Leveraging the interpersonal context of child development to promote family resilience: A universal prevention approach from preconception through early childhood

Abstract

Significant mental health problems affect one in five youth in the United States; in tandem with the child mental health epidemic, parents in the United States report high and rising rates of burnout and mental health challenges of their own. Multiple well-established theoretical perspectives demonstrate the high degree of interdependence between children's and their parents’ mental health, including intergenerational transmission, prenatal programming, attachment, and temperament and self-regulation theories. Drawing on these perspectives, we argue that a universal prevention approach that centers the development of psychopathology within the context of the parent-child dyad can promote resilience and arrest emerging mental health problems for children and their parents, during sensitive developmental windows (e.g., preconception through early childhood). Derived from this integrated theoretical framework, we review empirical support for the following targets to promote family resilience: screening for current and historical parent risk factors and resilience resources; strengthening healthy, reciprocal social ties; and supporting youth socioemotional skill acquisition. Our review of the literature highlights how improvements in these areas can have cascading benefits across development, for both parents and their children, as well as for future generations. We conclude with actionable, empirically-supported recommendations that can have profound impacts on these targets through changes in federal and state policies, community healthcare settings, and early childhood education and care programs. To achieve enduring, multigenerational impacts, societal and community-level policies, programs, and practices must interweave efforts to support child mental health with efforts to promote parent adjustment and wellbeing.