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Supporting the children of alcohol dependent parents
Evaluation of the Children of Alcohol Dependent Parents programme identifies critical success factors.

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Innovation fund programme

The Department of Health and Social Care has just (1 June 2023) published an independent evaluation of the Children of Alcohol Dependent Parents (CADeP) innovation fund (IF) programme in England. The programme was evaluated by the Tavistock Institute of Human Relations (TIHR), in partnership with IFF Research, between October 2018 and March 2022.

Context

It is estimated that there are around 120,552 alcohol dependent adults living with children in England, based on data from 2018 to 2019. Of these, around 21% were in treatment in 2020, indicating an unmet need of 79%. Meanwhile, around 478,000 children are living with an alcohol or drug dependent parent, which equates to a rate of 40 children per 1,000 parents.

Parental alcohol misuse (PAM) has a multifaceted impact on children. It also often co-exists with other problems including parental conflict. Parental conflict is defined as conflict between parents that is frequent, intense and poorly resolved. It is not domestic abuse because there is not an imbalance of power, neither parent seeks to control the other, and neither parent is fearful of the other.

The programme

The CADeP IF programme provided funding to 9 areas to support them in innovating and improving systems and practices to enhance the identification of, and outcomes for, children of alcohol dependent parents (ADPs) and their families. It also aimed to increase awareness of parental conflict among services and explore ways of addressing it among such families.

The evaluation

The research team found that the programme led to improvements in the timely identification of ADPs and children of ADPs in three main ways:

  1. Co-location of adult treatment staff with social care
  2. Strategic leadership to facilitate closer collaboration and communication between adult and children’s services teams and other services
  3. Workforce development targeted at children’s services staff and substance misuse practitioners

The evaluation also found that the programme contributed to improvements and innovations for support both parents and children by the four methods listed below. It is clear that the additional funding was key to these:

  1. Hiring new staff to reduce the caseload of treatment providers, giving them the opportunity to engage and support families in more flexible ways
  2. Increasing capacity for the delivery of more whole-family interventions
  3. Integrating parental conflict work into the support provided to parents, children and families
  4. Expanding capacity or introducing new services specifically targeted at children and young people

Impact

The evaluation found three principal impacts

Increased participation rates

Analysis of data on adults receiving treatment for alcohol and drug misuse showed a noticeable increase in the number of parents accessing treatment. In particular, the number of parents accessing treatment increased by 42% between 2017 to 2018 (prior to the start of the pandemic) and 2019 to 2020, while nationally it was just 6% over this period.

Positive impact on parents accessing treatment

Several of the IF projects highlighted statistically significant positive impacts on parents who received whole-family support, including improvements in their wellbeing, parenting, relationship quality and self-reported health outcomes.

These findings were supported by qualitative evidence, which showed that parents valued the way whole-family support often enabled them to realise the impact their behaviour had on their children. In addition, parents reported that the support helped them to address parental conflict and relationship issues, while experiencing improved life satisfaction and general wellbeing as a result of changes in their behaviour.

Positive impact of whole-family support and therapeutic interventions on young people

The evaluation also included some examples of statistically significant impacts of services delivered as part of the CADeP IF projects on children and young people, relating to their life satisfaction and wellbeing. Qualitative interviews supported these findings and showed that individual or group interventions:

  • helped to teach young people new coping strategies
  • increased their understanding of their parents’ alcohol dependence and their relationship with them
  • also often improved their wellbeing

Recommendations

The evaluation of the programme highlighted several key recommendations, the most important of which was for the government to provide proper, continuous funding. The evaluation showed that whole-family support work and therapeutic support for children is effective, but also very resource intensive, and often requires the support of specialist staff and services that can address the needs of parents, children and wider family members.

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