The Use of Child-Centered Ecomaps to Describe Engagement, Teamwork, Conflict and Child Focus in Coparenting Networks: The International Coparenting Collaborative Approach

Abstract

When young children come to the attention of helping professionals because they are experiencing significant behavioral or emotional challenges, effective solutions frequently involve establishing whether there are strains or ruptures in the child’s coparenting network impeding functional communication about the child. Coparenting refers to the shared—and ideally, mutual—parenting efforts of adults working together to socialize, care for, and raise children for whom they share responsibility. Among the most important aims in understanding and strengthening the family’s coparenting alliance is evaluating who the various adults are comprising the functional coparenting network. As part of a coordinated effort to provide guidance in best practices for evaluating coparenting, an International Coparenting Collaborative (ICC) has highlighted the use of a pictoral mapping tool—a child-centered ecomap—as one effective means of assessing coparental engagement and learning more about existing levels of child-related teamwork and conflict. Completed ecomaps provided by multiple coparenting adults in the same family also provide an opening to highlight and explore child focus and to facilitate pivotal information sharing among the multiple caregivers. In this article, we examine the use of child-centered ecomaps in a variety of family-centered cases seen in four different collaborating sites and services partnering in the ICC. The cases highlight the unique value of an assessment tool that goes beyond simply illuminating the nature of the child’s coparenting system to afford the interventionist with a means of refocusing coparents’ attention on the perspective of the child. Closing reflections focus on the child-centered ecomap’s advantages, both as a method for learning more about coparenting in the family and for setting a stage for subsequent child-centered work with the family through more comprehensive and nuanced case conceptualization.

1. Introduction

Visual and pictorial mapping devices, such as family sculpting (Satir 1972) and jointly produced drawings (Gennari et al. 2024; Mostwin 1982) have been used creatively in family therapies for over 50 years. These visual tools were designed by clinicians seeking simple methods to help families better understand their own dynamics, relationships, and patterns over time. Two semi-standardized paper-and-pencil tools in particular—the genogram and the ecological map (or ecomap)—gained notoriety for their value on helping organize and visualize complex and often vast amounts of information about family systems across time and space. At their best, these structured visual representations can illuminate previously unseen connections, sometimes challenge existing perceptions, and ideally, open new pathways for change.

In this article, we conduct an overview and examine the structured use of a pictoral mapping device, the child-centered ecomap, as an assessment that can be productively used in infant-family mental health settings. The child-centered ecomap has been one of several conventions employed by contributors to an International Coparenting Collaborative (ICC), a group of family experts who convened to develop systematic guidance for professionals who work with families of infants and young children (McHale et al. 2023). The ICC has introduced a coordinated family systems framework professionals can use in approaching newly referred cases. This coordinated approach helps the most significant coparents in the family develop a better understanding of how intrafamily dynamics affect the child’s social and emotional adjustment, so they might work to strengthen and improve those processes. Four coparenting processes—engagement, teamwork, conflict and child focus—are evaluated and discussed with the family during intake assessments that include both informant reports and family (triadic) observations; child-centered ecomaps are of particular use in helping frame conversations around engagement and child focus but can also in some cases induce productive conversations about coparental teamwork and conflict. More on the ICC initiative will be outlined below; for full details, readers are referred to (McHale et al. 2023, 2024b). First, however, we offer a brief overview of pictoral mapping devices in family therapies.

1.1. Visual Mapping Devices in Clinical Settings: A Brief Overview

Among the many different conventions introduced over the past half century, the genogram has stood the test of time as a particularly creative method for identifying patterns in family dynamics, exploring intergenerational influences on behavior, and when used adeptly, fostering communication among family members (McGoldrick et al. 2020; Shellenberger 2007). The term genogram emerged in family therapy literature years after Murray Bowen and his colleagues first introduced the concept of a “family diagram” (Kerr and Bowen 1988). Over time, genograms became an amalgamation of genealogical family trees and Bowen’s systemic framework (Butler 2008; Guerin et al. 1987). Today, the term family diagram has largely faded, as genograms have gained widespread use in both clinical and research settings. While Bowen’s original concept positioned the family as an emotional unit, contemporary genogram practice acknowledges multiple contextual layers influencing family dynamics (Butler 2008).

Genograms offer elaborate visual representations of family relationships and go beyond basic genealogical information to also map emotional ties, behavioral patterns (e.g., addiction, divorce, career pursuits), and interpersonal dynamics (e.g., supportive, conflict-ridden, distant; c.f. DeMaria et al. 2013; Libbon et al. 2019). Various conventions—including continuous or double lines, dotted, dashed, or wavy lines—symbolize closeness, estrangement, or stress within familial bonds (Bradt 1980). In mental health settings, genograms offer a symbolic representation of family structures, facilitating discussions about generational strengths, past traumas, and cultural influences (Cuartas Arias 2017). These visuals can be used by clinicians to support families in recognizing longstanding issues, improving communication, and ultimately, fostering healing.

Although genograms serve as exceptional tools for systemic family assessment, their practical application in routine mental healthcare does face challenges. Practitioners often regard genograms as supplementary rather than central to intervention efforts (Taylor et al. 2013). Common barriers, including time constraints, competing documentation demands, and insufficient preparatory training—also limit their routine use (Joseph et al. 2023). As healthcare systems transition to electronic medical records, simple and innovative digital genogram solutions may be needed if there is to be continued implementation in and integration in clinical practice (Joseph et al. 2023).

