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Health, Sports & Psychology

Engaging children and adults when there is problematic alcohol and drug use

Updated Tuesday 7th February 2012

Providing professional help to families where alcohol or drugs are being used requires a delicate approach, explains Andy Taylor.

  • The research on which this piece is based focused on the challenges of engaging children and parents in treatment when there is problematic alcohol use by parents or carers. It involved an in-depth qualitative study of 20 families. In total information on 48 children from 20 parents was gathered.

Many parents who use alcohol or drugs to harmful levels are all too aware of the consequences for their children and seek and welcome professional help.

At the same time, however, for a variety of reasons, parents (who may be also experiencing other pressures or difficulties) are often reluctant to ask for, or accept, help, feeling the need to hide problems from the outside world. There may be a number of reasons for this.

A common concern is that children may be taken away if they say too much about their circumstances and parents are often suspicious of social workers and other professionals for this reason. Having spoken to numerous parents in such situations, many say that they often feel they are blamed, told off or criticised and that this just adds to their own negative feelings about themselves.

They also say that they worry about more people finding out about the family and its problems – this, they feel, can make things worse for their children, if the family is seen as different from others at school or in the local community. Here is one account from a 13 year old I will call Sarah, the eldest daughter in the family talking about the stigma experienced by her younger brothers:

"I know that there are some spiteful kids at school kind of teasing my brothers and saying things like 'Oh your mum's an alcoholic'. We live quite near the school so that people who go there make it common knowledge...  like, all our neighbours know, so its horrible for the kids because they will be playing out."

Because of such experiences many parents see secrecy as the best way of protecting their children. However children themselves often find this difficult because, whilst they may feel loyalty towards their family, at the same time they often have anxieties that they need to share with others.

I've spoken to many children in these situations from the ages of four to eighteen. It was clear that even the very young ones had a fairly clear idea of what their parents were doing, even when their parents thought otherwise.

There are other reasons why parents are reluctant to engage with professionals. Many say that, as they are so preoccupied and distracted because of their drug or alcohol dependence, this leaves them with less energy to tackle the problem.

All of these explanations appear to make sense in a way, but they do have major implications for children. What children have told me is that often feel very alone and cut off from opportunities to talk and so gain support from others outside the immediate family. This makes them more vulnerable. They often also feel caught between wanting to talk to others, and feeling disloyal.

This is what Jenny, one 13 year-old said:

"I find it really hard to talk about my mum and stuff like that, and to talk about stuff with my dad... but with the help of the worker, I was kind of talking about it and they were in the room, my dad, brother and sister and they were talking about it... and they were saying 'it's alright, you can talk about your mum' and I started to cry... and went out of the room and came back with a piece of paper and started writing down how I felt about everything... it helped me find a way to talk to my dad and how I was feeling."

My conversations with children and young people also highlight the fact that how they respond to offers of help depends on what is going on for them at that stage in their life, as well as what is happening in their families.

Here a play worker talks about the way Lucy, a seven year-old, responded to her father's heavy drinking

"She was extremely anxious and talked about 'worries' all the time. She reacts very strongly to the ring-pull of the father's beer can, but is very shut down with any issues to do with family, alcohol or school."

This illustrates that younger children may need to communicate their feelings and anxieties in ways other than just talking.

It's also important that professionals who work with such young children are able to observe the impact of family distress on younger children and have the skills and confidence to engage with them. Finding a way of acknowledging the child's experience through approaches suited to their age and experience is very important.

One of the most difficult things for older children who may have lived with the effects of their parents' drinking or drug use for a long time was the terrible sense of frustration and anger about what they see as their parents' inability to change a distressing family situation.

Many children attempt to control their parents drinking behavior but become frustrated or angry. As, Karl, one 14 year-old put it:

"I gave my mother seven chances to own up to it, but she doesn't own up"

In such situations children often try to hide their parents' alcohol, usually without much success. As Richard, a 10 year-old said:

"The other day, when my sister was at her mates I found a bottle of vodka that was all gone and I was the adult because my mum was drunk. I didn't know what to do... like, I might have dome something to upset her."

Children may have lived with their anxieties about such situations for some time without being able to talk about them. As a consequence, they feel very torn about speaking openly.

At times I found that they could acknowledge with startling clarity how desperate things were but at others saying that they have not really been affected. It's important to realise that children in such situations may take a while to express their true feelings.

Successful methods of working with such children often involve taking into consideration these experiences and how they may have affected them - taking into account their mixed feelings in ways that allows the children to explore them.

Such children often wish to be allowed to discuss their painful feelings, but at the same time also wish to talk about the positive and happier aspects of their family life, with a focus on how things might improve and revert to better times.

Older children also describe the feelings of both frustration and anger that they often experience as a result of their parents' drinking. Many children at this age had experienced periods of things not changing, despite having seen droves of professionals come and go from the house over the years.

This may have led to a feeling that 'nothing ever changes' and a lack of trust in adults generally. This can result in children developing responses where they shut off or shut down. Fifteen year-old Aron:

"I remember myself getting angry quite a lot of the time and there was nothing for me to do except sit in my room, play loud music and bother the neighbours."

This lack of trust and sense of resignation has implications for how professionals develop relationships with children given these experiences which may have impacted on children's capacity to trust adults in general.

Parental alcohol misuse may have added to adolescent feelings of isolation and confusion, particularly when these young people attempted even more than usual to keep their friendships and peer contacts separate from their family problems.

Children is such circumstances often welcome approaches where the whole family, or as many as possible, can discuss things together as long as this is handled in a way that does not make things worse. This is often not only about helping them sort out tensions with parents but also with siblings.

Protecting Our Children: Professional Voices


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