An Exploration of the Ways in which Social Workers Can Effectively Support Children and Families where there is Parental Substance Misuse (PSM)

This dissertation explores the ways in which social workers can effectively support children and families where there is parental substance misuse (PSM). It examines the impact of PSM on children, social work interventions, and the need for sustainable services.

Running head: DISSERTATION
An Exploration of the Ways in which Social Workers Can Effectively Support Children
and Families where there is Parental Substance Misuse (PSM)
Name of the Student:
Name of the University:
Author’s Note:

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Abstract
In United Kingdom, an independent fact checking charity has identified that a total of 250-
350,000 children were affected by the parental drug usage. Statistics reveal that a third of the
population associated with the drug treatment population that have the childcare responsibility,
while 120,000 children are found to be living with a parent who is engaged with a treatment.
Large numbers of Irish and United Kingdom studies have revealed that the people affected by
drugs are smaller compared to the ones affected by alcohol. It has been estimated that about 1
million children are living in families that have issues with drinking and drug usage. This
number is seven greater than the ones that are affected by other usage of drug. It is important to
mention that most of the parents that use drugs and drink alcohol in moderation do not pose any
risk or harm to their children. The research is also required to understand the major areas of
resilience that are vital to target (behavioural components and the psychological components).
The differences that exists between the different variables like the age or gender, drug problems
or living with alcohol, differences that exists between the mental health problems and the
different drug types, paternal problems or maternal problems, the different types of the risk
factors or protective factors that the children are exposed to. There is an urgent need of
intervention and services that are clearly target the processes and the protective factors so that a
sustainable structure can be maintained. For the purpose of sustaining the services, it is important
to note that the services must the maintainable, funded, and well supported. However, it has been
sent that the services are funded for only a short period of time and they lack the clarity over the
sustenance of the projects.

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Table of Contents
1. Introduction..................................................................................................................................4
1.1 Topic......................................................................................................................................4
1.2 Background............................................................................................................................4
1.3 Rationale................................................................................................................................6
1.4 Literature search....................................................................................................................7
1.4 Structure of dissertation.........................................................................................................8
2. Literature Review........................................................................................................................8
2.1 Context of the topic...............................................................................................................8
2.2 Critical discussion................................................................................................................13
2.2.1 Background...................................................................................................................13
2.2.2 Impact of parental Substance Misuse (PSM) on children............................................15
2.2.3 Social work intervention with the families having PSM..............................................19
2.3Summary...............................................................................................................................22
3. Research Proposal......................................................................................................................22
3.1 Research aim and questions.................................................................................................22
3.2 Methodology........................................................................................................................23
3.2.1 Introduction...................................................................................................................23
3.2.2 Research method...........................................................................................................23
3.3.3 Social work practice its methodological issues and implications.................................25

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3.3 Data collection.....................................................................................................................26
3.4 Identification of gaps...........................................................................................................26
3.5 Ethical considerations..........................................................................................................28
3.6 Summary..............................................................................................................................28
4. Conclusion.................................................................................................................................31
5. References..................................................................................................................................35

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1. Introduction
1.1 Topic
The topic of the dissertation is “An Exploration of the Ways in which Social Workers
Can Effectively Support Children and Families where there is Parental Substance Misuse
(PSM)”.
1.2 Background
It has been known that a large number of children are affected by the parental substance
use and the effects are found to be equally serious (Herrenkohl et al. 2013). In UK it has been
identified that a total of 250-350,000 children were affected by the parental drug usage (Full Fact
2019). Thus, statistics reveal that a third of the population associated with the drug treatment
population that have the childcare responsibility, while 120,000 children are found to be living
with a parent who is engaged with a treatment (Adfam.org.uk 2019). While at the same time
there are 5 times as many children that are affected from the parental alcohol misuse (Jaffee et al.
2013). The issue of parental drug problem is associated with the exposure to criminal behaviour,
separation, poverty, emotional abuse, physical abuse, isolation, and neglect (Paris et al.2015).
While the long term effects include the behavioural, cognitive, and emotional and psychological
problems like depression, separation and post- traumatic stress disorder (PTSD) (Dimitry 2012).
Moreover, the other effects include the poor educational attainment, offending behaviour, and
substance misuse (Felitti et al. 2019).From the year 1999 and 2002, a study was conducted that
explored the extent to which the family and child social work care are affected overt time. In this
study, it has been mentioned that parental substance misuse cannot be defined properly and it is
almost difficult to be certain about the extent of the impact (Schindler and Bröning 2015). It is
important to mention this is widely occurring issue and to some of the children this can cause a

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serious issue and can certainly impact the social services of the children. The potential for the
parenting capacity and the children face serious issues when the parents neglect their children
(Stoltenborgh et al 2015). The neglect will severally impact the physical development, emotional
development, and children’s health (Lewis et al. 2015). The education of the children is also at
jeopardy and issues can arise and it can put the children into the sexual and physical abuse.
While it is important to mention that the impact on the children will impact depending on the
stage of the development and age of the children. It is also important to note that there is a link
between the parents that are misusing the substances and the children will also be doing the same
thing is not established yet. However, research has showed that the children of such substance
abuse parents will not be problem drinkers in the later part of their life. Moreover, research has
also shown that that the substance abuse parents that show high dependence on the substance
will be impacting the health and increase the tendencies of substance misuse (Heitzeg et al.
2015). It has been noticed that if the children are exposed to the parental substance misuse along
with the risk factors like the mental health problems and the domestic abuse, then it can create
greater amount of risk and such children will also have substance misuse problems and mental
health issues. While it has been seen that the parental substance misuse not only affects the
children but also the wider family members and this includes the partners, grandparents as well
as the siblings (Neger and Prinz, 2015). Research has shown that the families have expressed
issues like the anxiety, distress, and stress as well (Kolk 2017). This is even greater when the one
or both of the parents is a substance abuser the children are dependent on the parents. The
members of the wider family members are not able to cope up with the loss of relationship and it
is due to the substance misuse (Orford et al. 2013). Moreover, it has been observed that death
generally occurs among the alcohol and drug abusers. Children are generally dependent on their

