At least one in six young people in Ireland suffers from alcohol-related harms at home due to parental problem alcohol use. This exposure is considered an adverse childhood experience (ACE), the effects of which can be lifelong, impacting both physical and mental health. Silent Voices, an initiative of Alcohol Action Ireland (AAI), seeks to highlight the harm caused by parental problem alcohol use and its impact across the lifespan.1

Using accounts from children – including reflections from adult children of alcoholics (ACOAs) – affected by parental problem alcohol use, AAI collaborated with the School of Applied Psychology at University College Cork (UCC) to understand how children cope with this ACE, particularly during their school years.2 It considers the role that schools could play in identifying and supporting this cohort of children and makes recommendations for teachers, schools, and the education system.

Alcohol-related harm to children

Research has shown that children growing up in a home with parental problem alcohol use are more likely to develop problems with substance use themselves and experience poor outcomes that persist into adulthood.3 Moreover, these children have been observed to adapt to their environment by developing a role within their dysfunctional family, which when carried into adulthood and into other relationships can have negative consequences.4,5,6

The roles include the ‘family hero’, who in overachieving and trying to make the family look good often feels isolated, and the ‘mascot’, who jokes in order to turn the focus away from the painful truth of the situation yet is often fearful, embarrassed, and angry. The ‘scapegoat’, whose negative behaviour turns attention away from the alcohol-dependent person, gets into trouble at work or school and often turns to high-risk behaviours, while the ‘lost child’ withdraws from the situation, cares deeply but emotionally checks out to avoid trouble and drama. The ‘caretaker’, highly responsible, manages conflict and keeps the family going and yet enables the addict by taking on their problems and duties.5

Parental problem alcohol use and the school environment

Children may also worry about their parent’s wellbeing, which can affect their ability to concentrate and learn. Research shows that children of chronic alcohol users can exhibit learning difficulties, reading problems, poor concentration, and low performance in school.7 Research also shows that the unpredictable and frightening behaviour of parental substance use can cause symptoms in children similar to that of post-traumatic stress disorder (PTSD).7,8

School can provide a safe haven for children experiencing parental problem alcohol use, but even away from home many children reported carrying the burden of their home lives with them. Often a sense of confusion exists, with the child unable to fully comprehend or articulate what is going on in their home and unable to understand that their situation is not normal. Another common theme is secrecy and loyalty
to their parents.

As they enter secondary school, children gain a greater awareness and understanding of their environment. The UCC study indicates that varying coping strategies were employed, from rebellion to apathy to industriousness – keeping busy externally to distract from inner turmoil.2 With all strategies, the common goal is one of escapism and avoidance of a painful reality.

What can help?

Research highlights that factors that provide support, friendship, and opportunities for development build children’s resilience and protect them against some harmful impacts of ACEs.9 The UCC study includes direct quotations and accounts of experiences from ACOAs, explaining what helped them to cope better during their school years and what their recommendations for the future are, echoing those made in the academic literature.

The importance of a sensitive approach to the child was highlighted. The fact that it should not be the child’s responsibility to come forward for help is reflected in the recommendations noting the importance of the immediate availability of someone to talk to when needed. A good support network outside the home was key to becoming resilient, reinforcing the concept of ‘one good adult’.10, 11

Respondents felt that children need a place where they can feel safe to talk about their problems. Increasing openness on the issue of parental problem alcohol use among school-aged children might help them to feel more comfortable in coming forward in this environment. Educational talks about alcohol and the availability of school psychologists were also suggested.

Participants also expressed the need for early intervention, greater awareness among professionals, access to talk therapies, and the provision of trauma-informed frontline services.12 Overall, a wider societal awareness of alcohol-related harm is key to tackling the stigma and thus enabling parents to get treatment and children to get appropriate supports. Implementation of a public health campaign to address this was suggested.

Recommendations

For schools and teachers

Building on the feedback by ACOAs, the study sets out a number of recommendations:

• Educators are extremely well placed to identify children experiencing harm from parental problem alcohol use that impacts their development. Training provision in relation to trauma-informed approaches and ACEs should be implemented at teacher training level and at all levels of professional development – from teachers to principals to education welfare officers to special needs assistants and administrative staff.
• Guidance on the issues pertaining to children with ACEs in schools, including parental problem alcohol use, should be made available to all educators.
• Schools should seek to strengthen collaboration with Tusla and An Garda Síochána to support a child who might be at risk of hidden harm. The United Kingdom’s early intervention model, Operation Encompass,13 should be implemented in Ireland. 

