Lisa’s depression and low self-esteem loom pretty large here. Having been with two men who physically abused her, she is now in a relationship with a man who openly puts her down. Her lack of belief in herself is likely to negatively impact on her ability to parent. If you think you are worthless, then it can be difficult to believe that you have anything to offer which other people might need. You might wish to consider what could have happened in Lisa’s own family of origin to make her feel like this. Perhaps she grew up in a similar family. Family patterns do often repeat themselves.

Gender is clearly an important issue. Lee seems to see it as his right to lord it over the rest of the family and put down Lisa and the girls. By contrast he favouritises Josh. However, although he seems confident and self-assured by comparison to Lisa, it’s worth asking why a confident, self-assured man would have lived at home with his mother until he was in his forties, and why he chose to live with someone like Lisa, who is so depressed and easy to dominate. Perhaps Lee’s self-esteem is also pretty low, and this is how he bolsters it? Picking someone even weaker than oneself can be a way of giving oneself a feeling of being strong.

Although it can be very difficult to find a useful ‘in’ to working with families like these, it is important not to minimise the psychological harm they may do to children. The children have grown up with a mother who is not generally responsive to their needs; the girls have been exposed to domestic violence and now are arguably being subjected to a form of emotional abuse by their stepfather who seems to put them down just for being girls. All four children have been exposed to role models which may not be very helpful when it comes to forming adult relationships of their own. If you look at the behaviour of the girls – Chloe expressing suicidal thoughts, Caitlin still bedwetting at 8, Hannah pregnant at 14– it does suggest that all three are unhappy and insecure, and makes one wonder whether there is more going on in this family than Tracey currently knows: more serious abuse for example.