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parents and it has affected the children who are dependent of such substance abuse parents
(Kelley et al. 2015).
1.3 Rationale
In the recent years, it has been seen that there is an increasing amount of recognition to
the parental misuse of alcohol or drugs on the children that are known to the social services in
United Kingdom (Munro et al. 2014). Engaging with the children and families that are associated
with the substance abuse and it is a necessary section for the purpose social work practice
(Calhoun et al. 2015). On the other hand, particular attention has been given in this context due
to the sensitive nature of this context. Whether the focus of the social workers is on the children
service group or the adults, it is important to accept that the social workers need play a big role in
identification, assessment, and proper intervention for the substance abuse (McKinlay et al.
2014).Whereas, research has shown that the social workers are not engaging with the parental
substance abuse and at the same time they feel that it is neither their duty not their responsibility
to do so (Forrester, Westlake and Glynn 2012). Social workers meet people at the different
points of the life that are having issues of substance abuse. This required a different level of
support and motivation. The vital part is that support and motivation offered maximises the
chances of behaviour change and even in people that are highly resistant (Tyler and Melander
2015). Adversarial discussion will only result into entrenchment of the positions and it will be an
opposite of the desired outcomes. While at the same time, it is important to note that still there
will be people that will be unwilling to change even if the best-efforts are being applied by the
social workers. People that have changed over their substance use, either they are abstaining or
reducing have reported that they are finding it difficult to maintain the change in terms of long
medium and short term. Substance use service when attended can provide support as long as the

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intervention lasts (Smith and Wilson 2016). Thus, the role of the social workers is it support the
change process and to ensure that the care plan receives the additional support until the
intervention finishes. This is applied to the members of the family, children, and individual
themselves. The role of the social workers is to encourage the affected people, and also reflect on
to the strengths and achievements (Snyder and Smith 2015). Thus, not providing the post
intervention support will lead to the increase in the problematic issue. The social workers are
said to be facing the additional amount of problems when they were working with the substance
misuse parents. The usage of the substances by the parent negatively impacts the eagerness of the
parents to work with the social worker and also hinders the issues recognized by a child. Thus,
this leads to a situation where the children are seen to remain in the care. There are evidences in
which majority of the social workers support as well as reject the negative stereotypes. This
further leads to supportive outcomes (Pumariega et al. 2014).
1.4 Literature search
This study will be secondary research and it will investigate the effective social work
interventions for the families and children that are facing issues like the parent substance issue
and what are the problems that a social worker might feel while dealing with the situation.
Additionally, it will also investigate in the way a social worker can support a children who are
affected by PSM. It has been evident that the parent substance abuse is a national phenomenon in
UK (Adamson and Templeton 2012). This is done to understand the depth and breadth of the
parent substance abuse. Thus, it is important to mention that the social and the political aspects
will be mentioned in the study. While it is important to mention that the social policy is an
important part and integral part of the social work practice and at the same time social work also
varies according to different countries. While it is important mention that the health and welfare

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system in United Kingdom is strong and it makes the social work in United Kingdom a unique
feature. Due to this differences there will be data and researches presented for the UK. While
considering and suggesting the interventions the research will be based on a national aspects of
United Kingdom and can also be generalised for populace of the United Kingdom as well.
1.4 Structure of dissertation
The dissertation will have the traditional structure and will be consisting of the following
the sections.
 Literature Review- The literature review will be divided into two parts. The first
part will include the general social theories, political theories, and practice. The
second part will consist of both the thematic and critical discussion regarding the
current knowledge regarding the social work.
 Research proposal- the research [proposal will be including the research questions
and aims. This will be followed by the methodology like the theoretical basis of
the research proposal. The research proposal will be included with a theory that
will include an explicit theory.
 Conclusion- This will mainly be a reflection of the total content and will
summarize the key points regarding the topic.
2. Literature Review
2.1 Context of the topic
The social workers have to understand a range of social issues that they face and the issue
of finding a model that will be helping them to do this. In this regard, social theory like general
system theory can be a very useful tool. The general systems theory is developed because

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different disciplines always try to find a way out of complex situations and interactions. Thus,
important part of the general systems theory is that it will be used to draw attention to a wide
range of issues in the social work practice and that influences a wide range of situation. The
possible targets of intervention are called as the target systems. It is important to mention that in
case of the casework action system; the situation is often limited to one of the both parents and
the social workers (Turner 2017). Similarly, in a community it will be conducted within a
committee. While ion a residential work the work will be conducted within the resident and the
staff representatives. The contribution of the systems theory is applicable within the scientific
and philosophical understanding are useful. However, the main question is its applicability in
terms of the practical situation. Within the systems theory, the families are thought to be as living
systems and this challenged the orthodoxies that are present in the psychological and emotional
problems within the individual terms. This theory has enabled the professionals and the
dynamics of how to think constantly and it altered the way an individual lead his or her life in
and out of the family. This also introduced the ideas of permeability and family boundaries
(Hanson 2014). The systems theory moved away from the linear causality and also took into
account of the idea of circular causality. Except in cases where a case of child abuse is caused by
an individual by exercising psychological power, financial, intimidating, and bullying. It is
important to note that systems theory is an interdisciplinary study that includes the complex
systems. Especially the social work falls within the purview of a professional field and thus
requires the application of social sciences so that the living conditions of the individuals and the
communities can be improved. For the social workers, systems theory is valuable because it
teaches and assists the social workers to define and address the various issues that exist within
the social system (Greene 2017). The systems theory includes a wide range of methodological