Unlike genograms, which focus inward on family histories, ecomaps emphasize contemporary external connections by visually mapping social, community, and institutional relationships. Originally designed for child welfare assessment (Hartman 1978), ecomaps illustrate networks encompassing extended family, friendships, work, recreation, and healthcare providers. As with genograms, various visual conventions convey relationship strength, stress, or support (Hartman 1995). Because ecomaps depict a client’s present situation rather than historical patterns, they provide a useful practical framework for assessing support systems and stressors, shaping hypotheses for intervention and mapping change and progress over time.

Despite their extensive use, ecomaps traditionally center adult clients as heads of families, with less emphasis on children’s experiences. Recognizing this gap, infant-family mental health practitioners have adapted ecomapping to highlight children’s emotional supports. The child-centered ecomap (McHale and Dickstein 2019) places the child at the center of their relational network, illustrating attachment bonds with coparents and significant caregivers. Though the child-centered ecomap does not have the same extensive history as do adult ecomaps, they are ideally suited for capturing the multiple bonds that many infants and young children share with others during the first few years of life—particularly in complex family circumstances where others besides their biological mother and father may be part of their functional coparenting system.

The term coparenting refers to the shared—and ideally, mutual—parenting efforts of adults working together to socialize, care for, and raise children for whom they share responsibility (McHale and Lindahl 2011). Coparents are sometimes limited to a child’s mother and father, though in countless families throughout the world, they are not the lone or even the salient coparental partners. Coparents can be grandparents, great-grandparents and/or members of the extended blood or fictive kinship network, sperm-donor parents or surrogate mothers who gay or straight couples intentionally include in the child’s life, new residential partners of one or both biological parents in divorce situations, live-in nannies, au pairs, caregiving neighbors who may spend as much or more time with infants and young children as do the child’s working parents, kin or non-kin foster parents in situations where children have been temporarily removed from the home by child protective investigators, but where there are aims for reunification, and many other complex family configurations (McHale et al. 2024a).

The identities of all coparenting adults—mother and father, parents and grandparents, biological parents and stepparents, foster and biological parents, and so on—must be taken into consideration when mapping the young child’s emotional field. Regardless of who the partners in the family’s alliance are, what matters is that the principles in care and upbringing communicate frequently and cooperatively so the child’s emotional needs can be adequately met (McHale and Lindahl 2011). This perspective on coparenting is an inclusive one that acknowledges the life circumstances of all children, including countless of children coparented by unmarried men and women and by other family caregivers not formally recognized by the system of law. An illustrative case in point is an ecomap presented by McHale and Dickstein (2019), capturing the family circumstances of Alyssa, a 2½ year old girl recently referred by her preschool center because she had begun demonstrating behavior management issues (Figure 1).

The child’s day-to-day caregiver was Miriam, who Alyssa called “grandma”, and Miriam’s longtime boyfriend Damon, who the girl referred to as Grandpa. Miriam was in fact the child’s paternal aunt—Alyssa’s father (Miriam’s brother Juan) was in a residential substance treatment program, though the child had a strong bond with him and spent time visiting him on the weekends twice a month. The child had not seen her mother Anita, an exotic dancer, for several months, but knew who she was and Anita (who was also in a treatment program) was welcome in Miriam’s home. Also important in Alyssa’s life was her actual paternal grandmother Angela, whose health problems prevented her from looking after Alyssa, but who often hosted the family in her apartment on Sunday afternoons for visits and meals.

The two women on the right are Alyssa’s old (Miss Jawana) and new (Miss Becky) daycare providers. In drawing the ecomap, Miriam explained that Jawana had been an important attachment figure for Alyssa, a warm and stable presence in the toddler’s life every day during a phase when her family was undergoing some upheaval. Because ecomaps are designed to capture all the important adults in the child’s life, not just immediate family members, Miriam’s inclusion of Jawana was appropriate, child focused and ultimately revelatory. The clinician working with the family naturally had many questions at the outset about Alyssa’s family situation. She asked about relationships among the different adults, about conflict, separations, health problems, all in search of clues about some family dynamic that may have been responsible for Alyssa’s sudden and uncharacteristic behavior problems. However, as the clinician explored the ecomap, it became clear the complex, but functional family was not the driver of Alyssa’s problems. Rather, Alyssa was experiencing misery in Becky’s class, complicated by the separation from her once stable and beloved attachment figure Jawana. Per rules of the daycare center, Alyssa “graduated” to the class with older toddlers after she was toilet trained. Becky, Alyssa discovered, was a more structuring, somewhat less nurturing provider than was Jawana, and Alyssa responded by protesting class rules, crying, refusing naptimes, disrupting circle activities, and quarreling with other children. None of the behavior had been evident in the younger class. Once the cause of Alyssa’s distress became better known, the school and family worked together so Alyssa could have some special time with Jawana for several weeks while remaining in Becky’s class to help facilitate the transition. While it seemed likely that prior transitions and separations in the child’s family life had primed her to have the strong response she did in her daycare, without an ecomap there would have been misplaced detective work seeking out relational pathology within a coparenting and family system that had coalesced to take excellent care of the child despite its many challenges.

