Parental Substance Misuse: An Exploration of the Impact of Substance Abuse on Children

1.0 Introduction

1.1 Background and Problem Definition

It is beyond debаte thаt the use or misuse of substаnce hаs severe impаct on the well being of children. The term substаnce refers to both the illicit аnd non illicit forms of drugs. The use of substаnce by а pаrent becomes misuse when the pаrent in question uses it to the level where the usаge becomes hаzаrdous for both the behаviour аnd heаlth of the pаrent аs well аs the life of the children involved. The hаrmful behаviour in the pаrent hinders the pаrent’s аbility to tаke good cаre of their children which is the children’s fundаmentаl right (Forrester 2011, p. 4). The pаrentаl substаnce misuse hаs physicаl, behаviourаl, sociаl аnd emotionаl or mentаl consequences for the children. Parental substance Misuse is a major issue that has captured the attention of social worker and professional as well as policy makers with regard to wellbeing and needs of a child (Murphy & Harbin, 2003, p.354). The National Treatment Agency (2012, p.3) notes that over 50% of the total adults undergoing drug treatment in 2012 were parents of which a third (66,193) were living with children under the age of 18. Out of these, those who live with their children are 40,852 while those who live with children who are not theirs are 25,341. While not all parents with substance misuse problems harm their children, past research evidence has indicated that there is a solid relationship amid parental drug abuse and negative outcomes for the child (Murphy & Harbin, 2003, p. 357). This is mainly attributed to the reduced ability of the parents to provide emotional and practical for the children (The National Treatment Agency, 2012). Different research findings which have investigated child outcomes due to parental substance abuse, have arrived at different findings, albeit all having the tendency of being negative. This project explores the impact of parental substance misuse on children, particularly focusing on child outcomes from a sociological viewpoint аnd highlights the sociаl work thаt hаs been done so fаr in the light of criticаl best prаctice to аddress the issue of pаrentаl substаnce misuse in the UK.

The project also synthesises recent literature on child outcomes due to parental drug abuse and further applies theoretical and empirical findings to ChildLine case study, to analyse the impacts of parental child drug abuse based on ChildLine reported cases.

1.2 Purpose and Objectives of the Project

The core purpose of this project is to explore and examine the impacts of parental substance abuse on children with a focus on the UK. In order to attain this purpose, the project seeks to fulfil three core objectives. These are: 1. To critically review findings on the impact of parental substance misuse on children 2. To connect theory to recent evidence presented in ChildLine parental substance misuse reported findings so as to identify new information about the impact on the child 3. To assess the social work interventions that will help protect the children affected by parental substance misuse.

1.3 Relevance of the Research Project

Adamson and Templeton (2012, p.14) have found that substance abuse has significantly increased over the years. With such increases, such drug use affects important aspects of children’s lives and social workers constantly need to understand the changing nature of problems that young people are faced with. The findings of this project, therefore, are relevant in providing different dimensions to social work practitioners and policy makers on the issues children are faced with. This is imperative in further facilitating development of effective interventions to address these issues. Furthermore, this project is relevant as it adds new and up to date knowledge and information to the already existing literature on the impacts of parental substance abuse on children.

1.4 Reason for Interest in the Topic

The reason for undertaking this project is purely professional and to critically evaluate the process used for the systematic literature search. In addition, my interest in this project is due to a wide experience working with children and thus gaining an understanding on the needs of children especially with regard to their relationships with their parents. Valentine, Jayne and Gould (2010) in their findings note that the parents are the most influential people in the attitudes, social development and wellbeing of children. It is now essentiаl thаt children should be protected from every form of mаltreаtment or situаtions thаt hinders their аccess to sаfe аnd effective cаre. In а study by Lаybourn et аl. (1996) а child respondent wаs quoted sаying,”Mа mum got hurt on the outside аnd we got hurt on the inside”. The stаtement illustrаtes the psychologicаl problems fаced by the children in fаmilies with substаnce misuse. Children аre vulnerаble аnd thus, justify the need of interventions for solving their sociаl аnd heаlth problems through vаrious counsellors. With interest in making the lives of children better, reviewing findings on the impact of parental substance misuse on children, as well as investigating any new information that has arisen is essential.

1.5 Methodology

1.5.1 Research Method and Design

This project used qualitative method to analyse information on the impacts of parental substance abuse on children. This was based on both comparative analysis between theory and empirical evidence as well as a case study analysis. Secondary data from previously completed studies were collected and evaluated in order to understand the wide spectrum of issues children are faced with when their parents are abusing substances. Substance abuse in this regard includes both alcohol abuse and drug misuse. These two are considered together since studies have found that difficulties due to both forms of substance abuse are similar and that most parents who misuse substances, tend to use a combination of both (Tunnard, 2002, p.8). Furthermore, the study employs a case study research design to evaluate the impacts within the current environment in the UK. A focus is given to ChildLine UK, where data was collected from its recent reports.

1.5.2 Search Strategy for Systematic Literature Search

In order to identify the relevant research findings with regard to the effects children are faced with due to parental substance misuse, information was researched using various search engines such as Google, CINAHL, British Nursing Index (BNI), Medline, AMED, Ebscohost, and Proquest. Keywords used in searching for articles included “impact of parental substance abuse on children”, “parental substance misuse”, “child outcomes in parental substance abuse”, and “child intervention measures in parental substance misuse”. The inclusion criteria for the search terms were that the publication had to be from reputable journals or they had to be from reputable organisations, and from government websites. This ensured a higher validity and credibility of the sources used in this research study. Furthermore, only articles published from the year 2002 to 2013 were used in this project. This time period was chosen to ensure that the research contains not only up and current information (2008-2013), but also that it does ignore critical research findings in the immediate past (2002-2007). From the search results, core journals used in this project included Child Abuse Review, British Journal of Social Work, British Journal of Child Abuse and Neglect, Children & Society, Journal of Family Psychology, Joseph RoundTree Foundation, Journal Of Youth Studies, Child & Family Social Work, Journal of Sociology & Social Welfare, Child Welfare, Children & Society, Child & Family Social Work, Attachment & Human Development, and Child & Adolescent Social Work Journal.