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practices and the theoretical across many disciplines. Basically the systems theory is seen to be
engaged with the structure of the complex system and it exerts a special emphasis on how the
different parts of a system interact with each other and to the entire system, Therefore, in social
sciences the social from the perspective of systems theory usually means how the individuals try
to relate to each other and to the society as a whole, along with it the effects that the social
pressures have on a typical individual. Social workers have a variety of role and these include
from being a mental health professional to a policy advisor. Moreover, social workers also take
the role of a court liaison and also fetch resources for the clients (Keynes 2018).
It is important to mention that the behind all these roles the main aim is to improve the social
conditions of the individuals and promote social justice. Whereas it is important to mention that
the social workers employ the systems theory that is based on understanding the dynamic
interrelationships between the individuals, societies, institutions, families. The social workers go
on to identify the how a system functions and what are the aspects of the system that affect the
individuals negatively. Moreover, the social workers look to understand the ways through which
they can bring positive changes by bringing changes into the community and the social work
system. Systems theory highlights the factors that can influence the behaviour including the life
atmosphere, social class, school, friends, and family (Liu et al. 2016). Hence, social workers can
utilize this model while dealing with the situation like PSM to bring out positive traits among the
abusers.
Attachment theory is basically concerned with the self-development with relation to
others. This theory highlights that the emotional proximity, physical proximity is necessary for
an infant to development attachment and it is biologically necessary as well. Being separated
emotionally and physically can create sadness, anxiety, and loneliness (Coady and Lehmann

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2016). The behaviours of attachment are present through the life cycle of an individual.
Moreover, attachment between a child and their primary caregiver will play determining effect
on the functioning and later relationships. The attachment theory when used within the
perspective of addiction has emphasized that addiction should be centred on the transformative
potential of the human relationships and therapeutic relationships (Shardlow et al. 2015). In
particular, it is important to note that therapy based on attachment helps towards the
development of the empathic attachment relationships that will be helping individuals that are
substance dependent and also helps them to get acquainted with their own emotional shelf. The
people that are addicted and have tendency of substance misuse can be treated and it can also
help them to develop a capacity for healthy relationships (Payne 2015). It has been estimated that
children that less than are less than 18 years of age and at least one of the parents that has
substance abuse have revealed that the younger children will be having issues with the proper
development and will also struggle in their life and is likely to experiences the substance use
problems, behavioural problems and emotional problems (Turner 2017). The other negative
impacts that emanate from the parental substance misuse are the disruption in finances, social
life, communication, routines, roles, rituals. The families that are having substance misuse
parents can be characterized by fear, role reversal, emotional chaos, abuse, or violence, conflict,
loss, environment of secrecy. It is important to mention that relationships serve as the conduits of
communication that effectively connects the family members with each other. Here, the
attachment theory provides a way of communication through which quality of relationships and
understanding of development can be understood between the family members (Holmes 2014).
A parent with tendencies of substance abuse will have altered mood will have the mind set of
spending more money on the addiction, and at the same time will spend significant amounts of

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money also to recover from the effects of the substance. This leads to a situation where the
parent is unable to foster a healthy attachment with his or her children (Dregan, Brown and
Armstrong 2011). This will highly affect the attachment system that is built within the
interaction between the attachment figure and the infants (Wu and Parker 2017).
Social work practice and the social workers provide assistance and preventive services to
the diverse type of the communities at the macro, mezzo, and micro levels. The social workers
are generally responsible for the development and implementation of the preventive programs in
communities and schools and also to evaluate their effectiveness (To et al. 2014). A preventive
program cannot be developed without the proper involvement and funding from the municipal,
county, state, and national level. Due to this the social workers must utilize the existing research
and at the same time can conduct new research if they think there is a requirement and it would
be best to meet the needs of the individuals and the communities (Holland, Williams and
Forrester, 2014). The link that the social workers have with their community in the United
Kingdom also allows the scope of further research as well as prevention of substance within the
communities that the social workers work with (Dingle et al. 2015). Due to this the social
workers are the valued members of the community and they at the same time are able to form
collaborations with the members of the community, representatives of the community- based
organizations, and educators so that the drug prevention and other alcohol prevention programs
can be addressed (Begun and Clapp 2016). While it is important to mention that the social
workers can provide efficient services and most effective services are capable to address a
variety of behavioural health issues as well as to attend to a variety of social issues (Forrester and
Harwin 2011). Within the clinical setting it is important to mention that the social workers get
the opportunity to conduct the drug and alcohol prevention among the parents so that the

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screening questions can be provided to the clients so as to obtain a screening irrespective of the
demographics and age (Hong et al. 2014). The social workers are placed in a strategic position
that facilitates them to intervene through the continuum of prevention to treatment as they
practice through the different modalities. Therefore, the social workers play the vital roles in the
development of prevention programs pertaining to the substance abuse (Snyder and Smith 2015).
2.2 Critical discussion
2.2.1 Background
There are still substantial numbers of children that are growing up in families affected by
the substance misuse. While it is important to mention that alcohol remains one of the highest
misused substances although its prevalence has been reducing and commonly restricted among
certain age groups (World Health Organization 2014). There is a growing amount of concern
among the service providers and the policy makers regarding the short term and the long- term
effects of the parental substance misuse and its impact on the children. Moreover, the issue has a
lot of gravity because solutions must be found so that the impact of substance abuse can be
minimised among the children (Caselman 2015). The use of alcohol and illegal drugs not only
affects the behaviour and health of the parents but it also jeopardises the lives of the children.
The impact on the children can include a wide range of areas, like the community, school, and
home. Large numbers of Irish and United Kingdom studies have revealed that the people
affected by drugs are smaller compared to the ones affected by alcohol (Davoren et al. 2016). It
has been estimated that about 1 million children are living in families that have issues with
drinking and drug usage. This number is seven greater than the ones that are affected by other
usage of drug. It is important to mention that most of the parents that use drugs and drink alcohol
in moderation do not pose any risk or harm to their children (Allan 2014.). However, carers and

