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Parental alcohol misuse exposes children to a variety of risks.
 
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What can I do?

This section of the website is an overview only. Please look at the Resources section, other areas of the website, the ENCARE page or website for your own country, and key organisations in your country for more information.

Whilst for many of these children and their families, the required response will involve specialist input, particularly where domestic abuse is also present, part of the response is about doing things that any of us would do to respond to a family member, friend, colleague or patient/client who is suffering because of a problem or trauma in their lives.

This support can be offered before as well as alongside specialist input. The partner pages of this site that have considered the response to children living with parental alcohol misuse and to children living with parental domestic abuse contain more detailed information that will not be replicated here. However, the key things to bear in mind include:

  • Acknowledge that you might be the first person a child has spoken to, that they might be very scared and upset, and that they have been very brave in talking to you.
  • To find time in a quiet space for a child to talk to you, in their own words, about the problems at home. To discuss with the child what their needs are and how you can help.
  • To consider the child’s safety first and foremost, the questions that you might need to ask to be able to assess risk, and the action that you might have to take.
  • As far as possible to maintain confidentiality but to discuss with a child that this might not always be possible. Where others do have to get involved, try to talk to the child about this and support them with this, as well as keeping them informed about what is happening if you are able to do this.
  • Ask about how the child copes and what support they have or need. Consider whether family members, the school or other professionals could get involved as part of a wider support package for the child. Help the child to develop a safety plan where appropriate.
  • Ensure that you respond appropriately within the remit of your role. Discuss with the child what help you can offer to them. Ensure that you get the support that you need from your Manager or Supervisor.

The quotes selected below (taken from studies reviewed in Gorin, 2004 pages 57-67) highlight positive things that children have said about people who they have found helpful and supportive:

  • “I feel….happier when I talk about it, than keeping it inside. It helps me because they know a bit what I’ve been through and they know what [my] mum’s been through and it helps a lot” (talking about friends).
  • “I think with the social worker and them, like they talk about stuff, other things at first so I grow to trust them and then we would start talking about stuff like that (the sexual abuse).
  • “It was good because then you knew what they were going through and they knew what you were going through. And you could talk about it; there was some girls and another boy my age and we used to sit down and talk about it” (talking about domestic violence refuges).
  • “….gives me something to look forward to…I did a creative poetry workshop….it gets [my] emotions out, it gets [my] feelings out and it tends to help a lot. It’s kind of therapeutic” (talking about attending a service for young carers).
  • “I phoned ChildLine twice, just to talk to them really. It’s just nice to have someone you don’t know who [you] can put all your bits and bobs on to and even, if they don’t take it in, as long as they are listening. It’s easier to talk to a stranger sometimes because you can let all your real feelings out. You don’t have to worry about what they may think of you. You don’t have to be afraid of saying something” (talking about phone a help-line).


Understandably, however, professionals can feel extremely wary of getting involved and uncertain about the best way of trying to help children living in these environments. Whilst it can seem like some professionals avoid such cases, this is usually because of a lack of knowledge or confidence about what to do, and worry about getting it wrong. Many professionals, including those from some specialist professions (for example, social work) receive no or limited training in dealing with such issues, even where such problems feature regularly and prominently on their caseloads.

However, all of this can often mean that opportunities for identification and intervention and assessment are missed, and children and their families may ‘fall through the net’, only to be picked up further down the line when things are likely to have deteriorated even further for many of these families. What is clear is that the safety and well-being of child(ren) and adult victims (usually mothers) must be paramount.

What is needed?