1.2. Evaluating Coparenting: The ICC Approach

When infants and young children like Alyssa experience emotional or behavioral difficulties, they sometimes come to the attention of helping professionals who possess expertise in infant and early childhood mental health. Historically, interventions offered for very young children have been focused on strengthening, and where necessary repairing, strained child–parent (and most typically, child-mother) attachment bonds. Certainly, dyadic therapies are also appropriate for and offered to fathers and infants when fathers are primary caregivers. Further, it is not uncommon for ancillary supports to sometimes be offered to couples. However, truly systemic approaches where infant mental health interventionists intentionally engage the infant and all members of the child’s family system are uncommon (Opie et al. 2023). It was against this backdrop that the ICC formed in 2022 to discuss what was known about engaging and working with family triads and family collectives (as opposed to child–parent dyads or parent-parent couples), and to offer guidance for how to engage with families around strengthening their coparenting alliance to best support the young child who was experiencing difficulties.

A core foundation for this effort was the ICC’s identification of four primary constructs central to the functioning of every coparenting family system—coparental engagement, teamwork, conflict, and child focus. First, as concerns engagement, the quantity and quality of engagement by each coparent is important to understand, for significant disengagement or exclusion by any one coparent can be a sign of strain in the coparental alliance (Corboz-Warnery et al. 1993; Elliston et al. 2008; Fivaz-Depeursinge and Corboz-Warnery 1999). As for teamwork, it is the sine qua non of effective coparenting. Cooperative, collaborative alliances involve far more than just the absence of conflict (McConnell and Kerig 2002). Rather, respect that coparents show one another as important caregivers and attachment figures for the child, together with regular communication and coordination, help the adults support one another in the mutual aim of promoting children’s sense of family-level security (Bein et al. 2022; Frascarolo et al. 2009; Konold and Abidin 2001; Mangelsdorf et al. 2011; McHale 1997). Child-related conflict, of course, is unsettling to children—even very young infants (Crockenberg et al. 2007; Graham et al. 2013; Moore 2010)—and a key question about the family’s coparental alliance concerns whether the adults can minimize disputatious, antagonistic interchanges and communications related to the child. And perhaps most importantly, because effective coparents must be attuned to the child’s sensibilities, it is important that the adults in a coparenting collective be able to maintain a child focus—mindful of and mutually responsive to children’s needs and perspectives.

In evaluating families, observational assessments are indispensable in documenting family functioning in each of these four realms. However, observations are imperfect tools that can offer incomplete perspective on the family—as case in point, an observation of Alyssa interacting together with Miriam and Damon would have uncovered rather little for remediation that would have materially influenced the child’s emotional distress. Hence ancillary self-report instruments provide additional, clarifying—and sometimes differing—perspective and context. The ICC’s aims were to create a common, standardized approach that could be used across a variety of professional settings to frame initial service intakes with families of very young children—validly assessing coparenting dynamics and elevating adults’ mindfulness about the role their coparenting would play in supporting child adjustment (McHale et al. 2023, 2024b). To contextualize the data presented in this report, families across the partnering clinical service sites completed a limited but common set of measures overlain onto the service’s standard intake procedure. The protocol which was developed emerged from an iterative 3-year process in which front-line researcher-practitioners, all international experts in observational methods for evaluating coparenting, introduced ecomap assessment to standard clinical practice. The protocol included reports from each coparent about the child’s adjustment issues, a self-report of the parent’s own coparenting behavior, a standardized triadic observation (the Lausanne Trilogue play; Fivaz-Depeursinge and Corboz-Warnery 1999), and the child-centered ecomap. The ICC viewed the ecomaps as one essential building block for understanding who the child’s effective coparents are. As with Alyssa, once relationships were depicted, additional inquiries about the child’s relationships with various coparents and the coparents’ relationships with one another became easier. And, when multiple coparents independently produce child-centered ecomaps, the meaning and significance of any discrepancies in their individual depictions of the child’s relational network can be explored, with conversations redirecting coparents to the issue of the child’s perspective. A common probe can be what the infant or young child might say if they were the one rendering the same pictoral map. Being asked to see the word through the child’s eyes helps the adults learn to decenter from their own positions to collaborate better as a team.

It is important to add that it is not uncommon for different coparents to view the child’s world somewhat differently. In fact, slightly different perspectives may be normative, though ultimately what matters is whether coparents are able to recognize and when needed, reconcile differing perspectives (McHale and Lindahl 2011). Discussing advantages and problems of another visual tool, family sculptures, Constantine (1978) remarked that in the most common therapeutic situation, in which family members themselves are asked to serve as the elements of one another’s sculptures, inter-adult conflict can lead to a major control struggle that can prevent the parents from participating in each other’s sculpture. The capacity to work collaboratively toward shared understanding can be probed when ecomaps diverge; McHale and Dickstein (2019) provide one such example of divergence in ecomaps drawn by a coparenting mother and grandmother during the first month following the mother’s release from incarceration and return home to coparent her preschooler. In their drawings, the grandmother depicted the mother as more distant from the child than the mother depicted herself, creating openings for discussing contrasts between how each woman felt, and what the child might feel, and need.

With this context drawn, we now present new ecomap data from the core “International Coparenting Collaborative (ICC; McHale et al. 2023) initiative, which was designed to test applicability of a “universal” framing approach for therapeutic work with families of clinically referred children. The ICC designed a common framework for intake assessments that facilitated the evaluation of coparental engagement, teamwork, conflict and child-focus in families of children birth to age 5 who had been referred for behavioral or emotional concerns. Five of the 7 cases to be presented below are of very young children who were part of the ICC initiative, with an additional two cases of young adolescents who took part in an ancillary project led by members of the ICC. Among the set of informant-report measures completed during the intake process are ecomap drawings rendered independently by different informants; in each case detailed in this report, separate ecomaps were drawn by the child’s mother and father. In the two families in which the older children were seen as part of the ancillary project, the clinicians also directed the child to render her own ecomap drawing, as well. The aims in each case were to help elucidate and illuminate the family’s coparenting structure and dynamics of the family system. Those interested in learning more about the ICC initiative and reviewing the complete ICC protocol are referred to McHale et al. (2024b).

