1. SmithBattle, Lee PhD, RN
  2. Leonard, Victoria PhD, RN, APRN


Despite keen interest in teen mothers' outcomes, few studies have followed teen mothers prospectively or examined how outcomes are shaped by family relationships and practices over time. This multigenerational, hermeneutic study began 21 years ago when 16 families were interviewed after the teen's infant reached 8 to 10 months of age. Families were re-interviewed every 4 to 5 years. This article describes the 3 families who exemplified adversarial caregiving at the first study and how their relationships unfolded and shaped long-term outcomes. Findings alert clinicians to the importance of recognizing red flags and intervening early to interrupt adversarial caregiving.