Most importantly, it is necessary to ask children what they would like to happen when they seek help for their problems at home, and what kind of services they would like to see available to them. Unfortunately, there is very limited data available where children who are living with both parental alcohol misuse and parental violence and aggression have been given an opportunity to talk about these things (although it is worth remembering that where one problem is present very often the other problem will also exist). However, some things that children say they would like include:

  • Telephone help-lines
  • Drop-in centres
  • Fun activity groups
  • Befriending and mentoring services
  • Education initiatives
  • Respite services (many children end up in caring roles to parents or siblings)
  • Individual counselling
  • Group work e.g. support groups or young carers groups
  • Websites and chat-rooms
  • Support for the whole family
  • Support through domestic violence refuges
  • Residential services
  • Alternative living arrangements
  • Support for the non-drinking parent (and other family members, like grandparents)

Children usually want services that are available to them at times and places where it is possible for them to travel to and otherwise access such services, as well as services that are confidential. Most important appear to be services that provide children with the chance to be listened to as they talk about their problems; often children and young people value meeting others who are living or have lived in similar circumstances.

Having services that are child friendly, with age appropriate facilities and literature, are also important. It is also important to remember that a vital component of the support that needs to be available to children and young people will come from their family, friends and even things like pets.

What is out there?

There are virtually no services that specifically respond to children who are living with both parental alcohol misuse and parental violence and aggression. However, there are some examples of services and interventions which respond primarily to one or the other issue and hence, because of the common co-existence of both issues, will respond to (on their own or along with other services) other presenting problems. Examples of some services in England and the UK which are working in this way include the Family Alcohol Service in London and Addaction’s Breaking the Cycle Project. Are there other examples from other countries that can be given here??

One of our ENCARE projects, CHALVI has collected and collated a series of good practice examples where services are responding to children living with both issues. [Link to Good practices report available once published]

There is also evidence that interventions which are focused on supporting the parents can indirectly positively impact upon the children. For example, Behavioural Couples Therapy (BCT) with couples where there is both alcoholism and partner violence has found indications that a child’s psychological functioning can be positively influenced because of the change in parental and/or family functioning which can arise out of a successful BCT intervention (for a summary and references see O’Farrell T et al., 2004).

It is vital that services (children, adult, family, substance misuse, health, social care, domestic abuse) develop effective partnerships to promote efficient and appropriate responses. It will be important to also address each case on merit, rather than assuming that needs across the board will be the same. Further, care plans must outline how each presenting problem will be managed, rather than assuming that if one problem is resolved that the other(s) will also be resolved. A discussion on the key components of effective services to support children in special circumstances (including, of 5 groups listed, children of parents who have alcohol, drug or mental health problems, and children living with domestic violence) identified three broad themes in what must be considered (the context of this is the English / UK system but the underlying principles are applicable anywhere):

1) A holistic, multi-agency approach addressing the needs of the whole child rather than compartmentalising children’s social, educational, health and care needs; 2) The importance of links between adults’ and childrens’ services so that children who are in need because of their parents circumstances can be identified and supported; and 3) The value of providing children in special circumstances with intensive, targeted support within a framework of universal provision” Statham, 2004 p589.

Factors that can promote good working relationships with others include: understanding and respecting role and responsibilities of others; communication; regular contact and meetings; common priorities; joint training; awareness of local services and contacts; clear guidelines and procedures for working together; and maintaining staff teams

In the UK, the Stella Project is an excellent example of support that is in place to facilitate enhanced working of alcohol and domestic violence services in being able to respond to both issues as well as working more effectively together.

Useful reading

1. Cleaver H, Unell I & Aldgate J (1999). Children’s Needs– Parenting Capacity. Impact of parental mental illness, problem alcohol and drug use, and domestic violence on children’s development. London; Stationery Office.
2. Evans D (2006). Children, Alcohol and Family Violence. In Harbin F & Murphy M (2006) (Eds). Secret lives: growing with substance. Working with children and young people affected by familial substance misuse. Lyme Regis; Russell House Publishing; p55-79.
3. 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.
4. O’Farrell T et al. (2004). Partner Violence Before and After Couples-Based Alcoholism Treatment for Male Alcoholic Patients: The Role of Treatment Involvement and Abstinence. Journal of Consulting and Clinical Psychology 72 (2); 202-217.
5. Statham J (2004). Effective services to support children in special circumstances. Child: Care, Health and Development 30 (6); 589-598.

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