently avoid contact with the caregiver.  The second 
attachment type, known as insecure-resistant attachment, is 
observed in children whose caregivers are inconsistently 
available and whose behavior toward their child is 
unpredictable.  These children display ambivalence in their 
interactions with the caregiver, both seeking and resisting 
contact, as the caregiver is seen as unreliable.  Secure 
attachment is observed in children whose parents are 
consistently emotionally available and responsive to the 
child’s needs.  Children who demonstrate secure attachment 
find comfort in the parent-child relationship, viewing the 
caregiver as trustworthy and therefore feeling safe enough to 
confidently explore the world.  A fourth attachment style, 
disorganized attachment, was later introduced by Main and 
Solomon (1986) and was used to describe children who 
defied classification under Ainsworth’s rubric.  This 
attachment style is commonly seen in children whose parents 
are abusive or neglectful.  These children often exhibit 
disoriented behavior that lacks a coherent stance toward the 
caregiver, and typically represents significant interpersonal 
deficits.   

Although the four subtypes of attachment are described 
here, current research on the effects of parentification on 
attachment does so only in terms of secure versus insecure 
attachment and does not differentiate between the various 
subtypes.  In consideration of this, the discussion on the 



ENGELHARDT 
 

48 
 

effects of parentification on attachment will do so only in 
terms of secure versus insecure attachment in line with 
current research.  This lack of differentiation between the 
subtypes of attachment is discussed in the next section as a 
methodological weakness of current research.   

The development of secure attachments to significant 
caregivers such as parents, and the resulting construction of 
internal working models which will serve as prototypes for an 
individual’s future relationships, is a key task of childhood 
(Bowlby, 1958).  Oftentimes the attachment patterns formed 
during childhood, particularly with the mother, have long-
lasting effects in a variety of areas of an individual’s life, 
most importantly in the formation and maintenance of 
relationships throughout the lifespan (Bowlby, 1969).  The 
vast array of research on attachment has demonstrated that a 
child’s sense of security, overall well-being, and especially 
connections to others are dependent upon the early mother-
child relationship and the internal working models created 
from this relationship (Hooper, 2007b).  Given the fact that 
the process of parentification directly affects the parent-child 
relationship by blurring the lines that typically delineate 
parental versus childhood roles, it is logical to consider that 
parentification would have a negative impact on the child’s 
attachment pattern. 
 
Attachment and Parentification 

The current literature focusing on the association 
between parentification and childhood and adult attachment 
demonstrates mixed results regarding the effects of this 
pathological process on the attachment patterns of parentified 
individuals.  Some research demonstrates no subsequent 
effect of parentification on the development of secure or 
insecure attachment.  For example, Mayseless et al.  (2004) 
found no relationship between parentification and adult 
attachment, although these researchers examined current adult 
attachment styles as a function of childhood role reversal in 
its broadest form and did not differentiate between 
parentification and other forms of role reversal such as 
spousification, in which the parent looks to the child to fulfill 
needs for companionship.  In contrast, however, a large 
amount of literature in this area indicates that parentification 
leads to significant attachment issues during childhood, which 
often carry forth into adulthood (Boszormenyi-Nagy & Spark, 
1973; Earley & Cushway, 2002; Hooper, 2007a, 2007b; Katz 
et al., 2009; Macfie, Houts, et al., 2005; Macfie, McElwain, et 
al., 2005).   

This body of literature indicates that the parent-child 
relationship characterized by the parentification of the child 
also tends to be characterized by insecure attachment patterns 
between the child and the parentifying adult.  Whether and 
how this relationship comes to exist is often contingent upon 
the type of parentification that is experienced by the child.  
As stated above, instrumental parentification occurs when a 
parent looks to a child to handle the functional responsibilities 
of running a household, such as housekeeping and physically 
caring for family members (Hooper et al., 2008).  This type of 
parentification, when occurring in isolation, is speculated to 

