Working with complex families with parental substance abuse

Children raised in families with multiple risk factors including parental substance misuse and psychopathology, poverty, social isolation and at times hostile and harsh parenting practices have poor outcomes. These cumulative risk factors are associated with high rates of child maltreatment, in particular child neglect. Intervening to reduce risk and improve family functioning requires intensive family support addressing multiple domains of family functioning.

The Parents Under Pressure (PuP) program was designed specifically for high risk families providing an individualized approach to case planning with a focus on the quality of the parent-child relationship, and parental emotional dysregulation. There is a growing evidence base with the most recent RCT conducted in the UK finding positive benefits on parenal emotional regulation and child abuse potential compared to treatment as usual in families with parents engaged in community addiction services. The implications for the dissemination of the PuP program in family support work are discussed.