Toward Understanding the Consequences of Parentification: An Integrative Review of Theoretical and Empirical Literature

Background: Parentification of children occurs when children precociously take on adult responsibilities to meet family survival needs such as childcare, household maintenance, meal preparation, and emotional caretaking. This phenomenon tends to occur within family networks experiencing prolonged hardship, stress, or crisis, including parental substance abuse, mental or chronic illness, divorce, and/or poverty. Of primary concern is the influence that parentification may have on children’s development and life course. Scholars have debated whether parentification fosters strength, resilience, and youth assets such as adaptiveness, or whether such experiences distort children’s understanding of appropriate boundaries and interrupt healthy development. A clear and comprehensive understanding of the impact of parentification is necessary for helping professionals for the provision of tailored services to this unique population. A systematic review of empirical literature was conducted to address this gap in the literature, and to synthesize parentification findings across varied family circumstances and contexts.   

Methods: Five databases (CINAHL, Medline, PsychINFO, Social Sciences Citation Index, Social Work Abstracts) were searched for relevant parentification literature published prior to March 2019. The literature pull yielded a total of 669 citations, but resulted in a 420 net citations following de-duplication. Each citation was screened for inclusion or exclusion using the following criteria: (1) examined parentification or adultification as a predictor, mediator or moderator, or outcome; (2) was a peer-reviewed journal article; and (3) was in the English language. A total of 157 citations were coded for inclusion, and the key components (study design, sample characteristics, measures, main findings, limitations) were summarized for each article.

Results: Of the included articles, the following types of studies were identified: theoretical (n = 14), systematic reviews (n = 6), quantitative (n = 95), and qualitative (n = 21). Almost 30% of qualitative and quantitative studies utilized adult retrospective approaches. In terms of main findings, 62 studies concluded that parentification was a risk factor for various mental, emotional, social, and physical health outcomes. 19 studies found that parentification experiences could buffer children/adolescents from a range of different adversities in childhood (e.g., parental substance use, parental mental health, parental or sibling chronic illness, immigration). Finally, 34 studies found that parentification both promoted and compromised resilience.

Conclusions and Implications: This systematic literature review synthesized findings across  theoretical, quantitative, and qualitative studies related to parentification. Included studies highlighted the heterogeneity of findings across the parentification literature, and the ways in which the experience of parentification can serve as both a risk and protective factor. Results may inform practitioners’ approaches to working with parentified youth, including consideration of individual and contextual circumstances that may enhance their well-being, as well as those that increase developmental risk.  Additional research is required to further explore factors that may affect how parentification influences biopsychosocial outcomes throughout the life course, including gender, race/ethnicity, sibling support, parent circumstance, and depth of support from extended family, school, and neighbors, among others.