Home > Parental alcohol misuse and the impact on children: a rapid evidence review of service presentations and interventions.

Syed, Shabeer and Gilbert, Ruth and Wolpert, Miranda (2018) Parental alcohol misuse and the impact on children: a rapid evidence review of service presentations and interventions. London: UCL Great Ormond Street Institute of Child Health.

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Parental alcohol misuse (PAM) can have profound effects on children’s health and development. Yet, the extent to which the government, local authorities or clinical services are addressing PAM is not well understood. This rapid review was commissioned from the Children’s Policy Research Unit (CPRU) by the Department of Health and Social Care (DHSC) to inform national and local policy interventions for children affected by PAM. It combines published research (emphasising findings from systematic reviews), administrative data, birth cohort studies and expert feedback to seek answers on:

1. How do families who are affected by PAM present to services?
Objective: Review prevalence of PAM in England, as recorded by services where children and parents present.
2. What strategies to reduce PAM and its consequences for children could be integrated into existing services?
Objective: Review interventions aimed at reducing PAM and related-harms among children.

We summarise findings from 47 reviews and 313 primary studies of which 149 were randomised controlled trials (RCTs). However, a full systematic review involving synthesis of the quality and individual study findings was beyond the scope of this review.
• Whilst a large number of evaluations relevant to PAM have been reviewed previously, few well-funded or comprehensive studies have been conducted in the UK (only 2 relevant RCTs), and few interventions focus specifically on affected children.
• Family-based interventions focusing on systemic and behavioural couples’ therapy provide consistent positive evidence of improved family functioning and reductions of PAM, compared to interventions focusing on the problem drinker alone.
• Evidence of brief interventions (BI) in primary care including brief psychoeducational sessions, parenting skills interventions and psychoeducational groups, generally report positive results in encouraging affected parents into treatment and in improving family members psychosocial functioning, compared to treatment as usual.
• “Think-Family approaches” are a feasible approach for early identification and intervention for at-risk families affected by PAM, but need more robust evaluation.
• We found limited evidence on interventions for PAM regarding: (1) social care settings including those aimed at reducing out-of-home child placements, (2) community outreach interventions including housing services and 24/7 social support for high-risk drug and alcohol misusing mothers, (3) pharmacological interventions targeting pregnant women and the treatment impact this may have on children, and (4) interventions that target fathers.
• We found no evaluative intervention studies focusing on police settings, helplines, online interventions or education for PAM and/or affected children.

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