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Grand(parenting): Clinical Considerations for Working with Multi-generational Families

Grandparents raising their grandchildren is on the rise in the United States. According to PBS NEWSHOUR, grandparents raising their grandchildren has increased 7% since 2009 and that number is expected to grow. While there are a variety of reasons children may live with their grandparents including death, incarceration or mental illness, the opioid crisis is a major recent contributor and is impacting thousands of children and families.

When adult children cannot take care of their own, grandparents are faced with the difficult decision about whether to become their grandchildren’s caretaker or allow them to be placed in foster homes or state facilities. More and more often, grandparents are choosing to step in and raise these children. However, there are not enough systems and supports in place to support these caretakers including those who may be coping with fixed incomes, chronic illness, or a disability in their later life stage.

In my clinical work, I have seen a significant increase in the numbers of children and adolescents being raised by their grandparents. While each case is unique, I’ve noticed a constant- sometimes grandparents just want to be grandparents and sometimes grandchildren want to be treated as such.

The shift in role from grandparent to primary caretaker poses several challenges to the family system. Certain clinical considerations should be taken into account when working with a multigenerational family including the mourning of changes in familial roles and complications in identity of the child and his/her grandparent.

Mourning the Loss of the Grandparent Role

In providing caretaker consultation, it is imperative to take into account the possibility that the child’s caretaker may be mourning the loss of being the child’s grandparent and the implications this situation may have in his or her parenting style. To shift from being the fun loving, gift giving, goody sneaking grandparent to one who has to set limits and enforce discipline is not often viewed as ideal.

To label this difficult shift and validate feelings of guilt or regret, can provide the space for a grandparent to identify ways to fulfill both grandparenting desires and parenting responsibilities. In finding a balance, children can receive the nurturing they are used to from their grandparents, while benefiting from the safety and containment that limit setting and consistency provides.

The Implications of Shifting Family Roles on the Child’s Identity

Being raised by grandparents can impact a child’s sense of self and understanding about his or her own role within the family. Exploration of their perception of familial roles will strengthen insight into considerations for the family system and give direction to potential interventions.

In validating an adolescent’s confusion and frustration about the role of her grandparents having to set limits and enforce rules, I was astounded by the young adult’s ability to articulate her internal struggles with self identity as related to her caretaker.

This client shared with me that while her grandparents had to be both parents and grandparents concurrently, she felt lost within her own role in the family, noting that she wasn’t “really a daughter or a granddaughter.”

The loss of these definitive roles within her family system led to feelings of isolation and disrupted sense of self. This confusion and desperate attempts at self soothing and connection led to high risk behaviors including substance use, explosive anger and unhealthy relationships. Refocusing clinical work allowed her the opportunity to safely explore her identity and practice strategies to support healthy attachment patterns within and beyond her family system.

Considerations When Biological Parents Remain Involved

Another area for consideration when working with a multigenerational family is the impact of the biological parent(s) role and involvement in the child’s life. Children generally have a strong desire for connection to their biological parents, which may or may not be supported by their caregivers. Safety and legal considerations must be first considered, but just because a parent is not a full-time caretaker or guardian does not necessarily mean he or she should not have a role within their child’s life.

A clinician’s support within a family’s life may include fostering communication between grandparents and their adult children. Opening up forums for communication in order to set safe limits about involvement, explore biological parents’ roles in their children’s lives, and identifying strategies to ensure that, when appropriate, parents and grandparents work together to co-parent for the benefit of the child involved will support a child’s development of identity and attachment.

For more information on co-parenting, please click here.

Access to the original publication of this article can be found here.

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