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Breaking the Intergenerational Cycle of Abuse: A Randomized Controlled Prevention Trial in Parents with Serious

Sabine C Herpertz1, Corinne Neukel2, Katharina Williams2,3

  • 1Department of General Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany, sabine.herpertz@uni-heidelberg.de.

Psychotherapy and Psychosomatics
|December 18, 2025
PubMed

Insights

A mentalization-based parenting program improved parenting practices in parents with mental illness compared to standard care. This intervention shows promise in reducing child maltreatment risk for vulnerable families.

Area of Science:

  • Psychiatry
  • Child Development
  • Clinical Psychology

Background:

  • Children of parents with mental illness (MI) face increased risks of adverse childhood experiences and maltreatment.
  • Prevention trials for parents with MI are limited, and existing research has methodological shortcomings.

Purpose of the Study:

  • To evaluate the real-world efficacy of a 12-hour mentalization-based parenting counselling program (MB-PC).
  • To compare MB-PC with a psychoeducation workshop (SCC+) as adjuncts to standard clinical care (SCC).

Main Methods:

  • A large-scale, cluster-randomized, bicentre superiority trial involving 252 psychiatric patients in German hospitals.
  • MB-PC included individual and group sessions focused on understanding child mental states, supplemented by social counselling.
  • Intervention delivered by an interprofessional hospital team of non-psychotherapists.

Main Results:

  • MB-PC significantly improved parenting practices (Alabama Parenting Questionnaire total score) post-intervention compared to SCC+ (ES = 0.43, p=0.004).
  • Improvements in parenting practices diminished at 3-month follow-up (ES = 0.25, p=0.085).
  • Secondary outcomes, including reduced parental stress and child abuse potential, favored the MB-PC intervention.

Conclusions:

  • Mentalization-based parenting programs integrated into routine psychiatric care can reduce risks for child maltreatment and neglect.
  • This approach offers a valuable strategy for supporting offspring of parents with severe mental disorders.
Abstract

Keywords:
Child maltreatment preventionMentalization-based parenting counselingParental stressParenting practicesRoutine psychiatric care

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