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the parents that misuse the substances often result into unpredictable and chaotic lifestyle. The
parents even struggle to provide their children with safe and clear boundaries. Alcohol misuse is
described as alcohol dependence and harmful drinking. Harmful drinking can be described as a
pattern of alcohol consumption that it causes alcohol related problems and it includes the
psychological problems like alcohol related accidents, physical illness, and depression (Keyes,
Hatzenbuehler and Hasin 2011). Alcohol dependence can be described as addiction and
continued drinking of alcohol despite the knowledge of the harmful consequences of alcohol
usage. This is associated with increased number of criminal activities, physical health problems,
increased rate of mental health problems and domestic abuse and violence as well (Jordan,
Campbell and Follingstad 2010). Drug misuse and drug dependence is also a part of the parental
substance misuse (Velleman and Templeton 2016). Drug misuse can be described as the
dependence on consumption of excess amount of psychoactive substances that might lead to
legal problems, physical problems, psychological and social problems. While the drug misuse is
a prevalent is a society which is actually deprived. It is important to mention that the most
commonly used psychoactive substance England and Wales is cannabis (Wolff and Johnston
2014). This is followed by ecstasy and cocaine; opioids are found to be less used and pose
majority of the health problems. Research over the last two decades have highlighted that large
proportion of the children belonging from the families of parental substance misuse have been
found under the social work caseloads, serious case reviews and child protection reviews
(O'Connor et al. 2014). Although there is plethora of evidences linked to the parental substance
abuse, the interventions conducted by the social workers are basically based on the early parent
child attachment (Pajulo et al. 2012; Suchman et al. 2011). Only a little emphasis is put to the
consideration of how the substance misuse impacts the foetal exposure to the substances that

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contribute to the issues. Due to this reason, social worker have over emphasized on the
attachment theory and the approaches of understanding the families. In the last decade, the
prevalence of parental substance misuse had increased considerably. While it has also been
estimated that that 30 percent of the children are living in households where there is parental
substance abuse. The ones that are under the age of 16 are living with one of the parents that are
binge drinkers. Such number are about 3.4 million and a million of the children are living whose
both the parents are substance abusers. The research in this filed in gradually increasing and all
the fact supports that the impact of parental substance abuse is mounting constantly. It is also
important to mention that the prenatal impacts of parental substance misuse include the issues
like Foetal Alcohol Spectrum Disorder (FASD) and Neonatal Abstinence Syndrome (NAS)
(Fletcher, Nutton and Brend 2015).
2.2.2 Impact of parental Substance Misuse (PSM) on children
The impact of PSM on the unborn child
This topic which presents a considerable amount of research and it suggests that the drug and
alcohol usage depending on the severity and the frequency of usage can severely affect the
development of a growing baby. The environment in which the mother lives in during the
pregnancy also plays a role in the development of healthy babies (Razee et al. 2010). These
babies are vulnerable during the first 12 weeks of the pregnancy. The way the substance is used,
the stage of the pregnancy and the type of the substance used, the extent to which the substance
is used and its duration can considerably affect and all these parameters are significant (Holland
et al. 2013). The risks that are common in both the alcohol and drug misuse are the elevated risks
of cot death, smaller circumference of the head, reduced weight during birth, premature birth and
risks of miscarriage. However, it is an agreed fact that the more amount of alcohol consumed the

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greater is the impact on the unborn child (Niccols et al. 2012). Whereas it is also important to
mention that regular binge drinking is more dangerous in comparison to the regular consumption.
There are many people that indulge into other activities along with the alcohol abuse and such
risky behaviours can jeopardise the health of the new born child. Smoking cannabis along with
tobacco can often be considered as a deadly combination during the times of pregnancy and the
danger arises from the nicotine toxicity. The combination the mother’s diet, and substances along
with the substances can be considered as a critical factor that can both mitigate as well as
complicate the foetal health. The specific types of risks that can emanate from PSM are Hepatitis
and HIV, Neonatal Abstinence syndrome, foetal alcohol syndrome, and foetal alcohol spectrum
disorder. Alcohol is potentially considered to be harmful substance in terms of the development
of children because it affects the brain of the child and this occurs at the critical timing of
evolving foetal central nervous system. Therefore, this leads to three different categories of
syndrome (Bellis et al. 2014). Alcohol consumption during the time of pregnancy leads to the
three different categories of syndrome: cognitive or biological and behavioural problems,
dysfunction of the central nervous system, reduced growth or height. The prenatal exposure to
the alcohol leads to different types of issues ranging from intellectual abnormalities, behavioural
and physical difficulties. The term neonatal abstinence syndrome is described as the effect of
withdrawal from the on the babies that are exposed to the substances in the utero section. Studies
have indicated that exposure to cocaine has problems related to deficit in concentration and
attention (Forrester et al. 2016).
Impact of PSM on the health of child
The babies that are born with the withdrawal symptoms have diarrhoea, vomiting,
feeding problems, disturbed sleeping patterns, and high- pitched crying. Left alone in an

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unsupervised condition while the parents are indulged in activities like intoxication places
children at risk when the parent’s care and needs become a priority. For example, if the child
requires immediate medical; attention then such parents might neglect and ignore any medical
advice given. Often it is seen that the parents neglect the physical care of the children and the
levels of hygiene and due to this the children suffer because of lack of cleanliness (Kiraly and
Humphreys 2015.). Moreover, routine check- ups might be missed by as well. If the resources of
the family are stretched beyond the financial capacity due to drug and alcohol misuse, then it can
lead to poverty. Children may develop a range of issues pertaining to high levels of anxieties,
psychosomatic responses when living with substance abuse parents. This might include sleep
problems, bed wetting, headaches, and stomach aches. Furthermore, the mental and physical
health needs of a children when going through puberty might not be picked up by the parents and
this will lead to the lack of understanding and support (Kalmakis and Chandler 2014). During
these times children or young adults require because they go through the emotional and physical
changes and this can increase the vulnerabilities by several times. While there is another point
which requires mention that substance use is also accompanied by violence in home and the rates
or incidences of violence might increase during the times of late adolescence. Moreover, due to
the constant arguments and physical violence the children might fear from the physical violence
and sexual abuse as well. This will greatly undermine the health and wellbeing of the children.
Children at the same time might fear for their own safety if the substance abusing parent or a
non- drinking parent is unable to provide protection (Tyler and Melander 2015).
Impact of PSM on cognitive ability and education
The major impact of PSM is the stimulation it offers to the development of the child and
the way it impacts on the attainment and concentration. The children whose parents are indulged