1.5.3 Data Analysis

In order to analyse the issues uncovered from the research study, first empirical evidence was linked to theory through comparative analysis. Afterwards, based on these findings, a case study analysis was conducted based on ChildLine reported findings. This case study approach will provide a rich and in-depth view of the current child social situations (Hek & Moule, 2006, p.57). It further compares these with previous findings to identify new arising effects children are faced with as a result of parental substance misuse. As Baxter and Jack (2008, p. 544) argues, a qualitative case study is imperative in exploring certain phenomena in depth from various perspectives. Using the case study of ChildLine, this research study has mainly focused on providing different children’s perspectives and viewpoints on their parents' drug abuse.

1.6 Theories Relevant To This Research Topic

The theories relevant to this research topic include the social learning theory and attachment theory. Social learning theory postulates that people learn from their social environment through behavioural and cognitive interactions (Shaffer, 2009, p.46). On the other hand, attachment theory is concerned with the issues of emotional protection and safety which add to a sense of emotional safety and the quality of bonds between parent and child (O’Connor & Scott, 2007, p.6).

1.7 Organisation of the Research

The remaining parts of this paper are organised as follows: Section two presents a critical literature review on existing work parental substance misuse, focusing on the effects it has on children. The section reviews the theoretical approach used and the empirical findings on child outcomes for children in home with parental substance misuse. This also includes a review on various interventions that have been developed to minimise the negative impacts on children. The third section analyses and discusses the link between theory and empirical evidence and further analyse the case study of ChildLine based on theoretical and empirical analysis. Finally the fourth section summarises and succinctly concludes the main findings of the research paper.

2.0 Literature Review

This section reviews existing literature on the impact of parental substance abuse on children. The purpose of the section is to evaluate the extent of findings in child outcomes as well as intervention measures which have been studied. First, a theoretical background on the topic is explored and then empirical evidence on child outcomes and intervention measures analysed.

2.1 Theoretical Background

Parental substance misuse is used in this research to refer to excessive consumption of alcohol or drugs by people who have parental responsibilities and are mainly residing with children. A wide range of research studies have supported findings that parental substance misuse can have a manifold of negative consequences to their children. This is because substance abuse impairs the ability of the parents to take care of the children. Children are often vulnerable and the relationship between parents and children is very important in determining child outcomes in various aspects (Gorin, 2004, p.23). A search through literature revealed a number of theories which explained the link between parent-child relationship and child outcomes. However, this project focuses on two of these: social learning theory and attachment theory (O’Connor & Scott, 2007, p.8).

2.1.1 Social Learning Theory

Social learning theory is one of the important theoretical approaches which define the relationship between children and their parents and the possible outcomes for the children. According to Bandura (cited in Shaffer, 2009, p.46), one of the core scholars who have developed upon this theory, social learning theory postulates that people learn from their social environment through behavioural and cognitive interactions. This means the probability that a person will behave in a certain way increases when they associate with people who behave in the manner, irrespective of whether it is a social norm or not. Thus children are more likely to engage in substance misuse if they are exposed to those who do. Kelley, et al. (2010) argues that children who witness the use of drugs by parents increase their familiarity with it and thus higher likelihood that they would use them. This theory has been supported by other findings such as Kinsfogel and Grych (2004, p.510) who in investigating adolescent behaviour in relation to those of their parents, found that adolescent boys were more probable to be belligerent and vicious in their relationships if they were exposed to intimate partner violence from their parents. Even for smaller children below the ages of five, social learning theory has been highly evident as young toddlers imitate their parents’ actions (Guajardo, Snyder and Petersen, 2009, p.38).

2.1.2 Attachment Theory

Attachment theory was put forward by Bowlbbly. The essence of the theory is that the quality of care provided to a child by the parents, in particular, responsiveness and sensitivity to a child’s needs, leads to secure or insecure child development in terms of attachment (O’Connor & Scott, 2007, p.6). In this regard, attachment theory is concerned with the issues of emotional protection and safety which contribute to a sense of emotional security and the quality of bonds between parent and child. Mikulincer and Shaver (2007) noted that inconsistent and unhealthy bonds between the child and the parent disrupts various aspects of the internal self representation of a child and thus making have problems in social interactions as well as predisposing the children to poor emotional control.

2.1.3 Resilience Theory

The fundamentals of resilience theory have been embraced in the social work with the need for intervention of the development of children who have been caught between households with parents indulging in substance and drug abuse. The endorsement of this theory in initiating factors that enhance the protection of such children has been fundamental in restoring back the normalcy and that suitable environment suitable for them to co-exist. Greene (2011) states that there has been difficulty in defining resilience but theorists have summarised it simply as those mechanisms that are used to cope and adapt after an adverse event (pp.315-316). The principles of these theories have its foundations developed from the works of Freud, Bowlby, Ellis, Werner and Smith that bring out those mechanisms that provide that protective environment for those children who have been rescued from such abusive situations (Greene, 2011).