be the less harmful of the two types, particularly in the 
presence of a healthy and supportive relationship with the 
parent (Aldridge, 2006).  In the absence of emotional 
parentification, secure attachment can be formed if the 
instrumentally parentifying adult maintains emotional 
regularity and continuous availability for the child, provides 
consistent emotional and psychological support, and 
recognizes the child’s caregiving efforts (Aldridge, 2006; 
Hooper, 2007a, 2007b).  In emotional parentification, 
however, the child is expected to attend to the caregiver’s 
emotional and/or psychological needs while sacrificing his or 
her own needs for emotional support and attention as they are 
not reciprocated by the parent (Hooper, 2007a, 2007b).  In 
these instances, the development of secure attachment is 
severely disrupted since the child attempts to create some 
form of bond with the parent by providing emotional support 
without reciprocation (Hooper, 2007a; Katz et al., 2009).  
This disturbance of the parent-child relationship is further 
exacerbated by the fact that the child may experience feelings 
of guilt if unable to meet the parent’s expectations, and may 
develop a sense of obligation toward the parent without the 
parent feeling a corresponding sense of obligation toward the 
child (Boszormenyi-Nagy & Spark, 1973).  Due to the 
emotional unavailability and irregularity of the parent, 
insecure attachment is typically formed (Ainsworth et al., 
1978; Hooper, 2007a). 

This relationship, as it appears to the child through the 
process of parentification, is internalized, fostering future 
attachment issues throughout childhood and into adulthood 
(Earley & Cushway, 2002).  Specifically, these early 
perceptions of the self as caregiver to a dependent other may 
continue into adulthood.  For example, many individuals who 
were parentified as children report finding themselves in 
similar relationships as adults in which they take on the 
caregiving role (Earley & Cushway, 2002).  These individuals 
often experience anxiety over abandonment and loss, and 
demonstrate difficulty handling rejection and disappointment 
within interpersonal relationships (Katz et al., 2009).  This 
research is supported by findings that early attachment styles, 
particularly with the mother, remain relatively stable over 
time and predict attachment toward romantic partners and 
peers later in life (Zayas, Mischel, Shoda, & Aber, 2011). 
 
Mediating and Moderating Effects of Gender 

Current research points to the overarching influence of 
the mother-child (as opposed to father-child) relationship on 
attachment, as evidenced by the moderating effect of parent 
gender on parentification (Macfie, Houts, et al., 2005; 
Mayseless et al., 2004).  The mother’s role is commonly seen 
as vital in the development of a child’s interpersonal skills 
(Zayas et al., 2011).  Due to the fact that emotional 
parentification causes particular dysfunction in the mother-
child relationship and thereby hinders the development of a 
secure attachment, the child is typically unable to form 
healthy peer relationships (Macfie, Houts, et al., 2005).  For 
example, daughters’ emotional role reversal with mothers, but 
not with fathers, has been found to be associated with later 



PARENTIFICATION AND ATTACHMENT 
 

49 
 

deficits in well-being, expressed specifically through 
depressive symptoms (Katz et al., 2009).  This relationship 
between maternal role reversal and depressive symptoms in 
adulthood was found to be fully mediated by daughters’ 
attachment anxiety, a tendency to seek constant reassurance, 
and a fear of abandonment in interpersonal relationships that 
typically characterizes insecure attachment (Katz et al., 
2009).  In other words, due to the insecure attachment formed 
within the mother-child (but not the father-child) relationship, 
the emotionally parentified girls tended to exhibit anxiety 
about abandonment in interpersonal relationships, leading 
them to experience depressive symptoms in adulthood.  This 
conclusion is further supported by the finding that mother-
toddler emotional role reversal, but not father-child role 
reversal, is associated with social problems during 
kindergarten regardless of child gender (Macfie, Houts, et al., 
2005).  This finding illustrates how the pathological 
attachment formed with the mother through parentification 
can influence social relationships, even in early childhood.  
These differential effects observed for parent gender suggest 
that the mother-child relationship may be particularly 
influential on child attachment and social relationships in the 
face of parentification, perhaps due to the role of the mother 
as the primary model for young children’s socialization and 
formation of relationships. 

Child gender has also been found to play a role in the 
development of interpersonal deficits as a result of 
parentification and consequent attachment issues.  As stated 
above, maternal role reversal has been found to be associated 
with social problems during kindergarten, regardless of the 
child’s gender (Macfie, Houts, et al., 2005).  Interestingly, the 
researchers found that child gender moderated the 
relationship between role reversal and interpersonal deficits.  
Specifically, it was determined that father-child role reversal 
also predicted social problems, but only for male children.  
Furthermore, the relationship between maternal role-reversal 
and social problems was found to be stronger for mother-
daughter role reversal than for mother-son role reversal.  
Macfie, Houts, et al.  (2005) speculate that same-sex role 
reversal may particularly disrupt the development of 
interpersonal skills with same-sex peers, as children learn 
appropriate ways to interact with others through their 
relationships with their own parents.  While research suggests 
that the mother serves as a more influential force in the 
development of social skills regardless of child gender, 
fathers may serve a more specified role in that they assist in 
the socialization of their sons with regard to same-sex 
interactions. 
 
