Preventing intergenerational trauma transmission: A critical interpretive synthesis.

Aim and Objective: To synthesise and critically interpret literature of relevance to intervening in intergenerational transmission of relational trauma within parent-infant relationships.
Background: Intergenerational trauma is a discrete process and form of psychological trauma transmitted within families and communities. Intergenerational trauma can be transmitted through attachment relationships where the parent has experienced relational trauma and have significant impacts upon individuals across the lifespan, including predisposition to further trauma.
Design: Critical interpretive synthesis (CIS) was used. CIS is an inductive qualitative process that generates new theory grounded within reviewed literature.
Methods: The review commenced by systematically searching for literature on interventions for intergenerational trauma. As the core theoretical construct emerged, elements that may contribute to preventing intergenerational trauma were identified iteratively and influenced further searching. In the final synthesis, 77 articles were included from the fields of intergenerational trauma, trauma interventions and attachment interventions. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist.
Results: The key construct is that prevention of intergenerational trauma transmission is the key intervention. The two contributing constructs were identified as "resolving parental trauma" and "actively supporting parent-infant attachment."
Conclusions: Prevention is the most effective intervention approach for intergenerational transmission of trauma. Prevention requires trauma-specific interventions with adults and attachment-focused interventions within families. Preventative strategies need to target individual, relationship, familial, community and societal levels, as addressing and preventing trauma requires a multipronged, multisystemic approach.
Relevance to Clinical Practice: Systematic trauma-informed attachment-focused interventions in health and social service settings are recommended. There are opportunities to provide multifocal individual and relational interventions within existing services that work with parents to help prevent the likelihood and impact of transmission of intergenerational relational trauma within families. Nurses are well placed to provide preventative interventions in mental health, early childhood and primary health settings.
(© 2018 John Wiley & Sons Ltd.)