2.2 Review of Empirical Findings

2.2.1 Impact of Parental Substance Misuse on Children

Various research studies have provided empirical evidence on the impact of parental substance misuse on children. Most of the findings have shown that most of the child outcomes are often negative. Parental substance misuse has been strongly associated with child maltreatment in terms of neglect and child abuse (Freisthler & Holmes, 2012, p.26). Freisthler and Holmes (2012) note that the core social mechanism which allows for child maltreatment outcomes include reduced parental supervision and the impact of social disorganization due to the parent’s alcohol use. The impact on the child also goes beyond neglect and abuse. Kroll (2004) investigated recollections of children’s experiences living with parents who misused drugs. The findings noted that children became detached from their home life as they distorted, denied and kept secret the misuse of drugs by their parents. In this case, the child would cover up such drug misuse and pretend that life at home was normal. This resulted in detachment from reality for the young children, which also affected their social and cognitive development. Bancroft, et al. (2004) had similar findings in his recount of childhood experiences with substance using parents. Bancroft, et al. (2004, p. 8) interviewed 38 young people aged 15 to 27 who had at least one parent with substance misuse problems. Findings showed that core impacts included physical violence and verbal abuse which affected the self esteem and physical safety of the child. Other impacts included long parental absences which caused fear and uncertainty. While the children valued the relationship with their parents, most found it hard to communicate and relate with them while others had a feeling of loss about their parents not showing interest in them (Gorin, 2004, p.57). Another major impact faced by the children is role reversal. Some children took up the roles of taking care of their siblings and parents, resulting to role confusion, and making the child miss out on their childhood (Kroll, 2004, p.132). Moore, McArthur and Noble-Carr (2011) interviewed 15 children aged 11 to 17 years of age to investigate the level of care the children provided their parents with alcoholic or drug use problems. Findings from the qualitative study indicated that the children who were older spent a lot of time taking care of both their parents and younger siblings. The types of care provided included emotional support such as worrying about their parents' health or listening to their problems and financial support such as ensuring bills are paid, working part time or stealing food from stores. Other forms of care included personal care such as giving medication to parents, household tasks such as cleaning and cooking, caring for the siblings as well as monitoring the safety of the home, such as removing items which may cause harm to their parents when they are intoxicated (Velleman & Templeton, 2007, p.80). Research studies further showed that the impact of such care did not make the children any better off in terms of resilience, rather most had little confidence, little hope for the future, and poor self esteem (Moore, McArthur & Noble-Carr, 2011, p.171; Tunnard, 2002, p.20). Bancroft, et al. (2004, p.7) had similar findings where they noted that most of the children who had to take care of themselves faced higher risks of physical harm due to leaving electrical appliances on as they did house chores. A review of research also showed a close association between the numbers of children who entered the formal social care system, such as foster home placements with parental substance misuse. In Forester and Harwin’s (2006) research article, the core focus of investigation was the degree to which substance abuse in parents related to social work case overloads in Britain. They found that 34% of 290 social work cases involved some form of substance misuse from the parents. Of these 34%, the study further found that 62% of the children were undergoing proceedings to place the children in care, while 40% of the children had already been registered in child protection care. Furthermore, the study found the cases with parental substance misuse had the most vulnerability to child social care, as it involved children who were younger and parents who had a number of personal and social problems. A chi-square analysis between categories of social cases with parental substance abuse and those without parental substance abuse showed there is a stronger relationship between child social cases and substance misuse than there is between child social cases and non substance misuse. This finding was further supported by a subsequent research by the author to investigate the welfare of children in social care. Forrester and Harwin (2008) investigated the welfare of children allocated a social worker two years after referral to social care. Findings from 100 families with substance misusing parents across four London boroughs showed that after two years since referral, only 46% of the children remained with their parents, 26% of the children lived with other family relatives while 27% of the children had entered into the formal foster care system. Furthermore, the follow up indicated that 47% of them had no problems as they exhibited good emotional, behavioural and health development. 31% of the children continued experiencing problems, while 22% had more problems that they had years before referral. One of the core reasons which contributed to such poor welfare outcomes was the children remaining to stay at home with their parents than those who entered formal care. While entering formal care may have positive child outcomes, overall, it may still result to negative child outcomes due to parental separation and abandonment, resulting in a crisis of self identity as the child grows into an adolescent (Shaffer, 2009, p. 132; Tunnard, 2002, p. 20). In addition to these impacts, young children whose parents had problems with drug and alcohol use, tended to have problems in both psychosocial and cognitive development. Alshuler and Cleverly-Thomas (2011, p. 45) evaluated the health and wellbeing of 399 children aged from newborn to age 16 taken into care and whose parents abused methamphetamine. Psychosocial assessments and developmental screenings showed that 36% of the children had problems communicating, 30% had poor social and personal skills, and 28% had problems in problem solving and motor skills. For all children, withdrawn and aggressive behaviours scored highly, followed by post traumatic stress, dissociation, and anxiety. This finding has been supported by Ostler, Bahar, and Jessee (2010, p. 193) who found that children from misusing parents who had more social problems, were more aggressive and depressed and were less socially competent. For most part, most children were socially isolated due to feelings of shame that they could not bring their friends to their homes (Velleman & Templeton, 2007, p.80). In other cases, the parents’ behaviour tended to manifest itself in the future through the children’s behaviour. Chen, Propp, deLara and Corvo (2011) investigated 251 neglected children over a 17 year period to examine the relationship between childhood neglect and the likelihood of substance abuse in adolescent age. Findings from the study found that children who had experienced some form of neglect or who experienced violence in childhood were at a higher risk of misusing drugs and alcohol. Taking into account that parents who misuse drugs are likely to neglect and physically abuse their children, and then there is a likelihood of adolescents from such homes to also abuse drugs. Harwin (2008, p.365) had similar findings. The author explored the link between parental substance misuse and their children’s substance misuse and found a positive link due to the higher risk of exposure to the young people in such homes. On the other hand, research studies have indicated that there are gender differences with regard to child outcomes on parental drug misuse. For instance, Scaife (2008, p.53) found that child outcomes for problem substance users in the UK were worse off where the mothers misused substances than where the fathers did. Other findings such as Callaghan, Crimmins and Scweitzer (2011) and Bancroft, et al (2004) noted that drug misusing fathers were more likely to be violent than the mothers. Stigma tended to be more acute where the mother was misusing alcohol or/ and drugs. On average, the children, particularly males, viewed their mothers as victims, especially if the male partner was also using drugs.

