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

We developed FEDUP, a whole family approach to working with substance misuse, to help protect children living with parents who have drug or alcohol problems. FEDUP is no longer being delivered, but we carried out an evaluation to find out how effective it was.

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

FEDUP aimed 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 our evaluation suggests that it can help reduce the negative impact of parental drug and alcohol misuse on children.

How we evaluated 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 were 2 components to the evaluation of FEDUP, an impact evaluation and a process evaluation.

Impact evaluation

The impact evaluation was a quasi-experimental study. It used a naturally occurring group of children and parents waiting to take part in FEDUP as a comparison group. Parents and children only became part of the comparison group where there wasn't an appropriate group for them to join immediately so they would be waiting to receive the service regardless of the evaluation.

We used psychometric measures to assess the key primary outcomes of the service. We collected measures at 4 time points:

  • T0: at least 8 weeks before the programme begins (where families were 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

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

We also interviewed practitioners who delivered FEDUP. This provided an insight into their perspectives on the outcomes that the programme achieves.

We also interviewed professionals who referred families to the service.

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

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

Some parents weren't ready to take part in FEDUP so they didn't complete the programme.

These challenges 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 non substance using parents or carers.

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

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

Find out more about the tools used to measure outcomes

Contact our Evaluation team for more information.

What we learnt

Our final evaluation of FEDUP found that children who had completed the programme had higher self-esteem and were more able to process their feelings. They felt less angry and anxious; less responsible for their parents' behaviour; and more able to talk to their parents about their concerns. Those whose parents were actively engaged in the programme experienced more positive changes than those whose parents were less engaged.

Parents who took part in FEDUP reported having more understanding of how their substance use affects their children; being more able to communicate with their children; and establishing calmer home environments.

Some of these positive changes were maintained 6 months after the programme finished.

Read the final evaluation.

Impact and evidence

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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References

  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.