Effectiveness of psychosocial interventions for reducing parental substance misuse

McGovern, Ruth; Newham, James; Addison, Michelle; Hickman, Matthew; Kaner, Eileen

doi:10.1002/14651858.cd012823.pub2

Cited by 18 publications

(20 citation statements)

References 156 publications

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“…The appropriateness of involving the child in the intervention may be affected by the level of exposure the child has to the parent’s alcohol misuse, the risks associated with their pattern of alcohol use and the age of the child. Further, a recent meta-analysis found that parents did not reduce the frequency of their alcohol use when children were involved in psychosocial intervention sessions and it was suggested that the presence of the child may affect the parent’s engagement with the intervention ( McGovern et al., 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…A major review of UK child protection services highlighted the importance of preventive rather than reactive services as being more effective in improving child welfare ( Munro, 2011 ). Despite this, there is no established preventative intervention for parental alcohol misuse ( McGovern et al., 2021 ). Further, there remains uncertainty about who is best placed to respond to these lower level alcohol needs and what severity and nature of alcohol-related concern merited intervention from social care ( Hafford-Letchfield et al., 2017 ).…”

Section: Introductionmentioning

confidence: 99%

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Preferences for Delivering Brief Alcohol Intervention to Risky Drinking Parents in Children’s Social Care: A Discrete Choice Experiment

McGovern

Homer

Kaner

et al. 2022

Alcohol and Alcoholism

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Aims Many parents in contact with children’s social care services misuse alcohol however do not meet the threshold for specialist alcohol treatment, and typically do not receive appropriate support for their needs. Brief alcohol interventions have been found to be effective in healthcare settings, however, it is unknown whether the brief intervention structure delivered within health settings would transfer well into children’s social care. This paper aims to examine the characteristics of brief intervention for alcohol misusing parents which social care practitioners consider to be important and acceptable to implement in this sector. Methods We assessed preferences for, and acceptability of, brief alcohol intervention with parents in contact with children’s social care using a discrete choice experiment. We recruited 205 children’s social care practitioners from London and the North East of England. Data were analysed using mixed logit which accounted for repeated responses. Findings Six attributes showed statistically significant coefficients, suggesting that a brief intervention with these attributes would encourage implementation. These were: level of alcohol-related risk targeted; intervention recipient; timing of intervention; duration of sessions; number of sessions and intervention structure. The attribute of most importance identified based on the attribute with the largest coefficient in the conditional logit model was risk level. Conclusions Brief alcohol interventions delivered to parents in social care should focus on the impact upon children and the wider family, they should be a flexible part of on-going casework and should be more intensive and less structured.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Preferences for Delivering Brief Alcohol Intervention to Risky Drinking Parents in Children’s Social Care: A Discrete Choice Experiment

McGovern

Homer

Kaner

et al. 2022

Alcohol and Alcoholism

View full text Add to dashboard Cite

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“…Due to the complexity and multilayered risk in families affected by parental substance misuse, there is growing consensus that integrated and family-focused intervention models that address the cumulative and complex nature of vulnerabilities are needed (McGovern et al, 2021;Niccols et al, 2012aNiccols et al, , 2012b. A range of intervention models have been developed and are often focused on reducing parent psychopathology and improving the capacity to parent in a sensitive and developmentally appropriate manner (Eggins et al, in press;Syed et al, 2018).…”

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confidence: 99%

Therapeutic Process of Change During Participation in the Parents Under Pressure Program for a Cohort of Parents Who Misuse Substances

