The Parenting Practices Rating Scale is designed to document the clinical assessment of parenting by the targeted parent. The scale contains four primary items:
1.) Category Level of Parenting:
Item 1, the Category Level of Parenting, identifies deviant-abusive parenting relative to broadly normal-range parenting.
The Level of parenting is rated on a 4-point Likert scale (abusive, severely problematic, normal-range problematic, normal-range healthy), anchored by descriptive categories of parenting. Identifying the category of parenting locates the parenting in the corresponding Level of the rating scale.
The 4-point Likert scale is then brought together into two broad categories of parenting; deviant-abusive (Levels 1 and 2) and normal-range (Levels 3 and 4). It is this dichotomous classification that is used for diagnostic indicator 1 by the Diagnostic Checklist for Pathogenic Parenting to define a “normal-range parent” (Levels 3 and 4)
Ratings on Item 1: Category Levels should offer parenting examples to support the category rating.
2.) Permissive-Authoritarian Rating
Item 2, the Permissive-Authoritarian Rating, is a 0-100 dimensional rating along the continuum of lax and permissive parenting to over-controlling and authoritarian parenting, with normal-range parenting represented by the mid-range scores. This clinical rating represents the clinical judgement of the assessing mental health professional based on identified features of parental attitude and approach. Ratings on Item 2: Permissive-Authoritarian Rating should be supported with examples.
A heuristic for clinical rating is that scores in the upper and lower 20% (0-20 and 80-100) should be considered sufficiently extreme to raise child protection considerations (for neglect at the lower extremes and for hostile-aggressive parenting at the upper extremes).
Normal-range parenting should be considered ratings between 25-75, with allowances provided for the cultural values, religious values, and personal values of the parent. Clinical psychology typically recommends a mid-range balance along this dimension that incorporates flexible dialogue and negotiation with clearly defined rules, structure, and expectations (preferred rage of 40-60).
However, some parents tend to be more lax, negotiable, and permissive (building relationship at the expense of child maturity; 30s), while other parents tend to be more rule-oriented, authoritarian, and structured (building child maturity at the expense of relationship; 60s). These are value laden decisions for each parent, and as long as the parenting is broadly normal-range (25-75), parents should be allowed the right and discretion to form their families consistent with their cultural, religious, and personal value systems.
The nature of parental empathy is not a decisional factor, but is an important descriptive feature for treatment-related considerations. Throughout the professional literature, authentic parental empathy for the child is identified as the most important factor in parenting. Highly lax and permissive parenting (30s) can be entirely healthy for the child with the addition of authentic parental empathy for the child’s autonomous experience, and can be damaging for the child’s development in the absence of authentic parental empathy. Similarly, highly structured and authoritarian parenting (60s) can be entirely healthy for the child with the addition of authentic parental empathy, and can be damaging to the child’s development in the absence of authentic parental empathy.
The Empathy item is rated along a 5-point Likert scale, extending from narcissistic-style parenting evidencing an absence of authentic empathy for the child (emotional indifference or psychologically dominating projective identification), to borderline-style parenting of intrusive psychological over-involvement (psychologically anxious-intrusive parenting and projective identification).
Normal-range parental empathy is rated as a 3. Narcissistic absence of empathy is rated as 1. Borderline over-intrusive projective identification is rated a 5. The mid-range scores of 2 (absent of parental psychological involvement) and 4 (anxious over-intrusive parenting) are indicators of normal-range parenting of concern, while the more extreme scores of 1 or 5 would represent prominent clinical concerns for the child’s development.
Children flourish emotionally and psychologically from authentic parental empathy that is not projective of the parent’s own emotional and psychological needs and history (a normal-range rating of 3).
4.) Issues of Clinical Concern
Item 4 identifies parenting behaviors of potential clinical concern, such as psychiatric issues, substance use issues, and trauma history issues. These clinical concerns are modified by treatment. If the parent’s psychiatric issues are being stabilized by treatment, if the parent’s substance use issues are in substantial remission (1 year), and if the parent’s own trauma history has received treatment, then these issues are all of lesser and limited clinical concern. On the other hand, untreated major psychiatric pathology in a parent, active parental substance abuse, or unresolved parental trauma are all domains of prominent professional concern regarding the emotional and psychological well-being of the child.
Item 4, Issues of Clinical Concern, is a nominal rating scale of six categories of parental factors that would trigger treatment-related considerations.
Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857