2.2.2 Social Work Interventions

Working Together statutory guidance promotes a multi-agency child protection (DfE 2010). The role of the social workers in the multi-agency working is imperative in ensuring that early help is provided to the children. This also enhances the evidence based services provided by various agencies since a social worker is required to be able to make decisions regarding the type of response necessary in various child cases as soon as possible after referral, often a day (The London Safeguarding Children Board, 2013, p.2). Social work interventions are imperative in ensuring that children are protected and grow in a safe environment. Social work interventions have mainly been of two forms, working with the children as well as working with families to protect and help discern adversity witnessed amongst children in households with parental substance misuse (Social Services Improvement Agency, 2010, p.4). In addition, after the children are protected from the compelling adverse conditions witnessed in such rocky relationships in those households with parental substance abuse, there is the need to embark on a resilient theory to quench the adversity experienced by these children (Flynn, Dudding, and Barber, 2006, pp. 36-37). These measures have played a vital function in creating a recuperative environment that turns the adversity experienced and the risks that may reappear in the future. The emphasis on resilience also suggests the factors that are embraced to facilitate further protection of the children who have been influenced negatively in those households with parental substance abuse (Social Services Improvement Agency, 2010, p.4; Flynn et al., p.36). Gorin (2004) and Murphy and Harbin (2003, p.362) highlighted the need to communicate with children and making them understand the problems they and their parents are faced with. This especially helps in reducing confusion and feelings of isolation in children. In addition, Templeton, Novak and Wall (2011, p.172) found that young people viewed social services where they meet in groups and share their experiences and talk, learning about alcohol and drug additions, and learning to control their emotions as having been crucial in the dealing with parental substance misuse. Thus, Social workers need to work with children to encourage engagement with supportive people outside the family, engage in activities such as sports or clubs which would ensure their development of self esteem and a sense of self, and develop a desire and pride in being resilient and a survivor in times of adversity (Gorin, 2004, p.127). In particular, social workers help the children to build their strengths as well as develop meaning in their lives, help them acquire social skills and reframing negative experiences into positive ones. Nagle and Watson (2008) analyses intervention initiatives to enhance child outcomes for children with drug and alcohol misabusing parents in Islington. In the intervention programmes, social workers linked together both adult treatment programmes for parents with drug or alcohol problems as well as social care services for the children. This was aimed at balancing the safety needs of the children as well as the treatment needs of the parents, with a core purpose of preserving the family unit. Forrester, Copello, Waissbein and Pokhrel (2008, p. 410) investigated the success of an intensive family preservation interventions and noted that this service helped in meeting the UK government's goal of reducing the number of children entering care due to parental substance misuse. The study found that the intervention approach was highly professional, had significant cost savings to social work, and achieve permanent changes in most cases, even for the most complex of problems. These include motivational interviewing within the home and family setting and conducting periodical assessments to determine the safety of the child. A family focused intervention approach aims at improving family functioning and thus making it a safer place for children (Hayden, 2004, p.19). This aligns with Traube’s (2012) argument that involving families within the intervention mechanisms is imperative in enhancing the quality of child outcomes in the long term. Child protection procedures aim at restoring that required environment for the children abused and apprehending the perpetrators. The procedures include the relevant hotline numbers that have been released by the authorities such as the police where an individual feels that a child might be a victim of any significant harm arising from abuse should call and report (Kay, 2003, pp.75-76). Child protection procedures are stipulated by agencies and the information pertaining to how such matters are handled is emphasised. When an individual comes across a child who is a victim of abuse and gets to know the story should report these to the relevant authorities so that the necessary action is taken in response to that case of suspected child abuse (O'brian, Cheng Chung and Rhind, 1997, pp.5-6). The procedures have been initiated in the education sectors and awareness created where children are asked to share any information related to abuse whilst in the school or at their households. This is in revelation to those children who might suffer silently yet as they do not have that peace of mind in those households with parental substance abuse (Kay, 2003, pp. 75-76). This framework involves confidentiality of the information that is used to track down such scenarios and the principles discerned by the social work with the aim of protecting the children are embraced. Williams and Pritchard (2006) state that Section 175 of the Education Act 2002 explains the fundamentals of child protection and the necessary guidelines that both the public and private sectors should report cases of child abuse and any prevailing risks that could lead to such (p.138). Other social care interventions with greater child outcomes have focused on placing children with their birth families where possible rather than foster system. Kroll (2007, p.84) asserts that placing the children within their birth families as stipulate by the Children’s Act of 1989 is an important protective factor for vulnerable children. Kinship care provides children with a safe haven and helps in their sense of self and self identity development, than those placed in foster care systems. However, the type of social worker intervention highly relies on the age of the child as well as the level of risk the child is exposed to. For instance the Social Services Improvement Agency (2010, p.7) notes that different tiers of child social care needs align with different interventions. For instance, a child who is at risk of death and requires immediate protection and mitigation of such threats would seek help through intervention methodologies such as; contacting the child protection services or Court Protection Section 47 and cp protocols that provide that likelihood of promoting children’s welfare. This is through the implementation of the Common Assessment Framework (CAF) that is carried out through enquiries. This is as compared to children who have been profoundly been harmed due to parental substance abuse. In such a case, interventions may include family focused support, support from youth worker and teachers for the child, support child line services, counselling, as well as positive parenting services among others.

3.0 Analysis and Discussion

This section analyses and discusses the findings of the study. First, application of the theoretical perspectives of empirical evidence is evaluated and then the case study of ChildLine analysed based on theory and empirical evidence. Afterwards, ethics in conducting this study are examined as well as various policies which affect the impacts children are exposed to, due to parental substance misuse. Finally, this section closes with a discussion on the implication of the findings for social workers.

3.1 Application of Theory to Empirical Evidence

From the above empirical evidence, it can be noted that a number of impacts can be explained by either of the theoretical perspectives discussed above. Attachment theory as noted above noted that disrupted parent child relationships have the likelihood of resulting in an insecure child. From Kroll’s (2004) findings, it can be noted that children whose parents misuse drugs or alcohol, become detached from their home life and tend to pretend that life at home was normal. This aligns well with attachment theory where children try to cope by detaching themselves from their problems. Such detachment from reality for the young children can be problematic as it may affect their social and cognitive development. This reduces a sense of emotional security and the quality of bonds between parent and child (O’Connor & Scott, 2007, p.6). Attachment theory can also be applied in Bancroft, et al.’s (2004) and Gorin’s (2004, p.57) findings where core impacts included physical violence and verbal abuse which affected the self esteem and physical safety of the child. This is because this cause fear and uncertainty in the child, making them uncomfortable to get attached and bond with their parents. This aligns with Mikulincer and Shaver (2007) analysis on attachment theory where they noted that inconsistent and unhealthy bonds between the child and the parent disrupts various aspects of the internal self representation of a child and thus resulting in problems in social interactions and predisposing the children to poor emotional control. This further aligns with Velleman and Templeton (2007, p.80) and Moore, McArthur and Noble-Carr (2011, p.171) that children who assume adult roles due to parental drug misuse were not any better off in terms of resilience. Instead most had little confidence, little hope for the future, and poor self esteem. The lack of parental attachment may result to an identity crisis as the child grows older, which may make them even more withdrawn and aggressive (Alshuler & Cleverly-Thomas, 2011, p.45). On the other hand, social learning which postulates that people learn from their social environment though behavioural and cognitive interactions also strongly applies in the empirical evidence. For instance, Freisthler and Holmes (2012, p.26) noted that the core impacts of neglect and child abuse were as a result of social mechanisms such as lack of parental supervision and the impact of social disorganization, all of which the parents may have experienced from their own parents earlier on in life. This theory shows that with no intervention, there is likely to be a vicious cycle of negative impacts to the children of all those who had been raised in households with substance abusing parents. Forester and Harwin’s (2006) found a close association between the number of children who entered the formal social care system with parental substance misuse and noted that the parents who drugs most likely learnt such coping strategies from the previous generation. Harwin’s (2008, p.365) study as well as Chen, Propp, deLara and Corvo’s (2011) seventeen years investigation of children’s changing behaviour found support for social learning theory as parents’ behaviour tended to manifest itself in the growing adolescent’s behaviour. This was due to negative coping strategies they learnt from their parents as well as higher risk exposure to access such drugs. The children who witness the use of drugs by parents increase their familiarity with it and thus a higher likelihood that they would use them. Thus, Bandura’s reasoning in social learning theory that the probability increases that a person will behave in a certain way when they associate with people who behave in the manner holds true in parental substance misuse.

