Where's Dad? The Importance of Integrating Fatherhood and Parenting Programming into Substance Use Treatment for Men

Programme responses for men who perpetrate intimate partner violence in the context of alcohol or other drugs: a scoping review

Purpose

Substance use plays a significant role in the perpetration of much intimate partner violence (IPV). However, responses to these two issues are rarely integrated. Single focus programme responses can lead to poor outcomes for men as well as their families experiencing these intersecting issues. This scoping paper aims to establish the current state of knowledge on contextual factors influencing the development and implementation of combined programmes.

Design/methodology/approach

Four electronic databases were systematically searched in May 2021 and December 2021. Twenty-one peer-reviewed studies reporting on ten programmes were included.

Findings

This scoping review revealed that combined programme responses are an underdeveloped area of research and evaluation. The limited evidence base indicated systemic barriers hindering services’ capacity to expand this field of work, affecting implementation and outcomes. Support is required from the wider service systems to intervene in men’s perpetration of IPV in the context of substance use.

Practical implications

Findings in this scoping review demonstrate the importance of fostering a coordinated and collective response to IPV in the context of substance use. Combined programmes have the potential to reduce siloed practices, enabling more holistic responses for men with intersecting issues. However, researchers and policymakers must also address contextual issues hindering or enabling combined programmes’ implementation and development.

Originality/value

Mapping the evidence based on combined programmes provides direction for further development and research to expand this field of inquiry.

The association between maternal and paternal substance use and child substance use, internalizing and externalizing problems: a systematic review and meta-analysis

AIMS

There is substantial evidence showing an association between parental substance use and child substance use and/or mental health problems. Most research focuses upon maternal substance use, with the influence of paternal substance use often being overlooked. We aimed to investigate the differential effects of maternal and paternal substance use upon children aged 0-18 years.

METHODS

We used systematic review methods to identify observational studies examining the association between either maternal or paternal substance use and child substance use and/or mental health problems. The odds ratio (OR) effect measure was used, for ease of computation. We used a random-effects model with the inverse variance method to meta-analyse the findings from eligible studies.

RESULTS

We included 17 unique studies with a total of 47 374 child participants. Maternal and paternal substance use were both associated with increased odds of child any drug use [OR = 2.09; 95% confidence interval (CI) = 1.53, 2.86; n = 12 349 participants; three studies and OR = 2.86; 95% CI = 1.25, 6.54; n = 5692 participants; three studies, respectively], child alcohol problem use (OR = 2.16; 95% CI = 1.73, 2.71; n = 7339 participants; four studies and OR = 1.70; 95% CI = 1.36, 2.12; n = 14 219 participants; six studies), child externalizing problems (OR = 1.81; 95% CI = 1.01, 3.22; n = 1748 participants; three studies and OR = 1.60; 95% CI = 1.18, 2.17; n = 2508 participants; six studies) and child internalizing problems (OR = 1.60; 95% CI = 1.25, 2.06; n = 1748 participants; three studies and OR = 1.42; 95% CI = 1.12, 1.81; n = 2248 participants; five studies). Child any alcohol use was associated with maternal substance use only (OR = 2.26; 95% CI = 1.08, 4.70; n = 28 691 participants; five studies).

CONCLUSIONS

Both maternal and paternal substance use are associated with child substance use and mental health problems.

A recreational group intervention based on Relational Cultural Theory for women experiencing substance use disorders in Australia: A protocol

Gender differences exist in the progression, initiation and maintenance of substance use disorders (SUDs). Women encounter unique barriers to accessing treatment for their SUDs and commonly report higher perceptions of stigma around their substance use. Currently, there is a paucity of women-specific treatment options that address their perception of stigma and shame regarding SUDs. The Women of the West (WOW) programme is a pilot study that explores the subjective acceptability and feasibility of participating in a recreational and relational skill development group for women with SUDs. The pilot study adopts qualitative research methods including focus groups and interviews with ten participants who self-identify as women experiencing SUDs and two programme facilitators. The programme's primary aim is to promote participants' relational skills with peers in an enjoyable, and therapeutic environment. It is anticipated as participants develop their relational skills with peers, their sense of stigma regarding their SUDs and social isolation will decrease. Ultimately this can promote their long-term recovery from SUDs and overall well-being. Findings from this study will provide direction for future programme development and treatment services seeking to promote better outcomes for women with SUDs.

Impact of Plans of Safe Care on Prenatally Substance Exposed Infants

OBJECTIVE

To assess the impact of recent federal statute changes mandating child welfare-based Plan of Safe Care (POSC) supportive programming and community-based linkages to treatment providers, resources, and services for families of infants affected by prenatal substance exposure (IPSE).

STUDY DESIGN

Retrospective review of Delaware's statewide child welfare case registry data for IPSE birth notifications and subsequent hotline reports for serious physical injury/fatality concerns from November 1, 2018-October 31, 2020. Abstracted variables included IPSE sex, substance exposure type, family characteristics (maternal personal child welfare history or mental health diagnosis, treatment engagement), and POSC referrals.

RESULTS

Of 1436 IPSE, 1347 (93.8%) had POSC support. Most IPSE (67.2%) had exposure to single substance types prenatally. Nearly 90% avoided out-of-home placement. Nearly one-fourth of mothers delivered a prior IPSE; 40% of mothers had personal histories of childhood protective services involvement. Also, 43.5% of mothers and 9.1% of fathers were referred to community-based resources, including substance use, mental health treatment, parenting classes, and home visiting nursing. Nearly 58% of IPSE were referred for pediatric/developmental assessment. Notably, 0.82% (11 out of 1347) of IPSE with POSC sustained serious physical or fatal injury.

