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Child to Parent Abuse is largely hidden yet has a profound impact on a significant proportion of society. We need to work together to bring CPA out of the shadows and better support those living with abusive and violent behaviour, and healthcare professionals are a vital part of that work” – says social enterprise director Michelle John from PEGS.

“Child to Parent Abuse wasn’t even referenced in the Domestic Abuse Bill until the latest updates were passed just months ago. Now, there’s a section in the statutory guidance, sent out to authorities including healthcare bodies, which specifically details CPA.

There’s not yet a legal definition – but the Home Office and other Government departments are moving towards updating their policies.

Research began around 15 years ago, but there are still relatively few studies in comparison to those looking into other forms of abuse.

Voices are beginning to speak up about the extent and impact of CPA but, until recently, there was a real silence around the topic – as if it was taboo that there were parents being abused by their own children.

Because of this under-researching, under-reporting, and societal silence, we have no way of knowing exactly who’s impacted by this type of abuse, but experts currently predict at least 3% of UK households are affected.

A study recently released revealed that in Lancashire, 10% of the domestic abuse incidents police were called out to in a period of just over two years were cases where a parental figure was being targeted.

Why does this relate to healthcare professionals?

There’s a real gap when it comes to support for parents, carers and guardians – to overcome this, we need to ensure professionals across a wide variety of sectors have a real knowledge of CPA in order to effectively listen, signpost and assist.

Healthcare staff are vital to this process – we know from PEGS research that 75% of parents who’ve sought support have spoken to their GP (or their child’s GP) about what’s going on at home. 72% have chosen to speak to a CAMHS team and 17% to a health visitor.

We know a number of things can happen if the parent doesn’t get a supportive response: they may not try to speak to a professional again (80% have changed their mind about reaching out for support at least once). And the severity and frequency of the incidents will increase over time, therefore escalating the risk to the parent – one person every 19 days is killed by their child in England and Wales.

There’s no magic solution, of course, but being able to signpost and refer to the right services (such as Forensic CAMHS) and then keep advocating for that family if support is refused, is hugely impactful. So too is simply knowing what to say – and what not to say – being listened to non-judgementally, believed, and having a safe space to talk is hugely powerful.

What about the staff themselves?

CPA doesn’t discriminate, and with a workforce of 1.4million in the NHS we know there will be sadly many thousands who are experiencing abuse from their own child. So, it’s not just about who you may come into contact with professionally, it’s about your colleague sat next to you at lunch or working on the desk opposite yours.

An overwhelming 70% of working parents have to reduce their hours or leave their job altogether as a result of CPA – and those who stay are juggling physical, emotional, financial and even sexual abuse at home with the demands of a busy healthcare job.

Being able to spot the signs among patients as well as peers could see families being able to access support at a much earlier stage.

What are the early signs?

CPA does tend to be hidden by parents for fear of judgement, repercussions for their child (or their other children being considered unsafe to stay in the home) or a variety of other reasons.

It could be the person has financial stresses relating to their child’s spending (some even take out credit cards or run up debts in their parent’s name) or they may be physically hurt or struggling to eat, sleep or relax. They may try to justify unreasonable behaviour from their child in an attempt to cover up the severity of the abuse; or they may often be absent, late or need to leave work early.

Parents may be pushing for a diagnosis for their child in an attempt to explain why they are showing abusive behaviours (understandable in the situation, but in reality CPA sometimes has no obvious cause, and there are plenty of neuro-typical children who are abusive or violent to their parental figures).

If they open up about what’s going on, they may talk about ‘walking on eggshells’, living in fear, changing their behaviour or ignoring minor incidents to avoid escalating the situation. They may talk about behaviour displayed to other children in the home, and even pets or animals.

Knowledge is power:

The more you understand, the more you’re able to support patients and colleagues who may be experiencing CPA. Collectively, the more we talk about CPA, the more we can bring it out of the shadows and show parents, carers and guardians that they will be supported, listened to, and empowered if they choose to speak up about their experiences.

There are too many people living in fear right now, locking themselves in a home at night with someone who is violent and abusive towards them. Someone they still love despite their behaviour. Someone they still have parental responsibilities towards. Someone they don’t want to criminalise, marginalise or walk away from until the situation hits breaking point.

