Children of Parents with Mental Illness

As highlighted in this book and in the previous edition, the family therapy field has often failed to do justice to the needs of children. This failure is most poignant for the children of parents with mental illness (Reder, McClure, & Jolly, 2000). This is probably because: 1. Attempts to include children who may have experienced severe emotional or physical traumas in a range of family interviewing approaches may make such children feel even more trapped by conflicting loyalties, fears for the parents ’ safety, fears of retaliation, and sometimes by having engaged in a parent’s paranoid beliefs. 2. Different approaches to interviewing families, which may them-selves have been valid in eliciting and intervening in particular family pro-cesses, can nevertheless pose particular problems and dangers for this group of children. For example, the use of circular questioning that in-cludes children may unwittingly place them in untenable positions or face them with intolerable dilemmas about how to respond in front of a parent whom they may perceive as both vulnerable and frightening. Yet ap-proaches that stress the hierarchy of relationships within a family may both misperceive and alienate a child who has had to take on caring functions for a parent with mental illness. 3. Therapists working with the families of mentally ill members have commonly avoided attempts to actively engage the children, as they have usually been preoccupied with the interactions between the ill member and more “senior ” adults, which may be seen to impinge on the patient’s com-petence and self-image