Intergenerational Transmission 

Given that the parentification of children plays a 
substantial role in the development of attachment patterns and 
future relationships, it is not surprising that parentification is 
often transmitted across generations, in part due to issues with 
attachment arising in childhood and carrying forward into 
adulthood.  Despite the fact that individuals who were 
parentified as children often maintain their positions as 

caregivers in adult relationships, these individuals tend to 
compensate for their childhood losses by turning to their own 
children for nurturance and emotional needs (Earley & 
Cushway, 2002).  Specifically, parents who exhibit emotional 
role reversal with their own mothers also tend to participate in 
role reversal with their children, with gender specific 
outcomes (Macfie, McElwain, et al., 2005).  Mother-daughter 
role reversal has been found to be predicted by the mother’s 
role reversal with her own mother and insecure attachment to 
her.  Interestingly, however, a father who was involved in role 
reversal with his own mother does not himself typically 
participate in role reversal.  Instead, it was found that his wife 
is more likely to engage in mother-son role reversal, even if 
she herself did not experience parentification, in reaction to 
her husband’s experience of parentification (Macfie, 
McElwain, et al., 2005). 

These findings further support the assumption that 
dysfunction in the mother-child relationship tends to be more 
common and influential in the process of parentification, due 
to the pervasive role of the mother during young childhood as 
a model for future social relationships (Hooper, 2008; 
Mayseless et al., 2004; Zayas et al., 2011).  Furthermore, 
parentified mothers are themselves more likely to emotionally 
parentify their own children in accordance with the working 
model of the mother-child relationship that they themselves 
internalized as children (Hooper, 2007b).  Fathers, however, 
are less likely to do so because they tend to participate less in 
the social aspects of childrearing, such as teaching 
interpersonal skills, until their children are older (Macfie, 
Houts, et al., 2005).  Therefore, the transmission of 
attachment issues and parentification across generations 
appears to be moderated by parent gender, with mothers 
demonstrating a greater effect on child attachment 
development in the face of parentification. 
 
Summary 

Although there are mixed results with regard to the 
association between parentification and attachment, the 
majority of existing research suggests a cyclical relationship 
between the two.  Parental history of attachment issues often 
leads to the parentification of the individual’s own children, 
which in turn leads to attachment issues in the child that are 
potentially carried over into his or her own adulthood 
(Boszormenyi-Nagy & Spark, 1973; Earley & Cushway, 
2002; Hooper, 2007a, 2007b; Katz et al., 2009; Macfie, 
Houts, et al., 2005; Macfie, McElwain, et al., 2005).  In many 
cases, this leads to the replication of the parent-child 
relationship when the child becomes a parent him or herself, 
resulting in the intergenerational transmission of this 
pathological pattern of parent-child interactions (Macfie, 
McElwain, et al., 2005).  This is most likely to occur between 
mother and child, as opposed to father and child (Katz et al., 
2009), due to the pervasive role of the mother as a model in 
the orientation of young children toward social relationships 
(Zayas et al., 2011).  The child looks to the relationship with 
his or her mother as a prototype of all relationships.  When 
this relationship is dysfunctional it is internalized as such, 



ENGELHARDT 
 

50 
 

leading to problems with socialization throughout life 
including with his or her own children. 
 

