A Systematic Review of Qualitative Studies Exploring Lived Experiences, Perceived Impact, and Coping Strategies of Children and Young People Whose Parents Use Substances

Abstract

Parental substance use is highly prevalent worldwide, presenting major child safeguarding and public health concerns. Qualitative research enables in-depth understanding of how young people experience parental substance use and helps inform practice and policy through illustrative cases of experiences. This review aimed to synthesize published qualitative evidence exploring the lived experiences, perceived impact, and coping strategies of children and young people whose parents use substances. International literature databases including Medline, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, International Bibliography of the Social Sciences, Social Science Database, Sociology Collection, and Scopus were searched from inception to 2022, alongside grey literature searching and relevant websites. Qualitative accounts were included, provided by participants aged below 25 years. No language, date, or geographical limits were applied. A thematic synthesis of 35 studies, across 49 papers, covering over 700 children and young people’s voices, identified five overarching themes. These themes included, (a) living with the unpredictable: insecurity within the family; (b) social and emotional impact of parental substance use; (c) controlling the uncontrollable: creating safety within the family; (d) coping with and resisting the emotional and social impacts; and (e) formal and informal support. The findings emphasize that children and young people who experience parental substance use are trying to manage and mitigate vulnerabilities and be resilient to unpredictable, adverse, and often stigmatizing experiences, usually without formal support in place. Further research is needed to coproduce child-centered interventions that promote children and young people’s social and emotional resilience.

Co-producing an intervention to prevent mental health problems in children in contact with child welfare services

“…Both youth and family focused components were considered a priority within our co-production activities. As has been found in other studies of children experiencing adversity [70][71][72] and/or mental health problems [73], participants highlighted the need for CYP to be supported both separate to and within family structures. The initial phase of the intervention is an activity-based, youth focused intervention consisting of one-to-one interactions with a consistent practitioner with the primarily focus being upon building a relationship.…”

Co-production workshops with families experiencing multiple and interacting adversities including parental mental health, substance use, domestic violence, and poverty: intervention insights and principles from mothers, fathers, and young people

“…The current research explores insights of mothers, fathers, and young people who experience parental substance use, mental health, domestic violence and/or poverty in order to establish intervention principles that would guide intervention development. Previous co-production studies (39)(40)(41) and qualitative studies (42)(43)(44) have typically focussed on a single risk factor or only explored insights from one family member group (e.g., mothers or children). Whilst such studies provide an important understanding of experience and impact, they lack the understanding of how these risks often cluster and exacerbate adversity, as well as how to address support within the whole family.…”

The association between maternal and paternal substance use and child substance use, internalizing and externalizing problems: a systematic review and meta‐analysis

“…However, it is unlikely that providing treatment to substance using parents only will be enough to ameliorate vulnerability in affected children. Rather, children whose parents use substances may require support in their own right [69, 70] to mitigate risk coming from genetic vulnerability [71], reduce intergenerational trauma [72] and the impact of the adversity [5]. Supportive interventions for children who experience maternal and/or paternal substance use may also be needed to meet their needs as young carers [73].…”