CONCLUSIONS

POSC promote supportive, potentially protective linkages to community-based programming for IPSE and their families.

Improving Parenting Practices Among Fathers Who Misuse Opioids: Fathering Through Change Intervention

Fathers have been largely neglected in the parenting literature though there is a critical need to improve parenting practices among fathers who misuse opioids in the midst of the opioid epidemic. Urgency is critical to rapidly intervene in the lives of fathers and children to reduce misuse and interrupt intergenerational cycles of substance misuse. Thus, we provide an overview of solutions to adapt existing parenting interventions for fathers who misuse opioids to accelerate the pace of science for this population.

Fathers and substance misuse: a literature review

Purpose

The purpose of this paper is to review the following research questions from the available literature: What evidence is there to suggest that substance misuse specifically by fathers (including alcohol and other drugs) causes wider harms, including child welfare concerns? substance misuse, recovery, parents, fathers, fathering, drugs/ alcohol services. How do professionals respond specifically to substance misuse by fathers? Do interventions aimed at parental substance misuse (particularly in the UK) include both mothers and fathers and if so how?

Design/methodology/approach

A scoping literature review was conducted which identified 34 papers (including scoping reviews published in 2006 and 2008, covering the period 1990-2005) and 26 additional studies published between 2002 and 2020.

Findings

The review in this paper is organised into six themes: Negative impact of men’s substance misuse problems on their parenting behaviours; quality of the relationship between parents affected by substance misuse of the fathers, in turn affecting the parenting behaviour and outcomes for children; importance to fathers of their fathering role (for example, as a financial provider); difficulties fathers may face in developing their fathering role; sidelining of the fathering role in substance misuse services; and professionals tending to focus on the mother’s role in parenting inventions and services.

Originality/value

This paper focusses on fathers and substance misuse, which is an under-researched field within the wider contexts of fathering research and research into parental substance misuse.

Living Fatherhood in Adults Addicted to Substances: A Qualitative Study of Fathers in Psycho-Rehabilitative Drug Addiction Treatment for Heroin and Cocaine

The research aims to investigate the emotional experiences of the individuals who use drugs in terms of their parenting role as father, within a rehabilitative context. The study aims to analyze how dependence affects the exercise of the parental role, specifically paternity, with the aim of offering an overview of the father-son relationship while considering the possible limitations that characterize those who are forced to live parenting in an atypical way. It is necessary to help individuals who use drugs to be able to help them in life with the goal of establish a better parenting awareness and a good relationship with their father and their children. The research work made use of qualitative tools, specifically semi-structured interview, which was administered to a sample of 18 fathers that were treated in a rehabilitation clinic for individuals who use drugs. The used semi-structured interview made it possible to analyze the perception of participants about their paternity, the quality of the relationship with their father and their children, and the influence that the narcotic substance has generated in the relationship with their father and with their children.

Coparenting of fathers in residential substance use treatment

Purpose

Few studies have examined coparenting characteristics and experiences of fathers who use substances and are aggressive with their partners. The purpose of this paper is to use quantitative and qualitative measures to increase knowledge of coparenting of fathers with co-occurring substance use disorders and histories of intimate partner violence (IPV) to inform intervention efforts with this population.

Design/methodology/approach

Baseline interviews were used from 62 fathers in a residential treatment center who participated in a longitudinal research study about interventions for substance-misusing fathers. Coparenting-related themes were identified through qualitatively analyzing transcripts of fathers’ responses to the Articulated Thoughts in Simulated Situations (ATSS) task. Fathers completed the Coparenting Relationship Scale (CRS), Conflict Tactics Scale Revised and the Child Trauma Questionnaire. Correlations were examined to determine if themes generated from the ATSS task were associated with IPV severity or coparenting relationship.

Findings

Qualitative analysis of transcripts revealed six themes: hostility, dismissiveness, non-confrontational, child-focused, feeling undermined and being active or non-active in the ATSS task. Qualitative themes were not significantly correlated with self-reported coparenting on the CRS except coded dismissive responses were positively associated with self-reported undermining by their coparent. Self-reported physical and psychological aggression were significantly positively associated with self-reported coparent undermining but were not significantly associated with qualitative themes.

Originality/value

This study is the first to use qualitative analysis of responses to coparenting situations to understand ways fathers in substance misuse treatment with histories of IPV think about coparenting to guide interventions.

A randomized pilot trial of two parenting interventions for fathers in residential substance use disorder treatment

Residential substance misuse treatment programs for men typically do not integrate treatment for intimate partner violence (IPV) or parenting despite significant overlap between substance misuse, IPV and child maltreatment. A randomized trial compared two fatherhood focused interventions in 6-month residential substance misuse treatment programs. Fathers for Change (F4C) is an integrated intervention targeting IPV and child maltreatment. Dads 'n' Kids (DNK) is a psychoeducational intervention focused on child development and behavioral parenting skills. Sixty-two fathers were randomly assigned to F4C or DNK. They received 12 weeks of individual treatment while in the residential facility and were offered 4 aftercare sessions following discharge. They were assessed prior to treatment, at the time of residential discharge, following completion of the intervention booster sessions, and 3 months following intervention. Overall, both groups showed significant reductions in affect dysregulation, anger, and IPV. F4C fathers showed significantly greater decreases in affect dysregulation problems. There were no significant differences between groups on IPV but men who received F4C may have been less likely to use substances after leaving residential treatment. Integration of fatherhood focused interventions were possible and welcomed by residents at the facilities. F4C showed some benefit over DNK in terms of affect dysregulation symptoms and substance use relapse.