Intervention Programs For Children of Substance Abusing Parents: Realist Review and Program Evaluation Study

Abstract

Substance abuse is a pervasive issue affecting Canadian families, and a substantial number of children are impacted by alcohol or drug abusing parents. Children exposed to parental substance misuse are at increased risk for negative psychological, emotional, developmental, and behavioural outcomes, and a substantial proportion will go on to experience substance use issues later in life. Early intervention is key to providing support for these children and ultimately disrupting the family cycle of addiction. However, few family-based programs for children of substance abusing families are reported in the literature and information on program theory is lacking. A 2-study dissertation was conducted in order to address these gaps. First, a realist review study was undertaken to systematically review existing evaluations of family-based interventions aimed at improving psychosocial outcomes for children of substance abusing parents. A systematic search of academic and grey literature uncovered over 30 documents spanning 7 different intervention programs. Data were extracted on contexts, mechanisms, and outcomes for each program. Four demi-regularities, or patterns of program functioning, were found to account for the effectiveness of programs included in this review: 1) opportunities for positive parent-child interactions, 2) supportive peer-to-peer relationships, 3) the power of knowledge, and 4) engaging hard to reach families using strategies that are responsive to socio-economic needs and matching services to client lived experience. Second, a program evaluation of the Renascent Children’s Program was conducted in order to determine effective implementation and program outcomes for participating children and parents. A repeated measures, mixed methods design was used with 19 families (26 parents and 26 children) who enrolled in the program over a 16 month period. Results indicate that the Children’s Program yields significant improvements in child emotional and depressive symptoms, child conduct behaviours, parenting skills, parent emotion regulation, family functioning, and family communication. High levels of implementation fidelity were also found. These two dissertation studies shed light on theoretical process of family-based interventions for children of substance abusing parents and provide preliminary evidence of effectiveness of the Children’s Program.