For wider public services

• Awareness of parental alcohol use during pregnancy should be strengthened across society so that women have the information and support they require to stop drinking during pregnancy, thus preventing fetal alcohol spectrum disorders.
• Awareness of parental problem alcohol use and its impact on young people and adult children should be raised through information campaigns and training that targets healthcare, social care, early years, child protection, family support, education, and mental health sectors, as well as families and communities.
• Investment should be made so that frontline services and counsellors are trauma informed in order to recognise and adequately deal with the issues that stem from adversity in childhood and from children and adult children affected by parental problem alcohol use. Innovative evidence-based programmes should be more widely available in communities nationwide.14 

Impact of Covid-19 pandemic

This research predates Covid-19. AAI believes that the problem of young people experiencing issues in the home due to alcohol is likely to have increased significantly since early 2020 due to the pandemic. Data show that despite all licensed premises being closed during lockdown, alcohol sales experienced only a modest reduction, indicating that Ireland’s alcohol users substituted drinking in regulated licensed premises to consumption in the home.15 For young people, exposure to this increase in parental home drinking was accompanied by school closures, summer activities being curtailed, and lack of access to peer support.

Children and young people nowadays need their schools to be not just a place of learning but a place of refuge and support for other issues in their lives. Schools should become a place that recognises young people’s trauma, while teachers and schools should be supported to nurture trauma-informed environments.16

2 Keating L and Lambert S (2020) Understanding the experiences of adult children of alcoholics. Cork: All-Ireland Students Congress/UCC. Available online at: https://alcoholireland.ie/wpfb-file/annotated-fyp20final2028129-docx-pdf/2

3 Callingham M (2004) Survey for NACOA: Study to investigate the extent and nature of the problem of adults who grew up in a home with alcohol-dependent parents. London: National Association for Children of Addiction (NACOA).

4 Alvernia University (2021) Coping with addiction: 6 dysfunctional family roles. Reading, PA: Alvernia University. Available online at:
https://online.alvernia.edu/infographics/coping-with-addiction-6-dysfunctional-family-roles/

5 ASCERT (2013) Taking the lid off: a resource for families living with addiction and problematic substance abuse. Lisburn: ASCERT. Available online at: https://alcoholireland.ie/download/publications/alcohol_health/children_young_people/TakingTheLidOffBook.pdf

6 ASCERT (2008) Taking the lid off: a resource for families living with addiction and problematic substance abuse [workbook]. Lisburn: ASCERT. Available online at:
https://alcoholireland.ie/download/publications/alcohol_health/children_young_people/TakingTheLidOff_Adultworkbook.pdf

7 Cleaver H, Unell I and Aldgate J (2011) Children’s needs – parenting capacity: child abuse: parental mental illness, learning disability, substance misuse and domestic violence. London: The Stationery Office (TSO).

8 Holt S, Buckley H and Whelan S (2008) The impact of exposure to domestic violence on children and young people: a review of the literature. Child Abuse Negl 32(8): 797–810.

9 Bellis MA, Hughes K, Ford K, et al. (2018) Adverse childhood experiences and sources of childhood resilience: a retrospective study of their combined relationships with child health and educational attendance. BMC Public Health 18: 792. Available online at: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-5699-8

10 Walsh B (2015) The science of resilience: why some children can thrive despite adversity. Cambridge, MA: Harvard Graduate School of Education. Available online at: https://www.gse.harvard.edu/news/uk/15/03/science-resilience

11 Jigsaw (2020) What does one good adult mean? Dublin: Jigsaw. 

12 This mirrors recommendations made in a recently published UK report on alcohol harm. See Commission on Alcohol Harm (2020) ‘It’s everywhere’ – alcohol’s public face and private harm: the report of the Commission on Alcohol Harm. London: Commission on Alcohol Harm, pp. 15–22.

13      Operation Encompass directly connects the police with schools to ensure support for children living with domestic abuse in their homes, in light of a police-attended incident of domestic abuse the night before. Rapid provision of support within the school environment means children are better safeguarded against the short-term, medium-term, and long-term effects of domestic abuse. For further information, visit https://www.operationencompass.org/

14      Programmes specifically tackling parental alcohol misuse include: M-Pact
(https://www.actiononaddiction.org.uk/addiction-treatment/families-and-children/m-pact); Parents Under Pressure
(http://www.pupprogram.net.au/); and Rory (https://www.roryresource.org.uk/).

15 For AAI’s statement on alcohol sales figures, visit:
https://alcoholireland.ie/provisional-revenue-receipts-demonstrate-durability-irish-alcohol-market-despite-covid-19-crisis/

16 For further information on the joint AAI/Mental Health Ireland paper calling for trauma-informed services and schools, visit:
https://alcoholireland.ie/download/publications/Trauma-informed-care-position-paper.pdf