I call on all healthcare professionals to be aware, be knowledgeable, and be supportive – you may be the first person that parent has ever opened up to, and your response could make them feel safe enough to continue accessing support and maybe even start seeing the light at the end of the tunnel.

About the author:

Michelle John is the Founding Director of PEGS – she has lived experience of CPA and a background in family law and domestic abuse work. Named one of the WISE100 in 2020 just months into launching her social enterprise, Michelle has gone on to influence national policy, speak at multiple regional and national events, support more than 2,000 parents and train frontline professionals across the UK.

Visit www.pegsupport.co.uk or search PEGS Support on social media for more information.


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AVA is an expert, groundbreaking and independent charity working across the UK.

Their vision is a world without gender based violence and abuse. They aim to  inspire innovation and collaboration and encourage and enable direct service providers to help end gender based violence and abuse particularly against women and girls.AVA’s work is focused around those areas where they can make the best contribution to ending violence and abuse. They do this by making sure that survivors get the help and support they need in the here and now, through providing innovative training that has a proven direct impact on the professional practice of people supporting survivors of violence and abuse

developing a range of toolkits, e-learning and other material that supports professionals to provide effective and appropriate support to survivors of violence and abuse

using our influence and networks to ensure survivors voices are heard. We work closely with AVA in many areas including the Pathfinder project



SafeLives are a national charity dedicated to ending domestic abuse, for good. We combine insight from services, survivors and statistics to support people to become safe, well and rebuild their lives. Since 2005, SafeLives has worked with organisations across the country to transform the response to domestic abuse, with over 60,000 victims at highest risk of murder or serious harm now receiving co-ordinated support annually. SafeLives are members of the Pathfinder consortium.



Imkaan is a UK-based, Black feminist organisation. We are the only national second-tier women’s organisation dedicated to addressing violence against Black and minoritised women and girls i.e. women and girls which are defined in policy terms as Black and ‘Minority Ethnic’ (BME). The organisation holds nearly two decades of experience of working around issues such as domestic violence, forced marriage and ‘honour-based’ violence.

They work at local, national and international level, and in partnership with a range of organisations, to improve policy and practice responses to Black and minoritised women and girls. Imkaan works with it’s members to represent the expertise and perspectives of frontline, specialist and dedicated Black and minoritised women’s organisations that work to prevent and respond to violence against women and girls. Imkaan delivers a unique package of support which includes: quality assurance; accredited training and peer education; sustainability support to frontline Black and minoritised organisations; and facilitation of space for community engagement and development. They are a part of the Pathfinder Consortium.


The University of Bristol CAPC
The University of Bristol CAPC
The University of Bristol CAPC

The Centre for Academic Primary Care (CAPC) is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research.  It is part of Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching.

A dedicated team of researchers at the Centre work on domestic abuse projects and IRISi is a co-collaborator and partner on some of these projects including ReProvide, HERA and DRiDVA.

The Health Foundation
The Health Foundation
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The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK. The Health Foundation’s Exploring Social Franchising programme aims to generate a deeper understanding of the potential of social franchising models for scaling effective health and social care interventions within the NHS.

We are one of four project teams participating in the programme to develop a social franchise to enable the sustainable spread of our intervention, the IRIS Programme. We receive funding and support from the Health Foundation, including technical expertise on social franchising, and attend programme learning events. The Health Foundation has also commissioned a programme-wide evaluation to support understanding of the use of social franchising in the UK health and care system. We and our franchisees will support the evaluation through co-designing data collection requirements, providing access to data as requested, hosting site visits and attending learning events.



Standing Together Against Domestic Violence is a UK charity bringing communities together to end domestic abuse. They bring local services together to keep people safe

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STADV aim to end domestic abuse by changing the way that local services respond to it. They do this through an approach that they pioneered, called the Coordinated Community Response. The Coordinated Community Response brings services together to ensure local systems truly keep survivors safe, hold abusers to account, and prevent domestic abuse.

Their model of a coordinated local partnership to tackle and ultimately prevent domestic violence is now widely accepted as best practice. They are also a part of the Pathfinder consortium.


Spring Impact
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Spring Impact is a not-for-profit social enterprise born out of the frustration of seeing social organisations constantly reinventing the wheel and wasting scarce resources. Spring Impact uses a combination of tested commercial and social principles and extensive practical expertise to support organisations to identify, design and implement the right social replication model to scale their social impact.

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