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into the substance abuse are more likely to have problems problem in school and the issues will
include the low performance, poor concentration. Learning difficulties and this occurs due to the
limited amount of parental involvement (Fuller-Thomson, Mehta and Valeo 2014). The mothers
associated with the substance show tendencies of low responsiveness towards the child signals
and also unwillingness to cognitive band educational development of the babies. While such
mother show response in a manner that does not facilitate and promote child's attention. This can
lead to the long term conflictual cycles between the parents and the child. The children that are at
school will face difficulties in term of the serious academic difficulties, higher rates of
absenteeism, interpersonal problems, disruptive behaviour, and other learning difficulties
(Raitasalo et al. 2015). Moreover, there will be incidents of distraction and stress staying at
home. Children might experience bullying and mockery and it results into truancy and these in
turn become bullies so that they can defend themselves. This will hamper the children into the
acquisition and attainment of long term chances. Moreover, it is important to mention that the
young people might start to miss their schools because they are more involved into taking care of
the parents and looking after their sister and brothers. Looking after their family so that they can
give protection to their families and so that they do not indulge into behaviours drug taking,
substance misuse behaviours (Knight 2015).
Impact of PSM on the behavioural and emotional development
Parents that are preoccupied with the substances abuse will have range of consequences
on the emotional development of the children. A child that will be away from the care of their
parents will be physically, psychologically, emotionally detached from their parents. It becomes
hard for the preoccupied parents to keep a track of the mind of the children. Thus, it is important
to mention that lack of empathy, inconsistent responses, changes in the behaviour and mood will

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make life anxiety provoking and uncertain (Kelley et al. 2015). It is important to mention that the
PSM is linked with the development of disorganized and insecure attachment patterns. The main
issues that the children face are the feelings of unwanted and unloved. Therefore, it can be said
that the children whose parents are misusing alcohol can suffer from higher rates of separation
due to the loss of parents or due to hospitalisation, imprisonment, and absence (Maguire-Jack
and Showalter 2016). Child's removal from home for various reasons will also result into
separation of child from their parents. Furthermore, it has also been seen that when the behaviour
of the parents is frightening, worrying, inconsistent, and unusual then the small children find it
extremely difficult to put their feelings, anxieties and fear into words. Therefore, this results into
the development of post- traumatic stress disorder like bed wetting and problems with sleeping.
Thus, it needs to be mentioned that the lack of routines will lead to uncertainty and increase in
distress (Love et al. 2016).
2.2.3 Social work intervention with the families having PSM
The professionals or the social workers have identified a wide range of issues that
emanate from their contact and practice with the children. The social workers have seen that the
children showed signals of being distress and troubled as well as withdrawn by the both the
substance misuse and the feelings of being endangered (Kemp et al. 2014). They have found it
difficult to communicate with the children that are affected form PSM due to the issues of denial,
secrecy, and loyalty. Child protection social worker has highlighted that the child used to reveal
their feelings only after long period of time and only after they are out of the situation when they
found the issues of loyalty, safety is not in a critical condition. This can also be justified by the
fact that the children's experiences are treated as a reaction to the problem that are caused by the

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excessive alcohol or drug usage (Bloom and Phillips 2017). Actual communication with the
children is much more difficult and it is because of the environment where the parents are said to
be living all contributed as a major source of anxiety. These problems along with the conditions
of difficulties have made the regular access to the children a difficult task. The professionals also
commented on the protectiveness of the children towards the one or both the parents. The social
workers were amazed by the sheer levels of loyalty and support for the family. This was found to
be an amazing situation the children even if were facing difficult satiation were trying to save
their parents (McCollum and Trepper 2014). Due to this it became difficult to get glimpse of the
child response during such conditions at home (Guterman et al. 2013). It was seen that the
protective nature of the child and their unwillingness to share any information with the social
worker creates a sort of a barrier and it hinders the engagement of the social worker with the
affected children (Arbeiter and Toros 2017). Although, it is important to mention that the
complex dynamics that exist between the child and the parent is considered by academics to be
one of the ways of gaining information from the child's situation (Li et al. 2012). Furthermore,
the difficulties were created between the relationships that existed between the professionals and
the parents (Larkin, Felitti and Anda 2014). This is one of the major disadvantages that are
actually very dangerous for the children because if it gets too late, it is rather difficult to help the
children to recover. Moreover, it has also been seen that the social worker working with the
substance misuse team have found that the it is actually very difficult to take a note of the actual
drug taking behaviour of the parents and the levels to which the children are exposed. It is
important to mention that the when social workers get busy with the parents, the children’s needs
are often not taken in to account because the issue becomes distracted as per needs of the
children (Templeton 2014). While it is often seen that even if the parents gets ready to take their

21DISSERTATION
children to the social workers, they at times carry and often at times they do not carry their
children. Thus, when they focus it becomes difficult to focus where the social workers will put
their focused on, whether on the children on the parents. Moreover, it is important to mention
that the it is important to not to make assumptions regarding the older children and that they will
be able to cope up better because the emphasis is put on to the toddlers, infants, and prenatal
exposure. The vital fact is that the older children go to school or they are working elsewhere
when the parents are given the interventions and this makes the older children to be inaccessible
to the social workers or the professionals (Sidebotham et al. 2016).
Most importantly it is important to mention that the social worker has also mentioned that
the lack of the sustained observational evidences leads to the development of a picture that also
lacks the information of how the children were coping. It is important to mention that it is better
and it is more productive when the information is gained from the children itself. For example,
the intervention strategy also involves the strategies that can actively balance the absence of the
chidden. Therefore, the health and social care workers and professionals have mentioned it is
rather difficult to assess the circumstances and at the same time overcome the barriers that exist
in the realities and the behavioural impacts associated with the home setting. It is important to
mention that the aspects of stigmatization and dynamic issue of secrecy between the parents and
the children result into generation of significant amount of problems and to also generate inquiry
and engagement. Professionals on the other hand also feel that the lack of knowledge and with
respect to the child welfare, substance misuse has resulted in to assumptions, errors, and
stereotypes. This requires the assessment of both the needs and the situation (Allan 2014).