3.2 The Case of ChildLine

3.2.1 Brief Overview of ChildLine

ChildLine a charity and it operates a 24 hour free helpline and online service in the UK whose core purpose is to a confidential platform where children in trouble can call and speak freely about their problems. The aim of the service offered by ChildLine is to help and support young people below the age of 18 who are distressed and to further help in building resilience and independence in child outcomes (ChildLine Report 2012, p.5). The service offers counselling services for young children, and where the counsellors feel that a child may be in danger, other crucial agencies are also referred. In addition, the counsellors and social service workers working with Helpline are primarily volunteers (NSPCC, 2013).

3.2.2 Analysis of Children Experiences

An analysis of ChildLine case notes and recorded child experiences between 2008 and 2012 with parental substance abuse, revealed a number of things which affected children. About 21% on average of all children who called about family relationships aired concerns about parental alcohol misuse while 12% of this number aired their concerns about parental drug misuse. The greatest concern was physical abuse, fear, role reversal and neglect. “My mum drinks all the time and leaves me alone lots of times. I feel scared and lonely. I look after my mum when she drinks. I put her to bed. Mum shouts and hits me; she is worse on a Friday. I don't want to feel pain. I want to die.” (Angel, aged 10) (ChildLine Case Notes, 2010, p.1). The physical violence perpetrated was seen as the main problem (35% of children reported this) due to the tendency of parents becoming aggressive after intoxication. This also resulted to fear due to various factors such as fear of abandonment or parental separation if taken in by the foster system, fear of violence either to the child or between the parents, and fear of arguments. This aligns with Kroll’s (2004) and Moore, McArthur and Noble-Carr (2011) findings. Sexual abuse and neglect also featured prominently on the concerns of children who contacted ChildLine concerning parental substance abuse where 10% talked of sexual abuse and 4% talked of neglect. Taking on the roles of the parent, and relying on themselves were also some of the impacts the children faced. For most parts, the children were worried about their parents’ health, and fear and uncertainty were accompanied by parental drug misuse. Furthermore, 11% of the children who were counselled about alcohol and drug misuse, had also talked about their parents substance misuse (ChildLine Casenotes 2010). Most of these findings align with findings from previous research studies as well as attachment and social learning theory as children try to cope by detaching themselves from their problems and other by emulating their parents alcohol and drug use behaviour. However, a new impact was also noted over the five year period as rising in prominence especially among 13-18 year old. In 2008/2009, children felt like harming themselves or had suicidal thoughts due to parental substance abuse were about 2% (ChildLine Casenotes 2010, p. 9). However, in 2011/2012 period this number rose significantly by 39% from the 2010’s level. “I don’t want to be alive anymore. Mum has just yelled at me, I hate it. I know she can’t control her anger, but now I just want to die. I and my mum don’t get on at all. Mum drinks loads and she doesn’t have time for me anymore. I’ve had some vodka and I have more. I have a razor too and I think that there are about 24 tablets in the house.”(Paula, teenager) (ChildLine Report 2012, p.17). Suicidal thoughts and self harm among young people due to the adverse impacts of parental substance misuse, is a new emerging impact affecting children and young people. While previous research studies have reported on depression, fear, social problems and adolescent drug and alcohol misuse, none has focused on suicidal thoughts and self harm. These may be attributed to reduced sense of emotional security and the quality of bonds with the parents (O’Connor & Scott, 2007, p.6). It may also be due to fear and uncertainty as a result of physical violence and verbal abuse, or may be due to inconsistent and unhealthy bonds between the child and the parent which disrupts various aspects of a the internal self representation and thus resulting in problems in social interactions and predisposing the children to poor emotional control (Mikulincer & Shaver, 2007). By adopting poor coping strategies from their parents, the adolescents who have feelings of hopelessness for the future may also be susceptible to suicide (Backett-Milburn & Jackson, 2012). On average, in every 5 cases reported 1 child was referred to the children’s for protection leaving behind 7% of the total in uncertain resilience in those households with parental substance misuse. These findings are important both for policy makers and for social work practitioners in order to understand how to solve the varying needs of young individuals and children whose parents misuse alcohol or drugs.

3.3 Professional Ethics and Practice Dilemma

In carrying out this research study profession ethics and guidelines were followed. This is especially taking into account those children’s accounts and experiences were necessary in order to draw out the impacts the children are faced with. Since collecting data from children involves various ethical requirements with regard to use of children in research studies, and also requires the researcher to be trained in collecting data from children. Thus, in completing this research study findings were extrapolated from other primary research findings which had been recorded, rather than interviewing of children directly. This helped to comply with core social work professional ethical principles such as empowering people and sharing information effectively without breaching the duty of protecting a young confidant. Furthermore, this research has resulted to continued professional development and a contribution to the continuous improvement social work practice (The Policy, Ethics and Human Rights Committee, 2012, p.15).

3.4 Application of Policies

Over the past decade, there have been policy improvements with regard to reacting to the requirements of children affected by parental substance abuse. The greatest policy change took place with the publication of the Hidden Harm Report in 2003 and a following progress report in 2007. Findings from the progress report found that the government in England adopted 42 out of the 48 recommendations which had been provided in the Hidden Harm report. Coupled with increasing focus on youth work through policies such as Think Family, Respect and Troubled Families policy and the Every Child Matters policy. Children affected by parental substance misuse have increasingly been acknowledged (Adamson & Templeton, 2012, p.83). The National Drug Strategy has had a strong response to parental misuse and the impact on children. However, the recent 2012 Alcohol Strategy has been lax on parental alcohol misuse and the impact on children. This may be attributed to lower response related to harm done by parental alcohol abuse as compared to drugs. Furthermore, policy construction has been strongly focused on protection of young children than young people (p.84). A broader policy construction would be imperative in addressing the issues which both children and youths face.