2. Materials and Methods

Although all families followed in the ICC initiative completed the same array of ICC intake measures, depending on circumstances (hospital, divorce mediation program, community mental health clinic), specific instruments were sometimes integrated into existing service protocols at different times. As pertains to the ecomap, renderings from parents were typically, though not always, accommodated in the same session as parents completed other self-report measures. For the cases detailed in this report, a similar procedure—in which different respondents completed their own ecomaps independently during a single session that they attended together, and then later came together for a subsequent debriefing session to review the ecomaps and other intake data to gain a better understanding of coparenting engagement, teamwork, conflict, and child focus—was followed in 6 of the 7 cases. An exception was the fifth case from St. Petersburg, in which mother and father completed the instruments independently at separate remote locations, before coming together for the later debriefing session to review what was learned about coparenting engagement, teamwork, conflict, and child focus with the clinician.

Because the ecomaps in the ICC’s work are child-centered, the referred child (and not the adults) are depicted in the center of each coparent’s rendering. The assessor instructs the adults to populate the space around the child with the most important individuals in the child’s life—everyone with whom the child has a bond or “heart connection”. The proximity of individuals to the child reflects both geographical and emotional closeness, as perceived by the responding adult such that those with whom the child is closest are drawn nearest the center. The respondent then sketches lines that connect the infant or young child to each person, using conventions borrowed from genograms and traditional ecomaps (dotted or bolded lines) to depict attachment intensity (McHale and Dickstein 2019). Respondents differ in how they interpret these conventions, and so it is important that active guidance and collaborative assessment approaches (and debriefings) between the practitioner and respondent be the standard of practice when utilizing child-centered ecomaps in clinical practice.

The ecomap canvas can be as simple as a blank sheet of paper, but for the ICC initiative it contained a heart at the center in which respondents were to write the index child’s name. The clinician conducting the assessment then gave the following instructions:

“Nearly all young children develop close bonds or “heart connections” with important others. Please put your child’s name and age in the heart below. Next, draw circles that represent each of the important people in your child’s life, putting each person’s circle close to or farther away from your child’s heart to indicate how frequently your child sees, visits, or calls that person. Then connect each circle to the heart with a solid line for especially emotionally strong bonds, and a dotted line for others who are loved, but just not quite as emotionally close”.

Following the individual completion of ecomaps and other procedures, the ICC protocol involves a subsequent feedback session to review not just the Ecomap, but all completed instruments with all parties who completed them. During the feedback session, family members are reminded that this is an opportunity to bring prior assessment sessions and activities together, to elevate everyone’s shared understanding and awareness about the four major elements of positive coparenting

• Promoting Engagement for All
• Supporting and Teaming with One Another
• Containing and Minimizing Child-Related Conflict
• Assuring the Child is Seen and Heard

During this session, the ecomap can be especially helpful in facilitating the part of the conversation where the clinician is trying to understand more about coparental engagement; procedurally, the clinician first shares the maps that each person created so that the coparents can consider their similarities and differences. Optional probes might include the following: Who if anyone is missing? Would the child him or herself agree with and endorse the maps you have created(as a prelude to future sessions if therapy is undertaken)? Who (if anyone) portrayed on your drawings—besides yourselves—would you suggest we consider bringing in at some point to confer with about the child?

This last question can also be useful to loop back to later in the feedback session when discussing coparenting conflict. Though some other assessments in the ICC protocol completed by the coparents speak more directly to Child-Related Conflict, being able to envision other nexuses in the family system where there may be dissonance between caregiving adults can be very instructive. And if there are disparities in each parent’s ecomap about who the important adults are to the child, this can help buoy the conversation about child focus—seeing the world through the child’s eyes. Several of these elements of family process will be illustrated in the cases below.

3. Results

3.1. Application of the ICC Model with Families of Young Children: Four Cases from Rome, Italy

In Rome, Italy, the Parioli Center for Clinical and Forensic Studies serves children exhibiting emotional or behavioral symptoms in higher-conflict families, including many families contemplating, or in the process of separation and divorce. The first two cases presented below were families where the parents were still together, and the second two, cases where the couple had decided to split. In each case, both parents completed child-centered ecomaps separately, then convened for a feedback discussion to review them as per the ICC protocol.

Susan. Five-year-old Susan’s parents depicted a sprawling, complex network of relationships when they gave thought to the child’s loved ones (Figure 2). They recognized that the child had built significant relationships with the entire maternal family (especially with an aunt and an older cousin) who became a support even when the child presented her emotional dysregulation crises. The paternal grandmother, a widow, was also included in the maternal family and considered significant for the child. Another convergence of the parents’ representations concerned a nanny who left a few months ago: both described this loss as an event not yet emotionally processed (and for the family as a whole, it created a relational imbalance that had been difficult to reorganize). The nanny served as a genuine co-parent with the mother, who had become lonely and felt a lack of support.

