Improving outcomes for children and families affected by paternal substance misuse: a feasibility study of the Parents Under Pressure programme for fathers

  The impact of parental drug misuse on children and families is a major public health problem [4]. Parental drug misuse is closely associated with poor parenting, poor child development and increased rates of child maltreatment, particularly neglect [6, 22]. Children brought up in families affected by parental substance misuse are also more likely to develop alcohol and drug problems themselves, continuing the intergenerational transmission of harm [7]. As a consequence, improving outcomes for children and families affected by parental addiction is a key policy objective in the UK and elsewhere [36, 37]. The focus of this study is on families with preschool aged children in recognition of the increased risks posed to infants and young children living with drug dependent parents [22] and national government priorities to target parenting and family support in the foundation or ‘early years’ [38, 39].

To date, parenting research has focused almost exclusively on drug-using mothers and mothering [15, 29]. Little is known about the effectiveness of parenting interventions for families affected by paternal drug misuse [1]. Consequently, there is a compelling argument to involve fathers in programmes that aim to improve fathering and father-child relationships within the context of everyday family life.

One promising programme, developed specifically for drug-dependent parents, is the Parents under Pressure (PuP) programme. PuP was found to be effective in a randomised controlled trial (RCT) [16] with parents in methadone maintenance treatment and is currently the subject of a multi-centre RCT in the UK [40]. However, these evaluations primarily focus on mothers. Evidence from our review of the literature suggests that there are many challenges to involving fathers, especially high risk fathers with complex needs, in both parenting programmes [41] and research studies [3]. Thus, we need to determine: a) the uptake, retention and acceptability of PUP among drug-dependent fathers (and partners when recruited together); b) acceptability among staff referring into and delivering the programme and; c) critical factors that would affect a future RCT including, gaining informed consent, uptake and participation rates, the feasibility of gathering outcome and cost data from fathers, mothers and staff, and possible sources of contamination.

  • Start Date:

    1 February 2017

  • End Date:

    31 January 2019

  • Activity Type:


  • Funder:

    National Institute for Health Research

Project Team