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An evaluation of ‘Parents under pressure’ a parenting programme for mothers and fathers who misuse substances

Not all parents who misuse drugs or alcohol present a danger to their children; nevertheless, parental substance misuse can place babies and children at increased risk of maltreatment. Almost half of the families who were part of a serious case review between 2011 and 2014 misused alcohol or substances (Sidebotham et al, 2016). Substance misuse is often only one of a number of difficulties faced by these families, and these multiple adversities present a cumulative risk to children. The NSPCC is particularly concerned about risks to babies and young children given their greater vulnerability to maltreatment (Cuthbert et al, 2011) and as the scale of parental substance misuse has become clearer. Around 93,500 babies under the age of one in the UK are living with a parent who is classified as a ‘problematic’ drinker (Manning, 2011).

Parents Under Pressure (PuP) is a home-visiting service that aims to provide parenting support to parents who are in treatment1 for drug or alcohol misuse. This is with the aim of improving the quality of the parent–child relationship and reducing the risk of child maltreatment. The programme is underpinned by an ecological model that aims to address the complex and multiple problems inherent within these families and offers a structured yet non-sequential process of therapy. Mindfulness is a key aspect of the programme and the proposed mechanism of change, helping parents to recognise and regulate their emotions and be fully present throughout daily interactions with their child. Previous evaluations of PuP in Australia with the parents of children aged 2–8 years, and in the UK with pregnant mothers, found it to have a positive impact on parental wellbeing, parenting attitudes, child abuse potential, and outcomes for the child.

The NSPCC has delivered PuP since 2011 across eleven sites in England and Scotland. The service was initially delivered to families with parental substance misuse with children aged under two, but this was later extended to children aged under five. It was planned that the PuP programme would be delivered over a 20–24-week period.