This circumstance, it was later learned while discussing the ecomap, contributed to interparental conflict regarding the father’s engagement. During the feedback session, some specific differences in the parents’ representations were also analyzed: for the mother, all relationships were portrayed as intense except for the one with the children of a brother; for the father, Susan’s intense relationships were limited to those with her parents, her sister, her aunt and her teenage cousin. What meaning can be attributed to this difference? Which parent has projected his own experience onto the daughter? Perhaps the mother still perceives herself as part of her own family, while the father differentiates between the nuclear family and the extended family? In family psychotherapy, the clinician and family had the opportunity to delve into and work on these issues: balancing parental engagement, improving teamwork and moderating co-parental conflict; and encouraging the separation of the two parents from their families of origin (an especially significant undertaking for the mother).

Louis. Five-year-old Louis parents drew somewhat different eco-maps (Figure 3). His father felt the child considered mainly the parents and grandparents significant. Only for the maternal grandmother did the father use a line to indicate intensity of relationship with the child. The other relationships with uncles or friends were portrayed as more distant. The mother, by contrast, differentiated the relational network: the parents were closest and more significant, followed by the maternal grandparents and, more distant, the paternal ones. She also recognized the significance of numerous relationships with uncles, cousins, and family friends with their children. Overall, she attributes to the child far more significant relationships than those recognized by the father.

During the feedback, these differences were discussed. The father, on seeing the mother’s drawing—conceded that it was more realistic. The two parents reflected on their differences in considering the importance of emotional and social relationships. They felt that numerous conflicts arose from the wife’s perception of her husband as avoidant and socially withdrawn. The consultation offered opportunities to address issues of parental engagement and of the conflict stimulated by the mother’s perception of the father’s emotional withdrawal. It also created a platform for the father to share coparenting concerns that had led him to consider separation, primarily centered around emotional outbursts by the mother in the child’s presence when she became angry. These disclosures also provided openings to consider how the child’s tantrums were connected to his episodic involvement in hostile exchanges between parents. The ecomap and data review hence provided a port of entry that led to deeper conversation about romantic attachment, closeness and psychic intimacy between the spouses. During the work, the couple became aware of a pregnancy with a second child which they welcomed, after having previously been unable to plan with enthusiasm.

Antony. Seven-year-old Antony is the son of two separated and highly conflictual parents. After a Custody Evaluation, he was placed mainly with his father and his mother visits him a few days less than his father. The child is sometimes oppositional with his father and allied with his mother, requesting more time with her. In this family, the feedback session introduced a different kind of challenge. The mother neglected to include the father in the network of significant people for the son (Figure 4), whereas the father included the mother, though he placed her a bit distant from the child.

The mother explained that she had assumed she should only include people the child frequented when together with her. When asked where she would place the father, the mother rejected the consultant’s initiative to place the father near the son in the center, and proposed placing him farther away. Her rationale was that this would have been her son’s vision.

Further discussion noted that the father had included relatives (grandmother, aunts, siblings) who were part of the mother’s family of origin, while the mother did not depict those relationships. This became a port of entry to learn that the mother had cut off all relationships with her family of origin and that it was the father who had maintained a connection with them. The mother specified that Antony did not like to spend time with them, while the father felt that—apart from a few occasions in which the boy became oppositional with everyone—he was happy to share experiences with people who had known him since birth. An additional difference between the ecomaps was that the father neglected to include in his depiction of his son’s relational network three relationships that were indicated by the mother. The only relationship both parents saw of common relational significance was that with a child who was the son of a friend of Antony’s mother. It was noted that overall, the mother’s ecomap included a smaller number of relationships than the father’s. The consultation helped frame conversations about risks introduced by the mother’s entreaty for role reversal with the son so he would recognize her as an important parent for him, opposing his father and institutions that had judged her negatively. The clinician had made note of the mother’s vulnerabilities at a personality organization level. At the same time, the father was asked to reflect on opportunities to improve teamwork with the mother by mitigating his tendency to team up with the maternal grandmother and maternal aunt who had severed their relationship with the child’s mother. These issues became foci for efforts with the parents to moderate coparental competition trapping the child in parental conflict.

Mario. As did Antony, 6-year-old Mario also had separated and highly conflicted parents, so much so that his mother had filed a complaint of intimate partner violence (IPV) against Mario’s father. Mario was introduced as a child who sometimes withdrew, sometimes was sad, and sometimes had outbursts of anger, per parents’ reports. Unlike the previous case, however, on their child-centered ecomap renderings, both Mario’s father and mother recognized that their son’s most important relationships were those with his parents (Figure 5). Both also acknowledged the salience of Mario’ relationship with his maternal grandmother, even though the father had cut off all contact with his mother-in-law. On her drawing, the mother was able to acknowledge as important relationships Mario shared with his two older sisters (Diane and Carol), both born from the father’s previous marriage. One difference was that the father choosing not to depict relationships with certain relatives who lived in the mother’s country of origin, though the mother made efforts to connect her son with those individuals through video calls and stories. However, a more important difference was that the father connected Mario with his new partner—Ann—while the mother did not consider Ann at all.

The follow-on counseling with the coparents focused partly on parental competition that came from intense engagement by both in the life of their child, though it was precisely the discrepancies between the eco-maps related to the father’s new partner that allowed discovery that the parents’ conflict was mainly centered on the wife’s jealousy toward her husband. The mother had always attributed to the father several lovers, with Ann being one of them, according to the mother’s perception. Although the work saw many moments in which Mario’s mother and father managed to team together and collaborate, an antagonism remained that embodied the reasons behind the separation—for the mother, the husband was an unreliable and unfaithful man, for the father, the wife was emotionally unbalanced and manipulative. Mario maintained an equidistant relationship between the two but tended to defend the father because he seemed to have learned that the father was the one who was criticized the most. The counseling that followed the ICC intake process focused on helping the parents to define a better boundary between their marital conflict, which continued through criminal proceedings, and the ongoing need to respect each other as coparents and more positively involve and include the other parent in their dealings with Mario, even—and especially—in one another’s absence.