22DISSERTATION
2.3Summary
The literature review has highlighted that alcohol dependence can be described as a
craving and continued drinking of alcohol in spite of the knowing the harmful consequences of
alcohol usage. This is associated with increased number of criminal activities, physical health
problems, increased rate of mental health problems and domestic abuse and violence as well.
Drug misuse and drug dependence is also a part of the parental substance misuse. Substance
usage is also accompanied by violence in home and the rates or incidences of violence might
increase during the times of late adolescence (Sousa et al. 2011). Moreover, due to the constant
arguments and physical violence the children might fear from the physical violence and sexual
abuse as well (Margolin and Vickerman 2011). This will greatly undermine the health and
wellbeing of the children. Children at the same time might fear for their own safety if the
substance abusing parent or a non- drinking parent is unable to provide protection.
3. Research Proposal
3.1 Research aim and questions
The aim of the research is to find out the ways in which the social workers support the
families and children in effective ways in families that have Parental Substance Misuse (PSM).
The research questions are as follows:
 What are the issues and hindrances faced by the social workers when they work in
an area that have PSM?
 What are the ways through which the social workers can provide intervention to
the families so that the children can be supported?

23DISSERTATION
3.2 Methodology
3.2.1 Introduction
This research investigation will include a critical review of the research question
presented above and it will be a systematic review of secondary data and original research
already conducted. This systematic review will be conducted in a way to explore the ways in
which the social workers can effectively help the children as well as the families which has been
facing issues like PSM. The entire methodology section will be discussing the approach of the
systematic review and methodological issues that are existing in the social work research. The
subsequent steps will be exploring and justifying the methodology of the research which will
include the research method, potential sources, and the sampling from relevant literature. The
last of the final section of the methodology will discuss on the ethical considerations so as to
ensure the integrity and quality of the research project undertaken.
3.2.2 Research method
There are basically two different types of research called the qualitative and quantitative.
It is important to mention that the quantitative research approach includes the collection of the
numerical data that will be used for data analysis and it also includes the statistical tests (Orme
2013). For example, the aim will be to establish a relationship between the children and the
parents indulged with the abusive usage of substances and child protection. However, in contrast
the qualitative approach will include a process which will emphasize the words and the
qualitative technique in order to explore the meaning. This generally includes analysis of original
research article, study of systematic review and meta- analysis, an observations and interviews
from the focus groups and the individual interviews. This process means to explore the
subjective experiences of the respondents and with respect to a specific social phenomenon

24DISSERTATION
(Parris 2012). This rather depends on generating a theory instead of just testing it. It is important
to mention that both the research methodologies have their own strengths and weaknesses and
due to this the suitability of a specific type of approaches will be largely dependent on the aims
and the objectives of a specific research project. Moreover, professionals also add theoretical
frameworks that are also brought in together with the research approach and the professional
tasks (Braun and Clarke 2013). Furthermore, it is also important to mention that the social work
knowledge from the different approaches make it difficult for the social workers to actually
adhere to a single research approach. The secondary research is also called desk research and it
broadly includes the summarisation, interpretation and analysis is of the data based on the
primary research. Due to the readily available data, the research is found to be effective and
quick as it consumes less amount of time. However, this raises the reliability and the validity
concerns because the data is collected under certain conditions which might be unsuitable for the
research questions. Despite the drawbacks the secondary is considered to be best suited for the
dissertation because the different aspect of the subject is addressed separately. The secondary
research will provide the opportunity to investigate the PSM with respect to the dissertation and
also within the given timeframe and also requiring less money. Research methodology refers to
the broad framework that includes both the practical and the theoretical contexts and within this
research is conducted (Carey 2013). Thus this provides the proper justification for choosing one
research method over another. The research method refers to the collection of data and analysis
of the same. Researches on the PSM generally includes the both the quantitative research and
tools and the given the framework of a typical discipline, it is better to highlight that the research
methods of PSM vary differently. At one end of the research spectrum is the PSM research
spectrum and its tools and it is required to establish a cause effect relationship between the

25DISSERTATION
independent and the dependent variables. Like the relationship between the infant health and the
substance ingestion and the relationship between the child on the child protection registers and
the parental substance misuse. On one end of the spectrum is the techniques of qualitative
research and it is to establish the ideograph understanding of a typical phenomenon that will be
generating theories in the end. For example, the impact of PSM of the child welfare. Thus, the
research project will include the include the sample studies that will be the most relevant to the
topic and it will be conveniently use different types of the research methods that will help in the
triangulation and also in cross checking the findings (Akesson, Braganza and Root 2018). For
this research investigation, however, qualitative research method will be adopted and thematic
analysis will be utilised to answer the research question.
3.3.3 Social work practice its methodological issues and implications
There is a long tradition within the research regarding the usage of relationship based
paradigm, and this stems from the psychodynamic and psychosocial methods of the social work.
The paradigm is further differentiated in to the PR actioners, researchers, and policymakers.
Evidence based knowledge which is obtained from the usage of the multiple and complex tools
then simplified into different chapters that are bureaucratically imposed on the social workers
(Carey 2017). It has been seen that the voices of the social workers remain silent and it is
expected that the social workers effectively take into account of the evidence based practice
models that assist in the treatment of alcohol and drug. It is important to mention that the
research methods differ when the research study or the methodology of the study considers the
application of the findings and takes into account of the time, geography, ethnography, and
epistemology. Therefore, it is always important to tailor made the models and the theories so that
they can suit the needs of the different service users instead of the falsely generalisation (Fenton