3.5. Implications for the Effective Social Workers

As noted in the above discussion of social worker intervention, social workers have an important role to play ensuring that children affected by substance abuse are able to have positive outcomes. The findings in this research also have crucial implication for the effective social. A crucial task of the social worker is their ability to identify parental substance abuse as well as be able to gain an understanding of what it entails to be the child as well as the parent in such situations. Training in the skills of how to deal with children affected by substance misuse by the parents based on the cultural differences is imperative in improving outcomes. Furthermore, as noted in ChildLine's case, developing an effective communication means and trust is imperative in enabling and ensuring child focused intervention approach is taken. In terms of the suicide rates which has increased among teenagers who have been strongly affected by the negative outcome of parental substance abuse, adopting a family focused intervention strategy as proposed by Forrester, et al. (2008, p. 410) where the focus in aimed at improving the functioning of the family to make it safer. Furthermore, the young people can receive counselling or take part in a group meeting where children and young people with similar issues come together and talk about it; in order to deal with various issues they encounter (Templeton, Novak, & Wall, 2011).

Sociаl Services

Social services are aimed at protecting children and giving them back their lifestyles that had seemed to be lost. The fundamentals stipulated in the social service objectives centre around the providence of necessity for such children and taking the overall responsibility of bringing the victims of abuse to such places so that they get help. The help does not alienate the parents but rather brings them together and information shared about on how child abuse can be eliminated.

Nаtionаl Advisory Committee on Drugs

The committee estаblished in the yeаr 2000 is determined to work in collаborаtion with the government towаrds erаdicаtion of problems аssociаted with pаrentаl substаnce misuse. According to the lаtest regulаtion published by the nаme of Children First: Nаtionаl Guidelines for the Protection аnd Welfаre of Children, it is the primаry responsibility of the heаlth cаre sector to аddress the issue of pаrentаl substаnce misuse.

Children 1st

Children 1st is the new nаme for the 150 yeаr old Royаl Scottish Society for Prevention of Cruelty to Children (RSSPCC). The orgаnizаtion is dedicаted to working for ensuring а heаlthy аnd secure lifestyle for children. The orgаnizаtion works with pаrents аt а very eаrly stаge. In а study conducted by the orgаnizаtion, Fionа Herriot reported thаt mаjority number of pаrents found thаt direct supported helped them in understаnding the repercussions of their аctions аnd sаve their children from the detrimentаl effects of their own dependence on drugs (Snowden 2008, p. 1).

The orgаnizаtion emphаsizes the need to educаting the fаthers. Educаtion on drugs аnd аlcohol usаge should tаke plаce in schools very аctively. The students mаy invite pаrents over for informаl meetings аnd seminаrs where they cаn be tаught on the subject. Other thаn the need to educаte the mаsses through awareness of the dangers of drug abuse, the orgаnizаtion is аlso plаying аn active role by working in collаborаtion with vаrious locаl аuthorities in ensuring public cаre аnd fаmily group conferencing (Snowden 2008, p.2). Every fаmily thаt is аffected by the tаboo of substаnce misuse is аffected by it in а different wаy. Hence, the need for conferencing is inevitаble. Whаtever decision hаs to be mаde аbout the child should be mаde with the informed consent of the entire fаmily.

Aberlour Child Cаre Trust

The Aberlour Child Cаre Trust orgаnizаtion put together а Think Tаnk thаt consist of members from vаrious professions such аs educаtion, heаlth, criminаl justice, sociаl welfаre аnd аlcohol service providers. Aberlour Child Cаre Trust hаs а mаjor role in аddressing the substаnce misuse issue аs it hаs trаined numerous humаn resources who аre working in the field. Through the reseаrch, the Aberlour Child Cаre Trust put forwаrd vаrious recommendаtions for the policy frаmework in Scotlаnd to erаdicаte the curse of pаrentаl substаnce misuse. Aberlour аlwаys puts the needs of the child first (Cunninghаm 2009, p. 181). Timely identificаtion of risk is the best wаy the problem cаn be resolves. In this context, Aberlour is working with vаrious orgаnizаtions in both public аnd privаte sectors by providing support to the registered members who need help with their аddiction аnd children who need support in аccordаnce with the policy guidelines given by Sociаl Cаre Institute for Excellence (SCIE). For instаnce, Children аnd Fаmilies Sociаl Work Teаms аre now working in collаborаtion with The Glаsgow Community Addiction Teаms. These orgаnizаtions аre working on two bаsic principles of support service provision. These аre listening to the child in need аnd аctive engаgement of pаrents (Vellemаn 2007, p. 80).

NSPCC

NSPCC is аnother orgаnizаtion in the UK thаt is working with the mission thаt cruelty to children must stop. NSPCC is working in different аreаs аcross the UK to ensure thаt children in the UK get the life they deserve. The orgаnizаtion focuses in most аreаs where they cаn mаke the biggest impаct аnd fаcilitаtes chаnge. The orgаnizаtion is working for children who аre fаcing the highest level of risk. It is operаtive in Englаnd through its wide network of 32 brаnches. The orgаnizаtions hаs vаrious ongoing projects by the nаme of Child's Voice Appeаl, Yeаr 1999’s FULL STOP Cаmpаign, creаtion of Child Exploitаtion аnd Online Protection Centre (CEOP) аs well аs the locаl sаfeguаrding children boаrds (LSCBs), аnd creаtion of website by the nаme of INFORM. Through its FULL STOP Cаmpаign, NSPCC mаnаged to get mаssive public support. The number of professionаl involved in the erаdicаtion of the problem registered with INFORM аlone hаs gone from а few hundreds to 5,000 аnd it is currently helping 750,000 people аcross the UK.

NSPCC Helpline served аbout 30,000 аdults in а single yeаr аnd these cаlls mаde it possible for NSPCC to communicаte these cаlls to the police аnd relevаnt аgencies аnd helped 11,000 cаlls.

