Preventing Maltreatment in Substance Dependent Parents of children under 2.5 years

Background: Many babies in the UK are born to drug-dependent parents, and dependence on psychoactive drugs during the postnatal period is associated with high rates of child maltreatment, with around a quarter of these... [ view full abstract ]

Background: Many babies in the UK are born to drug-dependent parents, and dependence on psychoactive drugs during the postnatal period is associated with high rates of child maltreatment, with around a quarter of these children being subject to a child protection plan. Parents who are dependent on psychoactive drugs are at risk of a wide range of parenting problems, and studies have found reduced sensitivity and responsiveness to both the infant’s physical and emotional needs. The poor outcomes that are associated with such drug dependency appear to be linked to the multiple difficulties experienced by such parents.

Aims: This study evaluates the effectiveness of the Parents under Pressure (PuP) Programme (Dawe and Harnett 2007), which is an international intervention that provides intensive support to this group of parents.

Methods: A multicentre randomised controlled trial using a mixed-methods approach to data collection and analysis. The study is being conducted in six family centres across the UK, and targets primary caregivers of children less than 2.5 years of age who are substance dependent. Consenting participants are randomly allocated to either the 20-week PuP programme or to standard care. The primary outcome is child abuse potential, and secondary outcomes include parent-infant/toddler interaction, substance use, parental mental health and emotional regulation, parenting stress, and infant/toddler socio-emotional adjustment.
Results: We will present the preliminary findings of the study in terms of the key maltreatment data, and demonstrate outcomes using videoclips that have been coded using the CARE-Index.

Discussion: This paper will examine the PUP model of working in contrast with other models that have recently been evaluated with this group of parents, and its effectiveness in reducing maltreatment.