26DISSERTATION
2014). For example, a research on PSM is conducted in USA and the researchers in UK can draw
from the USA research without paying any attention to the differences in the differences that
exist in the healthcare policies and the welfare policies in both the countries. Thus, it is also
important to mention that there exist differences in the engagement and behaviour of the service
users (Shaw and Holland 2014).
3.3 Data collection
The aim of this research objective is to investigate the effect of the PSM on the
development of child. The objective of this research investigation is to link the effect of PSM on
the social work, like the same way social work practice will have on the dissertation of social
work. A detailed literature search will be conducted on the Google Scholar so that sufficient
number of articles can be discussed to answer the research question for this investigation.
Several inclusion and exclusion criteria will be implemented to narrow down the extracted
articles so that the articles will be relevant to the research questions presented in this
investigation. For instances, article published in the year older than 2014 will be excluded to
maintain the up to date information related to the research question. Articles published in English
language will only be considered for this investigation. Key words and phrases will be utilised
for the search of the research article. However, it is expected that lot of research article will be
extracted while using the keywords, therefore, PRISMA (Preferred Reporting Items for
Systematic Reviews and Meta-Analyses) tool will be utilised to narrow down the relevant and
recent articles (PRISMA 2019).
3.4 Identification of gaps
Identification of gaps that exists within the literature is a vital part of the research because the
information that was collected few years then to advance depending on the newer studies and

27DISSERTATION
this presents a significant amount of gap (McCollum and Trepper 2014.). Some of the recent
works that have been revised has presented that the how children are effected by the parental
substance misuse and it includes the several risk factors that have been faced by the people, the
protective processes, protective factors, and the evidences of resilience suggests that it reduces
the likelihood that children will experience poor results. The works in recent year have
highlighted what was already known and what and also the complexities that are associated with
the resilience and protective factors (Payne 2015). In relation to all these greater amount of
understanding can be received from the active role played by the children and responses of the
children according to a specific situation. The research is also required to understand the major
areas of resilience that are vital to target (behavioural components and the psychological
components). The differences that exists between the different variables like the age or gender,
drug problems or living with alcohol, differences that exists between the mental health problems
and the different drug types, paternal problems or maternal problems, the different types of the
risk factors or protective factors that the children are exposed to (Schindler and Bröning 2015).
Thus, it is important to mention that the resilience of a children changes depending on the age
and the different processes that either operate negatively or positively at the different life stages
or the development la changes. This asks for a longitudinal research. It has also been found that
the both the practice and policy have made inroads that have led to the recognition of population
and it has also required the prioritisation. Moreover, new ways of supporting and the children
and the families have been found that have impacted the entire number of the service models
with a promising aspects. The work has been highlighted to be having a challenges when it
comes to the commissioner, service providers and he practitioner. A growth and development in
the services is not reported in the services. There is a pressing need for a large number of

28DISSERTATION
services that cater the needs of the families and the children (Velleman and Templeton 2016).
There is a requirement of the intervention and the services that are clearly target the processes
and the protective factors so that a sustainable resilience can be maintained. For the purpose of
sustaining the services, it is important to note that the services must the sustainable, funded, and
well supported. However, it has been sent that the services are funded for only a short period of
time and they lack the clarity over the sustenance of the projects. Furthermore, the services are
only available for a small number of the geographical regions and the have only a limited
number of choices (Forrester and Harwin 2011). Thus, there is a need to increase the diversity
and choice. Moreover, majority of the focus needs to be put on the children that are at risk and
the services must be able to meet the requirements of the children that require a full spectrum of
need definitely needs along with the ones that are at the risk of significant amount of harm
(Templeton 2014.).
3.5 Ethical considerations
The research project is highly reliant on the usage of secondary data accrued from the
academic journals that are already available within the public domain and no primary research
will be conducted. For this reason, no ethical consideration is needed exclusively for this
investigation. However, proper credit will be given and permission will be requested where
needed while using secondary research data. This study is directed towards minimising the harm,
maximising the benefits with respect to the present knowledge in the area of research.
3.6 Summary
Resilience is actually a complex thing tom define because it is conceptualised as an
outcome and also as a process. It is a process that may be and may not be change and developed
as a global characteristic. While at the time this might show case itself differently under different

29DISSERTATION
circumstances. Therefore, resilience means something which has better than the expected
outcomes, better competence under the stress and positive functioning meaning recovery from
shocking condition (Larkin, Felitti and Anda 2014). Thus, the social workers must be able to
promote resilience and also develop protective factors both into the children and among the
families. It has been highlighted that instead of focussing on the presentation of problems by the
parents, the practitioners must focus on the enabling the family and the child so that they can
develop a protective factors and as a result it will enhance the resilience. There are three different
ways in which the practitioners can help their children to develop their resiliency (Kalmakis and
Chandler 2014). The ways that have been found to be promising are: showing the parents and the
children the other ways of living their life; providing the parents with the education of the
substance misuse education; providing education to the children so that they can freely express
their feelings. Thus, it is important to mention that supporting the families and the children that
are affected by the substance misuse by the parents and this requires an understanding of the
resilience and it includes both the protective factors and risk factors at the levels of the
environmental levels, family level and at the individual level (Holland et al. 2013). It is
important to note that a large number of the protective process and factors that can mitigate the
issues faced by the children that have poor outcomes and as a result of the experiences of misuse
of substance by the parents. The solutions can also pertain to the building of resiliency to
adversities. It is thus, important to note that social workers that the engage with the children will
engage with the families and children will develop the protective factors and the processes that
are available or present. Thus, it is a highlighting fact that the teaching about the impact on the
children and that develops into a resiliency must become a vital part of training for the social
workers. It can be seen that must of the development and progress have been made in terms of