4.0 Conclusion

The project has synthesised recent literature on child outcomes due to parental drug abuse and further applied theoretical and empirical findings to ChildLine case study, to analyse the impacts of parental child drug abuse based on ChildLine reported cases. Findings from the research indicate that impacts to the child were negative. Such impacts included child maltreatment in terms of neglect and child abuse, child detachment from reality, verbal abuse which affected the self esteem and physical safety of the child and long parental absences which caused fear and uncertainty. Other impacts included a feeling of loss of parents and childhood and children taking care of their siblings and parents. The instance where a child has to undergo this in silence with an aim of protecting and showing care of such parents and in return the parents physically abuses them indicates that measures should be embraced in order to discontinue this from happening. Furthermore, there was a close association between the numbers of children who entered the formal social care system and parental substance abuse, as well as a link between parental substance abuse and future substance abuse by the children. Young children whose parents had problems with drug and alcohol use, tended to have problems in both psychosocial and cognitive development, with the children affected by meth being more aggressive, depressed and less socially competent. Findings from the ChildLine case study align with the above findings. However, a recent emerging impact has been the tendency of children, especially adolescents, tending towards self harm and suicidal thoughts. These may be due to fear and uncertainty as a result of physical violence or verbal abuse, or may be due to inconsistent and unhealthy bonds between the child and the parent which disrupts various aspects of the internal self representation. This results to problems in social interactions and predisposing the children to poor emotional control. A critical implication of these findings is the significance of family focused interventions as well as policy construction aimed at the protection of both children and young people.

5.0 References

Adamson, J. & Tempelton, L. (2012) Silent Voices: Supporting Children and Young People Affected by Parental Alcohol Misuse. Children’s Commissioner. [Online]. Available at: http://www.childrenscommissioner.gpv.uk/force_download.php?fp=%2Fclient_assets%2Fcp%Fpublication%2F619%2FFINAL_OCC_Report_Silent_Voices_Parental_Alcohol_Misuse_FULL_REPORT_Sept_2012.pdf [Accessed 23 April 2013].

Altshuler, S. & Cleverly-Thomas, A. (2012) What Do We Know About Drug-Endangered Children When they Are First Placed into Care? Children Welfare, 90, 3, pp.45-68.

Backett-Milburn, K. & Jackson, S. (2012) Children’s Concerns about their Parents ‘Health and Well-being: Researching with ChildLine Scotland, Children & Society, 26, 5, 381-393.

Bancroft, A., Willson, S., Cunningham-Burley, S., Backett-Milburn, K. & Masters, H. (2004) Parental Drug and Alcohol Misuse: Resilience and Transition among Young people. Joseph RoundTree Foundation. [Online] Available at: http://www.jrf.org.uk/sites/files/jrf/1859352499.pdf> [Accessed 22 April2013].

Baxter, P. & Jack, S. (2008) Qualitative Case Study Methodology: Study Design and Implementation for Novice Researchers. The Qualitative Report, 13, 4, pp.544-559. [Online]. Available at: [Accessed on 20 April 2013].

Callaghan, T., Crimmins, J. & Schweitzer, R. (2011) Children of substance-using mothers: child health engagement and child protection outcomes. Journal Of Paediatrics & Child Health, 47, 4, pp.223-227.

Chen, W., Propp, J., deLara, E. & Corvo, K. (2011) Child Neglect and Its Association With Subsequent Juvenile Drug and Alcohol Offense. Child & Adolescent Social Work Journal, 28, 4, pp. 273-290.

ChildLine Casenotes (2010) Children Talking to ChildLine about Parental Alcohol and Drug misuse. [Online]. Available at: [Accessed 23 April 2013].

ChildLine Report (2012) Saying the Unsayable: What is Affecting Children in 2012. [Online]. Available at: [Accessed 23 April 2013]

Cleaver, E. (2007) Child protection, domestic violence and parental substance misuse; family experiences and effective practice. Reference & Research Book News, p. 5.

Cunningham, G. (2009) Where drugs rule, children suffer. Community Care, p. 181.

Flynn, R.J, Dudding, P.M, and Barber, J.G. (2006) Promoting resilience in child welfare. Ottawa, University of Ottawa Press. Available http://books.google.co.ke/books?id=sNFoU8ls7HgC&pg=PA34&dq=resilience+theory&hl=en&sa=X&ei=1oeIUYPaKImN7Aboz4DgBA&ved=0CDgQ6AEwAg#v=onepage&q=resilience%20theory&f=false [Accessed on 7 May 2013].

Forrester, D., Copello, A., Waissbein, C. & Pokhrel, S. (2008) Evaluation of an intensive family preservation service for families affected by parental substance misuse. Child Abuse Review, 17, 6, pp. 410-426.

Freisthler, B. & Holmes, M. (2012) Explicating the Social Mechanisms Linking Alcohol Use Behaviours and Ecology to Child Maltreatment. Journal Of Sociology & Social Welfare, 39, 4, pp. 25-48, Academic Search Premier, EBSCOhost. [Accessed on 19 April 2013].

Gorin, S., (2004) Understanding What Children Say: Children’s experiences of domestic violence, parental substance misuse and parental health problems. London: National Children’s Bureau.

Greene, R.R. (2011) Human Behaviour Theory, and Social Work Practise. Transactional publishers, Berrue Circle Piscataway, New Jersey. Available at:
Guajardo, N. R., Snyder, G. & Petersen, R. (2009) Relationships among parenting practices, parental stress, child behaviour, and children's social-cognitive development. Infant & Child Development, 18, 1, pp. 37-60.

Harwin, J. (2008) Focusing on Parental and Young People's Substance Misuse: exploring the links. Child Abuse Review, 17, 6, pp. 365-370.

Hayden, C. (2004) Parental substance misuse and child care social work: research in a city social work department in England. Child Abuse Review, 13, 1, pp. 18-30, Academic Search Premier, EBSCOhost, [Accessed on 19 April 2013].

Hek, G & Moule, P. (2006) Making sense of Research: An Introduction for Health and Social Care Practitioners (3rd ed). London, Sage

http://books.google.co.ke/books?id=HFdMYRa3-GoC&pg=PA315&dq=resilience+theory&hl=en&sa=X&ei=ALmIUdzuOsTcPfHXgZgG&ved=0CC0Q6AEwAA [Accessed on: 7 May 2013].
Johnson, M. (2003) Parental Substance Use and Safeguarding Children Workshop. NSPCC, p. 1-21.