Methodological Issues and Future Research 
 

While the literature on the association between 
parentification and attachment has contributed greatly to an 
understanding of this phenomenon and its effects on 
childhood development, conceptual and methodological 
issues exist.  A careful review of the existing literature reveals 
that the conceptualization of parentification commonly poses 
methodological challenges.  Parentification is considered to 
be a type of role reversal, which refers to the broader category 
of relational disturbances in which an adult looks to the child 
to fulfill unmet needs for intimacy, parenting, or socialization 
by expecting the child to take on the role of partner, parent, or 
peer (Macfie, Houts, et al., 2005).  Other types of role 
reversals include triangulation, in which the child is assigned 
the role of intermediary between two parents (Chase, 1999) 
and spousification, in which the adult looks to the child to 
fulfill intimacy needs.  There is an inconsistency in the terms 
utilized to denote the occurrence of parentification, with some 
researchers referring to the process directly as 
“parentification” (Barnett & Parker, 1998; Boszormenyi-
Nagy & Spark, 1973; Earley & Cushway, 2002; Hooper, 
2007a, 2007b, 2008; Hooper et al., 2008; Jones & Wells, 
1996) and others speaking of the problem in terms of “role 
reversal” (Katz et al., 2009; Macfie, Houts, et al., 2005; 
Macfie, McElwain, et al., 2005; Mayseless et al., 2004).  
Indeed, the terms are often used interchangeably.  Despite 
these differences in terminology, each of these authors is 
referring to essentially the same process in their research, in 
which a child adopts the parental role, and each author 
describes it as such when defining their terms.  Future 
research would benefit from a clarification of the similarities 
and differences between these terms and from increased 
uniformity of the terms and definitions employed across 
empirical studies and critical reviews of parentification. 

As stated above, the two subtypes of parentification—
emotional and instrumental—have the potential to create 
vastly different outcomes in the parentified individual.  While 
instrumental parentification is less destructive and can instill 
in the child a sense of maturity and competence, emotional 
parentification is rarely adaptive for the family and almost 
always is detrimental to child development (Hooper 2007a; 
Hooper et al., 2008).  Despite this knowledge, few studies on 
the effects of parentification distinguish between the two 
subtypes, instead grouping them into one overarching 
category of “parentification” (Jacobvitz et al., 2004; Jones & 
Wells, 1996; Katz et al., 2009; Macfie, Houts, et al., 2005; 
Macfie, McElwain, et al., 2005; Mayseless et al., 2004).  This 
simplification of a complex and multifaceted process severely 
limits the potential to uncover associations between 
parentification and outcomes.  Therefore, a second suggestion 
for future researchers is to distinguish between emotional and 
instrumental parentification and to examine how each affects 

child developmental tasks (such as attachment) and adult 
outcomes. 
 In addition to issues regarding the conceptualization of 
parentification, accurate measurement of parentification poses 
its own challenges.  A substantial proportion of studies 
examining the effects of parentification are retrospective in 
nature (Hooper et al., 2008; Jones & Wells, 1996; Katz et al., 
2009; Macfie, McElwain, et al., 2005; Mayseless et al., 
2004).  The most common type of instrument used to measure 
parentification, such as the Parentification Questionnaire 
(Jurkovic & Thirkield, 1998), requires participants to reflect 
on memories of past experiences.  These memories may have 
been distorted over time, particularly if they contain negative 
content, and are therefore potentially inaccurate.  Some 
researchers, however, have attempted to study current 
parentification, utilizing both video recordings of parent-child 
interactions (Macfie, Houts, et al., 2005) as well as parent and 
teacher reports (Jacobvitz et al., 2004).  Researchers wishing 
to examine the direct effects of parentification on children, 
particularly on childhood development, would benefit from 
continuing to utilize observational studies and multi-source 
ratings of current child functioning in order to understand 
parentification and its effects within the context of the family 
as a system, as opposed to relying on the memories of one 
individual.   

Moreover, despite the fact that there are multiple forms 
of attachment (Ainsworth et al., 1978; Main & Solomon, 
1986), currently researchers typically discuss the effects of 
parentification only in terms of secure versus insecure 
attachment styles (Boszormenyi-Nagy & Spark, 1973; Earley 
& Cushway, 2002; Hooper, 2007a, 2007b; Katz et al., 2009), 
and do not take into consideration the subtypes of insecure 
attachment.  Research that does consider the varying forms of 
insecure attachment only speculates briefly about their 
possible linkages to parentification, and does not directly test 
these relationships statistically (Macfie, Houts, et al., 2005; 
Macfie, McElwain, et al., 2005).  Therefore, a fourth 
recommendation is for researchers to examine the association 
between parentification and the various forms of insecure 
attachment.  More detailed knowledge about how 
parentification affects attachment styles in children would 
facilitate prevention and treatment, as these different patterns 
of attachment have varying influences on child and adult 
outcomes. 