In summary, the four cases seen at the Parioli Center each illustrate ways ecomapping might be used to heighten child focus by reflecting on risks involved if coparents do not read their child and the child’s relationship needs in an empathetic and reflective way and/or if they attribute to the child motivations that actually derive from their own emotional needs. When used as a port of entry, ecomapping can help coparents better respect their child’s feelings and safeguard relational resources that continue to be especially significant for them. The next case, seen at the Infant-Family Center (IFC) in St. Petersburg, Florida, details the utility of ecomapping in a complex family situation where the child has been placed outside of the custody of his biological parents with family relatives following a child protective investigation, but with hopes of eventual reunification.

3.2. Application of the ICC Model with a Child Welfare-Involved Case with Extended Family Coparents

Marcus. Four-year-old Marcus’ case came to the attention of the IFC after Marcus’ father had come to make acquaintance with a clinician from the IFC when he participated in a “Circle of Security” (COS; Hoffman et al. 2006) group, run by the clinician at a substance abuse treatment facility where the father was receiving services. Because the father had built trust and rapport with the COS facilitator, he and the mother of Marcus and Marcus’ three-year-old brother sought further coparenting support from the IFC. The father was African American and in his late 40s; the mother was European American and in her early 40s. Though the parents were older, the boys were the father’s first children, whereas the mother had an adult daughter in her early 20s who she raised prior to meeting the boys’ father. At the time of their self-referral, the family was actively involved with the child welfare system, and the children had been removed from their custody because of concerns with substance use and combativeness between the two parents. Though no violence had been directed toward the children, it was possible the boys may have been witnesses. While the couple worked through restrictive case plans both individually and (when being seen at the IFC), together, the boys were placed with a paternal aunt. The parents had been granted supervised visitation, but the father had somewhat more access since the children had been placed with his family and the paternal aunt (the father’s sister) was more accepting of his visitation. The father was also farther along in his treatment and motivation for change.

Coming to the IFC for coparenting work was a major step for the mother, though she was open and excited to participate. However, processing relationship difficulties was new and raw for her—she was experiencing this for the very first time and so was emotional at times, whereas the father had been undertaking similar contemplation as part of his substance treatment programming. This case differs from the prior four because the coparents, though living apart as were the coparents in Antony and Mario’s families, did not have their children living with either of them. The mother was housed in a shelter and the father in a residential substance treatment program. The case also differed in that Marcus’ parents were both firmly committed to working together in the best interests of their shared children. Though the coparents did appear for some in-person sessions together as their situations allowed, they each completed the child-centered Ecomaps alone at their temporary dwellings, within one day of each other. They completed one ecomap for each child, even though Marcus was showing the greater adjustment challenges.

The couple then came together later in-person to discuss the ecomaps and other ICC assessments. After asking the parents to talk about what they wanted for their children, the therapist explained that she would draw on the assessments they had completed to reinforce the positive ways they were working as a coparenting team already. She further explained that they had also be looking for places where the parents may be farther apart and for some things the parents may wish to work on. They began by looking at the two pairs of ecomaps (one completed for each child). Both parents had included not just themselves, but also the mother’s young adult daughter and the paternal aunt with whom the children had been placed and with whom the boys had developed strong bonds. The acknowledgement that the children had a bond with the paternal aunt was especially hard for the mother, as she reported that the aunt was not being cooperative in allowing her to have access to the children. The mother had drawn herself at a distance and less strongly connected to the children, which saddened her; the father’s drawing placed mother close to her children, to acknowledge that they held her closely in heart (Figure 6). Despite the slightly different interpretations and renderings, both parents did admirably in drawing the ecomap connections from the children to the different meaningful adults as though they were taking the perspective of their children, not themselves. Their child focus in rendering the ecomaps became a focal point for the work that lay ahead.

Each of the five cases discussed above was seen during the initial wave of data collection in the ICC initiative, which focused on very young children. Subsequently, one of the original project partners from the Child Neurology and Psychiatry Unit of the IRCCS Mondino Foundation in Pavia, Italy, after seeing a number of cases with children birth-to-age 5, began pilot work to establish whether the ICC protocol could also be used fruitfully with families with older children. The latest studies and practice guidelines for the treatment of adolescent patients with eating disorders (EDs) suggest that a multidisciplinary, family-centered approach may improve patients’ outcome, as the quality of family interactions, and, in particular, coparenting, is closely linked to the severity of EDs symptoms (Baradel et al. 2023; Mensi et al. 2021). The team in Pavia applied the International Coparenting Collaborative model to a group of adolescents with EDs and their families and assigned ecomap completion during the intake process not just to the coparenting adults, as is customary, but also to the eating disordered adolescents themselves. By mapping out the family system, social networks, and key relationships, the team anticipated that the ecomap might help highlight areas of emotional distance, stress, or conflict not immediately visible in traditional dialog (especially in adolescent therapy, where communication breakdowns are common). It was also projected that ecomaps might be useful in identifying strengths and resources and allowing the family to engage collaboratively in identifying and reshaping relational patterns. The final two cases in this report present results from this pilot expansion.