30DISSERTATION
modifying and understanding the effects of parental substance misuse (Dingle et al. 2015). This
can be translated into a practice and policy as there is so many aspects that remain to be learnt.
Thus, it is important to mention that it is vital thing to incorporate the protective factors and the
ideas along with the processes and resiliency into the routine social work practice. The role of
the social workers is it support the change process and to ensure that the care plan receives the
additional support until the intervention finishes. This is applied to the members of the family,
children, and individual themselves. The role of the social workers is to encourage the affected
people, and also reflect on to the strengths and achievements. Research has shown that the
relatives have expressed issues like the anxiety, distress, and stress. This is even greater when the
one of the relatives is a substance abuse parent and the children are dependent on the parents.
The members of the wider family members are not able to cope up with the loss of relationship
and it is due to the substance misuse (Caselman 2015). Moreover, in extreme cases the death of
the relatives has also occurred that have affected the children of such substance abuse parent.
Although there is plethora of evidences linked to the paternal substance abuse, the interventions
conducted by the social workers are basically based on the early parent child attachment. Only a
little emphasis is put to the consideration of how the substance misuse impacts the foetal
exposure to the substances that contribute to the issues. Due to this social worker have over
emphasized on the attachment theory and the approaches of understanding the families. In the
last decade, the prevalence of parental substance misuse had increased considerably. It is
important to mention that both the research methodologies have their own strengths and
weaknesses and due to this the suitability of a specific type of approaches will be largely
dependent on the aims and the objectives of a specific research project. Moreover, professionals
also add theoretical frameworks that are also brought in together with the research approach and

31DISSERTATION
the professional tasks. Furthermore, it is also important to mention that the social work
knowledge from the different approaches make it difficult for the social workers to actually
adhere to a single research approach. Due to this the social work research approach depends
largely on the models of the other disciplines that all together explores the depth and breadth of
the social phenomenon and ways of devising effective intervention (Begun and Clapp 2016).
4. Conclusion
From the above discussion it can be concluded that the issue of parental drug problem is
associated with the exposure to criminal behaviour, separation, poverty, emotional abuse,
physical abuse, isolation, and neglect. The potential for the parenting capacity and the children
face serious issues when the parents neglect their children. The neglect will severally impact the
physical development, emotional development, and children’s health. While at the same time it is
also important to mention that it is a specialist area among the all other service groups. Whether
the focus of the social workers is on the children service group or the adults, it is important to
accept that the social workers need play a big role in identification, assessment, and proper
intervention for the substance abuse. Whereas, research has shown that the social workers are not
engaging with the parental substance abuse and at the same time they feel that it is nether their
duty not their responsibility to do so. Social workers meet people at the different points of the
life that are having issues of substance abuse. This required a different level of support and
motivation. Thus, the role of the social workers is it support the change process and to ensure
that the care plan receives the additional support until the intervention finishes. This is applied to
the members of the family, children, and individual themselves. The role of the social workers is
to encourage the affected people, and also reflect on to the strengths and achievements. Thus, not
providing the post intervention support will lead to the increase in the problematic issue. The

32DISSERTATION
social workers are said to be facing the additional amount of problems when they were working
with the substance misuse parents. The general systems theory is that it will be used to draw
attention to a wide range of issues in the social work practice and that influences a wide range of
situation. The possible targets of intervention are called as the target systems. It is important to
mention that in case of the casework action system; the situation is often limited to one of the
both parents and the social workers. The systems theory moved away from the linear causality
and also took into account of the idea of circular causality. Except in cases where a case of child
abuse is caused by an individual by exercising psychological power, financial, intimidating, and
bullying. It is important to note that systems theory is an interdisciplinary study that includes the
complex systems. Especially the social work falls within the purview of a professional field and
thus requires the application of social sciences so that the living conditions of the individuals and
the communities can be improved. For the social workers, systems theory is valuable because it
teaches and assists the social workers to define and address the various issues that exist within
the social system. Moreover, the social workers look to understand the ways through which they
can bring positive changes by bringing changes into the community and the social work system.
Systems theory highlights the factors that can influence the behaviour including the life
atmosphere, social class, school, friends, and family. Attachment theory is basically concerned
with the self-development with relation to others. In particular, it is important to note that
therapy based on attachment helps towards the development of the empathic attachment
relationships that will be helping individuals that are substance dependent and also helps them to
get acquainted with their own emotional shelf. The people that are addicted and have tendency of
substance misuse can be treated and it can also help them to develop a capacity for healthy
relationships. The negative impacts that emanate from the parental substance misuse are the

33DISSERTATION
disruption in finances, social life, communication, routines, roles, rituals. The families that are
having substance misuse parents can be characterized by fear, role reversal, emotional chaos,
abuse, or violence, conflict, loss, environment of secrecy. It is important to mention that
relationships serve as the conduits of communication that effectively connects the family
members with each other. Here, the attachment theory provides a way of communication
provides a way through which quality of relationships and understanding of development can be
understood between the family members. The connection that the social workers have with their
community also allows the scope of further research as well as prevention of substance within
the communities that the social workers work with. Due to this the social workers are the valued
members of the community and they at the same time are able to form collaborations with the
members of the community, representatives of the community- based organizations, and
educators so that the drug prevention and other alcohol prevention programs can be addressed.
The social workers are placed in a strategic position that facilitates them to intervene through the
continuum of prevention to treatment as they practice through the different modalities. While it
is important to mention that the social workers not only provide community services but also
advocate the changes in the society on behalf of the clients. Therefore, the social workers play
the vital roles in the development of prevention programs pertaining to the substance abuse.
Some of the recent works that have been revised has presented that the how children are affected
by the parental substance misuse and it includes the several risk factors that have been faced by
the people, the protective processes, protective factors, and the evidences of resilience suggests
that it reduces the likelihood that children will experience poor results. The works in recent year
have highlighted what was already known and what and also the complexities that are associated
with the resilience and protective factors. In relation to all these greater amount of understanding

34DISSERTATION
can be received from the active role played by the children and responses of the children
according to a specific situation. The research is also required to understand the major areas of
resilience that are vital to target (behavioural components and the psychological components).

35DISSERTATION
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