A final suggestion concerns the implementation of 
current research findings to develop prevention and 
intervention strategies that address parentification, alongside 
the emergence of new research that tests the outcomes of such 
strategies.  Research to date has primarily focused on the 
impact of parentification on the parentified individual, and 
little has been done to explore the ways in which families 
might be helped to address this issue collectively (Earley & 
Cushway, 2002).  However, researchers and clinicians have 
begun exploring ways in which family systems theory 
(Bowen, 1966) can be applied to the problem of 
parentification within the context of family therapy (Byng-
Hall, 2002; Hooper, 2007a).  Within this form of therapy the 



PARENTIFICATION AND ATTACHMENT 
 

51 
 

dysfunctional working models which characterize the 
parentified relationship are dismantled (Byng-Hall, 2002) as 
both parents and children come to understand how they 
function as a connected system of individuals.  Family 
systems therapy may aim to assist parents in reducing their 
reliance on their children (Byng-Hall, 2002) as well as in 
helping parentified children understand how their attachment 
to their parents has been affected by this reliance.  A strategy 
at the level of secondary prevention which may prove 
effective is the development of treatment plans through 
identification of protective factors which mitigate the harmful 
effects of this process (Earley & Cushway, 2002).  Lastly, it 
has been noted that in cases where parentification constitutes 
severe neglect or maltreatment, temporary removal of the 
child or the provision of assistance to the parent through 
community programs may be necessary to protect the 
parentified child (Earley & Cushway, 2002).   

Research has demonstrated that parentification can 
potentially lead to insecure attachment (Boszormenyi-Nagy & 
Spark, 1973; Earley & Cushway, 2002; Hooper, 2007a, 
2007b; Katz et al., 2009; Macfie, Houts, et al., 2005; Macfie, 
McElwain, et al., 2005).  Given that attachment has been 
shown to exert an influence on a broad array of areas in both 
childhood and adulthood (Ainsworth et al., 1978; Byng-Hall, 
2002), it is imperative that strategies such as those listed 
above be further developed in order to target the process of 
parentification at both the level of the child and the parent.  
Moreover, successful interventions would have multiplicative 
effects by leading to intergenerational prevention.  By 
addressing the internal working models which promote the 
intergenerational transmission of parentification, intervention 
strategies would serve to prevent further parentification by 
breaking the cycle whereby the parentified child becomes the 
parentifying adult (Barnett & Parker, 1998).   

 
Conclusion 

 
First utilized by Boszormenyi-Nagy and Spark (1973) to 

describe a ubiquitous aspect of social relationships, the term 
“parentification” has come to refer most commonly to the 
process through which a child adopts the responsibilities of an 
adult, with the adult, in turn, adopting the position of the child 
in the parent-child relationship.  While much of the literature 
has focused primarily on the effects of parentification on 
adult outcomes (Earley & Cushway, 2002; Hooper 2007a, 
2007b, 2008; Hooper et al., 2008; Jones & Wells, 1996; Katz 
et al., 2009; Macfie, McElwain, et al., 2005; Mayseless et al., 
2004), researchers are beginning to explore the direct and 
contemporaneous effects of this pathological interaction 
pattern on child development (Earley & Cushway, 2002; 
Hooper, 2007a, 2008; Jacobvitz et al., 2004; Macfie, Houts, et 
al., 2005; Macfie, McElwain, et al., 2005).  In particular, 
researchers have demonstrated growing interest in the 
implications of parentification for the development of 
attachment patterns among children. 

Current literature on the influence of parentification on 
child development has repeatedly concluded that parentified 

children experience insecure attachments with the 
parentifying adult which tend to carry forth into adulthood, 
affecting future relationships with others and even potentially 
the parentified individual’s own children (Earley & Cushway, 
2002; Hooper, 2007a, 2008; Katz et al., 2009; Macfie, 
McElwain, et al., 2005).  Although parentification is a 
relatively new area of research, these findings have important 
implications for future areas of investigation and for the 
clinical understanding of parentification.  Most importantly, 
findings on attachment issues arising from the experience of 
parentification may illuminate potential pathways through 
which other outcomes, such as mental illness and social 
problems, arise. 

Continued research in this area would therefore enhance 
comprehension of the developmental implications of 
parentification and would increase knowledge of the ways in 
which parentification can lead to a variety of other outcomes 
throughout the lifespan.  Efforts to develop such an 
understanding would assist in mitigating the impact of 
parentification on the lives of those who experience it through 
the development of prevention and treatment programs.  
Importantly, future undertakings in this area have the 
potential to address directly the pervasive social problem of 
child neglect.   
 

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