3.3. ICC Ecomapping by Both Coparents and Their Adolescent Children: Two Cases from Pavia, Italy

April. Thirteen-year-old April was diagnosed with Eating Disorder Not Otherwise Specified (ED-NOS) and Generalized Anxiety Disorder (GAD). She came to the clinical team’s attention after experiencing repeated episodes of abdominal pain, followed by six months of restrictive eating, weight loss, and marked avoidance of social events involving food. She also exhibited anxiety related to food, anticipatory distress, and repetitive, time-consuming thoughts about eating. April is an intelligent adolescent who tends to relate to others in unique and idiosyncratic ways. Her immediate family includes her father Mario, her mother Lucia, and April herself. The family had proactively sought professional support, and from the outset, all three appeared cooperative and engaged in the rehabilitative process. In the initial three sessions, the standard ICC protocol was followed, including ecomapping to explore family and social relationships and a feedback session where all results from the intake assessment were reviewed and discussed with the family. As per the ICC protocol, assessments were used to center the family around key relational patterns of engagement, coordination and teamwork, conflict, and child focus. It was during the initial session—after introducing principles of Attachment-Based Family Therapy (ABFT) and discussing the interplay between eating disorders and family dynamics—that the team asked each family member to independently create an ecomap, a visual representation of their emotional world. What immediately stood out (Figure 7) was a significant discrepancy between April’s and her parents’ representations. Mario and Lucia appeared to overestimate April’s capacity for external relationships and her emotional engagement outside the family. In contrast, April’s ecomap showed no significant relationships beyond her parents. She drew herself between them, forming an enclosed triad. Even the one friend she mentioned was accompanied by a note of emotional disconnection.

Table dynamics opened the possibility for considering that April may not conceive of meaningful emotional ties outside of her primary attachment figures. It became plausible to hypothesize that her reluctance to step out of the familial triad reflected a developmental impasse—a difficulty in moving forward through the normative tasks of adolescence. Her symptoms might hence have been understood as a mechanism to remain anchored in a childhood-like dependency, avoiding the distress of individuation. When the ecomaps were shared and discussed with the family, April articulated that the outside world felt limiting due to her intense fear of losing control—an insight that offered a promising foundation for therapeutic work. Ecomapping also illuminated the symbiotic relationship within the triad, warranting further exploration into how control and identity were negotiated within the family system. The use of the ecomap not only made discrepancies visible and concrete, but also supported formation of a strong therapeutic alliance and guided the development of focused goals for therapy, including helping April’s parents temper their expectations and revise their idealized version of their daughter’s emotional life, and supporting April in forming a sense of identity separate from her parents, and in developing more functional communication patterns within the family.

Sara. Sixteen-year-old Sara had been diagnosed with Anorexia Nervosa, and came under the team’s care due to food restriction, body dysmorphia, and non-suicidal self-injury. Her eating disorder began at age 13, and her family managed a partial remission independently, without professional support. Sara’s family consists of her father Paolo, mother Iris, younger brother Davide, and Sara herself. Upon arrival, Iris appeared emotionally overwhelmed, often crying yet attempting to take control. Paolo, in contrast, was silent and defensive, while Sara openly expressed reluctance to engage in treatment. There was also considerable concern about shielding Davide, who was reportedly unaware of Sara’s mental health issues. All three completed ecomaps individually.

Notably, Paolo’s ecomap of Sara’s relationship network depicted very few significant relationships, and he even drew himself outside the ecomap box. While it was possible this anomaly reflected a misunderstanding of the task, the team interpreted it as a symbolic expression of emotional detachment from his daughter and perhaps his spouse. Sara and Iris, meanwhile, presented more closely aligned views of their emotional landscapes. It was particularly telling that Sara depicted her parents as physically close, yet emotionally distant—drawing her parents close to her (because she saw them every day) but using dotted lines to represent the intensity of the relationship because she felt disconnected from them (Figure 8). Sara’s rendering was hence a subtle but powerful representation of her experience of disconnection. During the session, Sara expressed anger toward her father, recalling a hurtful comment he had made years ago, which Paolo did not remember. This moment highlighted the emotional fracture in the father-daughter dyad and hinted at unresolved relational wounds.

When ecomap discrepancies were addressed in session, all parties acknowledged that Paolo seemed emotionally absent—not only from his children, but also from his wife. He was described as stubborn and self-focused, yet paradoxically dependent in daily functioning. As a result, Iris bore the bulk of the emotional, mental, and organizational labor, a burden she had previously kept silent about. Discussing this dynamic aloud brought visible relief to family members, especially Iris, creating a space where hidden tensions could be safely explored. The ecomap was hence a prompt that helped reveal latent emotional conflicts and triangulations, offering a pathway to define targeted therapy goals, including rebuilding the father–daughter connection, with particular attention to emotional expression and responsiveness, balancing the couple dynamic, reducing the emotional load on Iris, and (with time), including Davide in sessions to prevent emotional exclusion and clarify his role in the family system.

4. Discussion

The purpose of this article was to illustrate the substantial clinical benefit of including child-centered ecomaps as part of a comprehensive coparenting evaluation at the onset of new casework with a family whose child has been presenting with emotional or behavioral challenges. The Ecomap is a tool that simultaneously allows both for the visualization of the full relationship network of people who play meaningful roles in the life of a child who has been presenting concerns (or what Reiss 1989, referred to as the “Practicing Family”) and for derivation of important information regarding subjective representations of the coparents who render the drawings, affording insight into how they see their child in relation to family and non-family figures (the Represented Family; Reiss 1989). That is: the clinician becomes aware of those who may play a role in the child’s return to healthier functioning, while also noting how each parent expresses their own subjective representation of their child in the family context.