Kay, J. (2003) Protecting children a practical guide. London, Continuum. Available at: http://books.google.co.ke/books?id=wrCrBDF6D8EC&pg=PA75&dq=child+protection+procedures&hl=en&sa=X&ei=wJaIUb6wHayy7AbVkYCYBA&ved=0CFkQ6AEwCA#v=onepage&q=child%20protection%20procedures&f=false [Accessed on: 7 May 2013].

Kelley, ML., Klostermann, K., Doane, AN., Mignone, T., Lam, WK., Fals-Stewart, W. & Padilla, MA. (2010) The Case for Examining and Treating the Combined Effects of Parental Drug Use and Interparental Violence on Children in their Homes. Aggression and Violent Behaviour, 15, 1, pp. 76-82.

Kinsfogel KM. & Grych, JH. (2004) Interparental conflict and adolescent dating relationships: Integrating cognitive, emotional and peer influences. Journal of Family Psychology, 18, pp.505–515.

Kroll, B. (2004) Living with an elephant: Growing up with parental substance misuse. Child & Family Social Work, 9, 2, pp. 129-140.

Kroll, B. (2007) A Family Affair? Kinship care and parental substance misuse: some dilemmas explored. Child & Family Social Work, 12, 1, pp. 84-93, Academic Search Premier, EBSCOhost, [Accessed on 19 April 2013].

Mikulincer, M. & Shaver, P R. (2007) Attachment Patterns in Adulthood: Structure, dynamics and change. New York, Guilford Press.

Moore, T., McArthur, M., & Noble-Carr, D. (2011) Different but the same? Exploring the experiences of young people caring for a parent with an alcohol or other drug issue. Journal of Youth Studies, 14, 2, pp. 161-177.

Murphy, M & Harbin, F. (2003) The Assessment of Parental Substance Misuse and its Impact on Child Care in Calder, M & Hackett, S (Eds.) Assessment In Child Care. Russell House, Lyme Regis, England, pp. 353-361.

Nagle, A. & Watson, G. (2008) Parental Substance Misuse: an Islington perspective. Child Abuse Review, 17, 6, pp. 444-453.

NSPCC (2011) Our helplines’ achievements. Retrieved from http://www.nspcc.org.uk/what-we-do/what-weve-achieved/helpline-achievements/our-helplines-achievements_wda72318.html on December 9, 2011.

NSPCC (2013) ChildLine [Online]. Available at: [Accessed on 23 April 2013]

O’Connor, T. & Scott, S. (2007) Parenting and Outcomes for Children. Joseph RoundTree Foundation. [Online]. Available at: [Accessed 22 April 2013]

O'brian, C., Cheng Chung, Y.L, and Rhind, N. (1997) Responding to child abuse: procedures and practice for child protection in Hong Kong. Hong Kong, Hong Kong University Press. Available at: http://books.google.co.ke/books?id=ciy0saL-cxQC&printsec=frontcover&dq=child+protection+procedures&hl=en&sa=X&ei=wJaIUb6wHayy7AbVkYCYBA&ved=0CC0Q6AEwAA [ accessed on: 7 may 2013).
Ostler, T., Bahar, O. & Jessee, A. (2010) Mentalization in Children exposed to Parental Methamphetamine Abuse: relations to children's mental health and behavioral outcomes. Attachment & Human Development, 12, 3, pp. 193-207.

Scaife, V.H. (2008) Maternal and Paternal Drug Misuse and Outcomes for Children: Identifying Risk and Protective Factors. Children & Society, 22, 1, pp. 53-62.

Shaffer, D.R. (2009) Social and Personality Development (6th ed.). Wadsworth, Belmont CA.

Snowden, M. (2008) Parental Substance Misuse. Children 1st, p. 1-4.

Social Services Improvement Agency (2010) What works in promoting good outcomes for children in need where there is parental substance misuse? [Online]. Available at: < http://www.qni.org.uk/docs/What_works_in_promoting_good_outcomes.pdf> [Accessed on 22 April 2013]

Templeton, L., Novak, C. & Wall, S. (2011) Young people's views on services to help them deal with parental substance misuse. Drugs: Education, Prevention & Policy, 18, 3, pp. 172-178.

The London Safeguarding Children Board (2013) Briefing on working Together to safeguard Children 2013. [Online] Available at: [accessed 22 April 2013]

The National Treatment Agency (2012) Parents with Drug Problems: How Treatment Helps Families. [Online]. Available at: [Accessed 22 April 2013]

The Policy, Ethics and Human Rights Committee (2012) The Code of Ethics for Social Work: Statement of Principles. [Online]. Available at: [Accessed 23 April 2013]

Traube, DE. (2012) The Missing Link to Child Safety, Permanency, and Well-Being: Addressing Substance Misuse in Child Welfare. Social Work Research, June, Academic Search Premier, EBSCOhost, [Accessed on 19 April 2013].

Tunnard, J. (2002) Parental Drug Misuse – A Review of Impact and Intervention Studies. Research in Practice, [Online]. Available at: [Accessed 22 April 2013].

Valentine, G, Jayne, M, & Gould, M. (2010) Alcohol Consumption and Family Life. Joseph RoundTree Foundation. [Online]. Available from < http://www.jrf.org.uk/sites/files/jrf/alcohol-family-life-summary.pdf> [Accessed 20 April 2013].

Velleman, R. & Templeton, L. (2007) Understanding and Modifying the Impact of Parental Substance Misuse on Children. Advances in Psychiatric Treatment, vol.13, pp. 79-89.

Vincent, S, & Daniel, B. (2004) An analysis of children and young people's calls to ChildLine about abuse and neglect: a study for the Scottish Child Protection Review. Child Abuse Review, 13, 2, pp. 158-171, Academic Search Premier, EBSCOhost, [Accessed on 22 April 2013].

Williams, R., and Pritchard, C. (2006) Breaking the cycle of educational alienation a multi-professional approach. Maidenhead, England, Open University Press. Available at: http://books.google.co.ke/books?id=NSjgimNX0fsC&pg=PA138&dq=Education+Act+2002-reporting+cases+of+abuse+of+children&hl=en&sa=X&ei=WZyIUfn0OIuN7AaHyoD4Cw&ved=0CDoQ6AEwAg#v=onepage&q=Education%20Act%202002-reporting%20cases%20of%20abuse%20of%20children&f=false [accessed on: 7 May 2013].