Who are the Parents? Risk and Resiliency Among Parents of Youth Receiving Intensive Home-Based Psychiatric Treatment

Despite their explicit focus on family functioning and mounting evidence of the intergenerational mechanisms of childhood experiences (Zhang et al., 2022), very little is known about the parents of the high-risk youth receiving Intensive Home-Based Treatment (IHBT). Knowledge about parents' childhood experiences of risk and resilience, which are known to impact parenting behaviors, may provide insight into the complex clinical presentations frequently seen in this population and help guide the implementation of maximally effective interventions. The goal of this study was to examine and characterize the childhood experiences of parents whose children are enrolled in a community-based IHBT. Using a sample of 6,722 parents of children receiving IHBT, we collected parents' reports of their Adverse Childhood Events (ACE) and Resilient Childhood Events (RCE). In addition to examining the rates and profiles of ACEs and RCEs for the total sample, we examined how these rates and profiles differed between birth and non-birth parents. On average, parents reported 3.5 ACE (sd = 2.8) and 7.9 RCE (sd = 2.0). ACE and RCE scores were negatively related (r = - .43, p < .001). Compared to non-birth parents (e.g., kinship caregivers, foster parents), birth parents had higher ACE scores (3.7 vs. 2.8) and lower RCE scores (7.8 vs. 8.4). This study found high rates of reported childhood adversity among birth and non-birth parents of youth receiving IHBT. Both groups also reported substantial childhood resiliency-building experiences, highlighting the complexity of these variables. Non-birth parents in our sample presented with lower ACEs and higher resiliency-building experiences than birth parents, but the clinical implications of this trend will require further investigation. Taken together, the present findings lend additional empirical support to the notion that parents in IHBTs - whether biologically related or not to their children - present with childhood experiences that may differ from other parents and may meaningfully impact treatment outcomes. Thoughtful, multidisciplinary, and mixed methods unpacking is needed to form the basis of future policy and practice recommendations.