All the cases presented in this report were guided by the International Coparenting Collaborative’s framing approach and protocol, though individual variability among sites in sequencing and timing was also anticipated and accommodated for in the assessment protocols. Our focus in this article was on the ecomapping exercise and discussion, and the ways in which it helped support a more complete approach to the work by enabling a clearer picture about coparents engagement, teamwork, conflict and child focus. It is noteworthy that in each professional setting, the practitioners working with the families were able to accommodate administration and debriefing of the ecomapping in a manner that was not only amenable to their practice setting and acceptable to families, but that also helped advance the important clinical work that brought the family in for clinical services.

While the ICC collaborators drew on a common framework and means of approaching the ecomapping task with families, inevitably, individual respondents sometimes interpreted the exercise idiosyncratically. The technique, in the hands of a prepared clinician set to serve as a guide for the family, appears robust to differing interpretations (and as in the cases of Antony and Sara, potentially even misunderstandings) when the family understands the point of the ecomap—and, the clinician facilitates an open discussion that probes points of interest and ambiguity. The fact that there can be allowances made for use of slightly different graphic conventions and techniques in depictions is important, suggesting that the tool can accommodate the creativity of the therapist working with the family. In describing themes and variations, we hope professionals reflecting on use of ecomapping in their own work will consider potential innovations or variations custom-fitted to their client base and clinical situation.

The fact that the standard ICC protocol was flexible enough to benefit families of young children with both internalizing and externalizing symptoms, high conflict divorcing families, child welfare-involved families, eating disordered adolescents being treated in an outpatient setting, and other clients in both community and hospital-based settings further reinforces the utility of gathering systematic information about the child’s relational world from multiple informants. Examining the findings from the collaborating partner sites, several points are worth noting. First, regarding heightening the family’s child focus, comparisons of one parent’s ecomap with that of the other did serve in facilitating a better understanding of the child. Second, and relatedly, ecomap discussions allowed coparents to reflect on risks involved if they do not read their child’s emotional signals in an empathetic and reflective way and/or if they attribute motivations to the child that reflect their own emotional needs. Third, if there is a high level of conflict between parents, that conflict contributed to a divergent representation of the child that did not help to foster a sense of family integrity—likely to be the case both among parents who have and have not separated. Helping redirect coparents to the child’s needs and sensibilities is especially important in such cases. Fourth, and especially importantly, working with ecomaps can help parents come to respect their child’s feelings and safeguard the relational resources that are especially significant for them—pethaps the most valuable clinical indication of all for employing the tool.

From the cases involving adolescent girls with eating disorders and their families, further information came to light about ways that the ecomap can be useful both as a projective diagnostic tool and as a means of promoting family communication—an especially helpful support in pathologies where verbal dialog is obstructed by emotional distress or denial. Within the context of adolescent therapy, ecomapping allowed family members to exteriorize what had previously been their independent internal experiences, so that they could confront and process previously unspoken emotional distances, and ultimately collaboratively engage in reshaping relational patterns that may underlie or maintain psychopathology.

Regarding limitations of the work presented here, the pursuit and interpretation of family ecomaps with the five younger children was guided by and closely connected with the ICC objective to develop a meaningful, manageable and flexible framework pertinent across diverse, multi-national professional contexts—one that could elevate adults’ mindfulness about how coparental engagement, teamwork, conflict and child focus in their family might be related to children’s emotional challenges and path to recovery. The addition of the data from families with adolescents additionally highlight the importance of the child’s perspective in case conceptualization and treatment planning—though the ICC approach did not itself take into account the perspectives of very small children on their relational networks. Certainly, even very young children have the capacity to articulate their perspectives, and visual methods are particularly efficacious for this age group (Lefevre 2018; McHale et al. 1999; Winter 2010). Exploring the ways in which very young children’s accounting of their relationasl networks map or do not map onto coparental accounts would be a valuable addition to subsequent ecomapping research.

Regarding the utility of ecomapping and its relevance across the different cultural and societal contexts represented within the ICC, at this point we can only draw the tentative conclusion that families across the particular clinical contexts sampled saw value in and found meaningful the consideration of their child’s relational network during the clinical assessments designed by the ICC. As the ICC expands its efforts in the middle east and South America, there may be limits to the applicability and value of the technique in helping families understand coparenting. Network size, composition, and configurations are likely to also vary cross-culturally, though the essential importance of engagement, teamwork, conflict and child focus across cultures has to date shown remarkable applicability for helping to understand child adjustment. Finally, we would also caution that this work is still very new, and there could potentially be limitations and challenges in the use of ecomaps in family therapy. For example, for some families or adolescents, the process of creating an ecomap could be overwhelming and trigger defensiveness. It is also possible ecomaps might sometimes oversimplify complex emotional dynamics and be subject to misunderstanding. For these reasons, it is extremely important to provide careful facilitation to the process, and therapists should always remain mindful that the ecomap is just one tool in a broader therapeutic process aimed at promoting understanding, communication, and change.

5. Conclusions

Though still new, the ecomap shows substantial promise as a clinical tool in casework where the aims are to better understand and strengthen the child’s coparental alliance. The International Coparenting Collaborative continues work on the systematization of intake assessments and the expansion of longitudinal casework investigating the acceptability and impact of its framing and implementation guidelines for an ever-increasing range of families and family circumstances. In the interim, we share these data both for their heuristic value and as a stimulus for clinicians to consider the potential value added of ecomapping in their own work.