The case study presented by Busch and Lieberman highlights the multifaceted and complex nature of the intergenerational transmission of abusive and neglectful parenting. Whereas this case study's focal interest is the resolution of intrapsychic and relationship issues, Busch and Lieberman also point to the importance of the context of poverty and violence in which these dynamics occur, noting at the very end of their case study: “In order to stop the intergenerational cycle of violence, society will need to move beyond the individual mother and child and improve community support for our most vulnerable families.” Even in light of Letisha's remarkable insights and progress, guided by perinatal child parent psychotherapy, she still must live and raise her child in an environment rife with poverty, violence, and danger. This commentary will focus on contextual influences on child maltreatment, although this is not meant to exclude the individual and psychological factors that Letisha's case so powerfully illustrates.

Intergenerational transmission of abusive parenting has been among the most frequently and consistently offered etiological explanations in the child maltreatment literature. However, the intergenerational transmission of abusive or neglectful parenting is not inevitable, posing a challenge and an opportunity for understanding the etiology and sequelae of child maltreatment. The case presented by Busch and Lieberman speaks powerfully to one pathway to avert intergenerational transmission.