et al. 2022

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Objectives Despite a large evaluation literature for interventions aiming to improve the lives of families affected by parent substance misuse, very few studies have examined how families change when engaged with treatment. This study examines the interactive process of change in parent psychopathology and mindful parenting during participation in the Parents under Pressure (PuP) program for parents engaged in community addiction services. Methods Parents (n = 164) provided baseline, mid- and end-treatment measures of parent psychopathology and mindful parenting. Cross-lagged modelling was used to examine therapeutic process of change. Results Parent psychopathology decreased, and mindful parenting increased from baseline to end-treatment (ps < .001). Less psychopathology at mid-treatment predicted higher levels of overall mindful parenting upon completion of the PuP program (p = .005). Examination of the mindful parenting dimensions revealed variation in the therapeutic process of change. While higher levels of Non-Judgemental Acceptance of Parental Functioning (NJAPF) at baseline predicted lower psychopathology at mid-treatment (p = .03), higher levels of Compassion for Child (CC) at baseline predicted greater psychopathology at mid-treatment (p = 0.004). Higher levels of NJAPF mid-treatment predicted lower psychopathology upon treatment completion (p = .023), yet higher levels of Emotional Awareness of Child (EAC) at mid-treatment predicted greater psychopathology upon treatment completion (p = .023). Lower parent psychopathology at mid-treatment predicted higher levels of LFA, EAC, Self-Regulation in Parenting and NJAPF upon completion of the PuP program (ps < .05). Conclusions The findings highlight the importance of reducing parent psychopathology as a precursor to more mindful parenting and also provide new evidence regarding the way in which variation in mindful parenting dimensions influences the therapeutic process of change.

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“…This study targeted DVA and MH, used a brief, one-off empowerment-based approach, and treated these issues as bi-directional, offering concurrent support for DVA and MH, recognising and addressing the relationships between them. Studies targeting MH and SU often demonstrated more mixed or negative impacts on outcomes which could be related to the type of intervention delivered [128], or perhaps because they remove a trauma coping mechanism without providing additional support to manage this. There were also studies that demonstrated singular impacts on outcomes despite attempting to tackle DVA, MH, and SU in combination.…”

Section: Discussionmentioning

confidence: 99%

Family focused interventions that address parental domestic violence and abuse, mental ill-health, and substance misuse in combination: A systematic review

et al. 2022

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Parental domestic violence and abuse (DVA), mental ill-health (MH), and substance misuse (SU) are three public health issues that tend to cluster within families, risking negative impacts for both parents and children. Despite this, service provision for these issues has been historically siloed, increasing the barriers families face to accessing support. Our review aimed to identify family focused interventions that have combined impacts on parental DVA, MH, and/or SU. We searched 10 databases (MEDLINE, PsycINFO, Embase, CINAHL, Education Research Information Centre, Sociological Abstracts, Applied Social Sciences Index & Abstracts, ProQuest Dissertations and Theses Global, Web of Science Core Collection, and Cochrane Central Register of Controlled Trials) from inception to July 2021 for randomised controlled trials examining the effectiveness of family focused, psychosocial, preventive interventions targeting parents/carers at risk of, or experiencing, DVA, MH, and/or SU. Studies were included if they measured impacts on two or more of these issues. The Cochrane Risk of Bias Tool 2 was used to quality appraise studies, which were synthesised narratively, grouped in relation to the combination of DVA, MH, and/or SU outcomes measured. Harvest plots were used to illustrate the findings. Thirty-seven unique studies were identified for inclusion. Of these, none had a combined positive impact on all three outcomes and only one study demonstrated a combined positive impact on two outcomes. We also found studies that had combined adverse, mixed, or singular impacts. Most studies were based in the U.S., targeted mothers, and were rated as ‘some concerns’ or ‘high risk’ of bias. The results highlight the distinct lack of evidence for, and no ‘best bet’, family focused interventions targeting these often-clustered risks. This may, in part, be due to the ways interventions are currently conceptualised or designed to influence the relationships between DVA, MH, and/or SU. Trial registration: PROSPERO registration: CRD42020210350.

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Effectiveness of psychosocial interventions for reducing parental substance misuse

Cited by 18 publications

References 156 publications

Preferences for Delivering Brief Alcohol Intervention to Risky Drinking Parents in Children’s Social Care: A Discrete Choice Experiment

Preferences for Delivering Brief Alcohol Intervention to Risky Drinking Parents in Children’s Social Care: A Discrete Choice Experiment

Therapeutic Process of Change During Participation in the Parents Under Pressure Program for a Cohort of Parents Who Misuse Substances

Family focused interventions that address parental domestic violence and abuse, mental ill-health, and substance misuse in combination: A systematic review

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