Family Environment: Drug Using Parents (FEDUP) Evidence, impact and evaluation

We’ve developed FEDUP, a whole family approach to working with substance misuse, to help protect children living with parents who have drug or alcohol problems. The evidence so far suggests that it can help reduce the negative impact of parental drug and alcohol misuse on children.

How families' multiple and complex needs affect children

There is a growing emphasis on the need for more effective early intervention to help support families who have multiple and complex needs. Recent research (Devaney et al, 2013) suggests that the majority of serious child abuse cases involve families where parents are experiencing multiple challenges.

Experiencing social isolation, substance misuse, domestic abuse or mental health problems can make it harder for parents to deal with family life and put pressure on relationships. Those exposed to multiple adversities in childhood are at increased, cumulative risk of negative psychological, emotional and health-related outcomes in later life (Davidson et al, 2012).

Read more about child abuse and neglect.

How FEDUP is helping prevent child abuse and neglect

Children living with parents who have drug or alcohol problems can be more at risk of abuse and neglect. Although not all parents who drink or take drugs harm their children, parental substance misuse is a common factor in both serious case reviews and child protection plans (Forrester and Harwin, 2006; Brandon et al, 2010).

Research shows that parental drug use has the potential to interfere with virtually all aspects of a child’s health and development (ACMD, 2003, 2006).  However there is a lack of research into child protection interventions that identify and address this (Montgomery et al., 2009).

Existing research suggests that ways to help protect children from harm might include:

  • providing children with the opportunity to share their difficulties in a safe setting
  • developing a sustainable relationship with a trusted adult (Houmoller et al, 2011).

There is clear evidence that the best intervention for children is when their parent stops taking drugs. Sometimes it’s enough for parents to be challenged about their behaviour, and to show them the impact of their misuse on children (Barnard and McKeganey, 2004).

FEDUP is targeted at both children and their parents to provide a family based intensive intervention for some of the most vulnerable children.

FEDUP aims to:

  • provide a safe, confidential space where children can express their feelings and build self-esteem
  • help parents understand how their children are affected by their drug or alcohol problems
  • reduce the negative impact of parental alcohol and drug misuse on children
  • ensure that children are kept safe.

The FEDUP service was developed by the NSPCC in Grimsby, and was evaluated with positive results. The current evidence base gives clear indications that a whole family approach is likely to achieve better outcomes for the child.  

How we're evaluating this service

Using self-reported measures completed, at the beginning and end of the programme, we examined the outcomes of FEDUP for children and parents where parental substance misuse is a problem. We also conducted qualitative interviews with those who completed the programme to understand what aspects of it were most and least helpful.

There are 2 components to the evaluation of FEDUP, an impact evaluation and a process evaluation.

Impact evaluation

The impact evaluation is a quasi-experimental study. It uses a naturally occurring group of children and parents waiting for a group to commence as a comparison group. Parents and children only become part of the comparison group where there isn't an appropriate group for them to start immediately and they would be waiting, regardless of the evaluation, to receive the service.

Key primary outcomes of the service are measured using psychometric measures. Measures are collected at 4 time points:

  • T0: at least 8 weeks before the programme begins (where families are unable to start immediately)
  • T1: just before starting the programme
  • T2: at the final session of the programme
  • T3: 6 months after leaving the programme.

Process evaluation

13 children and 12 parents who completed FEDUP have been interviewed as part of the process evaluation. The interviews explored the experiences of service users and helped to identify underlying facilitators and barriers to the programme bringing about change for parents and children.

12 NSPCC practitioners who deliver FEDUP have also been interviewed, providing an insight into their perspectives on the outcomes that the programme achieves.

Referrers to the service will also be interviewed.

Parents who had problems with drugs and alcohol, sometimes struggled to complete the tool or measure they were given as part of the evaluation.

Often the parent engaged in the service wasn't the parent with alcohol or substance misuse difficulties so it wasn't appropriate for them to complete the measure.

These challenges, combined with drop out of parents from FEDUP, made it difficult to collect T1 and T2 data from parents. To overcome this, practitioners built in extra time in sessions for parents to focus on the evaluations. We also introduced an additional questionnaire to capture the views of carers or the non substance using parent.

This evaluation was carried out internally by the NSPCC evaluation department. It used the following measures:

  • Child Abuse Potential Inventory (CAPI) (protective parenting)
  • Adapted Rosenberg Self Esteem Scale for Children (child's self-esteem)
  • Strengths and Difficulties Questionnaire (children's emotional wellbeing)
  • HoNOSCA (children's social functioning)
  • Parent's Evaluation Wheel (non- standardised) (parent understanding of impact of behaviour on child)
  • Children's Evaluation Wheel (non- standardised) (children's safety skills)

Find out more about the tools used to measure outcomes

Contact Prakash Fernandes or Rachel Margolis for more information.

What we've learnt so far

Interim results from the pre and post measures and interviews with parents and children were published in October 2014. The findings provide promising evidence that FEDUP can help reduce the negative impact of parental drug and alcohol misuse on children.

Read the interim evaluation.

What we're doing next

A final evaluation report is expected to be published in early 2016. It will provide more insight into whether the programme was effective in changing parents' understanding, attitudes, and behaviour in the long-term. It will include findings from a comparison group who were on the waiting list for this service. It will also include interviews with practitioners delivering the programme, and the agencies who referred families to the service.

Impact and evidence hub

Find out how we evaluate and research the impact we’re making in protecting children, get tips and tools for researchers and access resources.

Our impact and evidence

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  1. Advisory Council on the Misuse of Drugs (ACMD) (2006) Hidden harm three years on: realities, challenges and opportunities. London: Advisory Council on the Misuse of Drugs (ACMD).

  2. Barnard, M. & McKeganey, N. (2004) The impact of parental problem drug use on children: what is the problem and what can be done to help? Addiction 99: 552-559. [Freely view abstract or access full text by subscription: Addiction 99: 552-559].

  3. Brandon, M., Bailey, S. and Belderson, P. (2010) Building on the learning from serious case reviews: a two-year analysis of child protection database notifications 2007-2009 (PDF) . London: Department for Education (DfE).

  4. Davidson, G., Bunting, L. and Webb, M.A. (2012) Families experiencing multiple adversities: a review of the international literature (PDF). Belfast: Barnardo's Northern Ireland.

  5. Devaney, J., Bunting, L., Hayes, D. and Lazenbatt, A. (2013) Translating learning into action: an overview of learning arising from case management reviews in Northern Ireland 2003-2008. Belfast: Department of Health, Social Services and Public Safety (DHSSPS).

  6. Forrester, D., and Harwin, J. (2006) Parental substance misuse and child care social work: findings from the first stage of a study of 100 families. Child and Family Social Work 11(4): 325-335. [Freely view abstract or access full text by subscription: Child and Family Social Work 11(4): 325-335].

  7. Houmoller, K. et al (2011) Juggling Harms: Coping with parental substance misuse­. London: London School of Hygiene and Tropical Medicine.

  8. Montgomery, P. et al (2009) Systematic Reviews of Interventions Following Physical Abuse: Helping Practitioners and Expert Witnesses Improve the Outcomes of Child Abuse. Department for Children, Schools and Families, London.