Les The information presented here will help you learn more about parenting and addiction!

3In the province of Quebec,
38% of adults in treatment for addiction are parents of children of 17 or younger and

20% of parents feel they need help concerning their role as a parent (30% of mothers and 15% of fathers).¹

Substance addiction directly interferes with parenthood¹² and puts strain on parents’ ability to provide their children with the care required for their development².

27% of fathers and 43% of mothers for whom a youth protection services report was retained have problematic alcohol and substance use habits¹³.

50% of children living with a parent with an addiction are placed in foster care at age 7 and this proportion increases at 70% at age 13⁸.

Some factors can reduce a child’s risks of developing problems¹⁴:

• Secure attachment
• Good family cohesion
• Good adaptive capacities in the family
• Interpersonal support for the child

HOWEVER, in organizations for addiction that also address parenthood, 60% do so only little or informally with their clients¹⁵. In addition, counsellors report feeling poorly equipped to support their clients in their role as parents¹⁶.

Several PSTP are offered in the United States, but also in Canada.

Since 2008, PSTP have been developed and adapted for families in which at least one parent has an addiction, and such programs have been implanted in several different addiction rehabilitation centers across the province of Quebec.

These programs aim to improve parents’ skills so they can better manage their children’s behaviours^{17, 18, 19, 20}.

PSTP have shown their effectiveness²¹ and appear to be promising for parents with an addiction^{13, 22, 23, 24, 25}.

These programs allow to ^{17, 26, 27, 28}:

• parental skills;
• inappropriate parental attitudes;
• the use of positive parental practices;
• the risks of poor treatment of children;
• the risks of negligence toward children.

Studies conducted with parents with an addiction indicate that those who completed a PSTP ¹³:

• have more realistic expectations regarding their children’s behaviours;
• are more empathic toward their children’s needs;
• use less physical punishment;
• show less signs of "parentification";
• value their children’s independence more.

12 months after having participated in a PSTP, these parents ^{29, 30}:

• deal better with situations where they are confronted to substance use;
• set more rules at home;
• use substances less.

Finally, families where children have been removed from their home due to a parent’s substance use habits and where the parent participated in a PSTP are more likely to be reunited again compared to families where parents did not participate in such programs²².

Factors associated with PSTP effectiveness

1. Taking action early : The best results are observed in children between ages 3 and 10^{31, 32, 33}.
2. Being accessible : Offering the program in proximity to clients and at the right time^{30, 33}.
3. Identifying specific needs : Performing a rigorous family assessment³³.
4. Improving family relationships : Including topics such as communication, selective attention, and parental control^{34, 35, 36}.
5. Generalizing change : Reinvesting changes made at the clinic at home³⁷.
6. Offering dosage and intensity : Between 25 and 50 hours of exposure are recommended along with weekly meetings³⁸.
7. Adapting interventions : To the children’s age, level of development and maturity^{6, 33, 39}.
8. Offering incentives : Promoting the recruitment and retention of families in the program (food, transportation, offering a neutral program, rewards for completing homework, graduation)^{40, 41}.
9. Using interactive teaching methods : Promoting role playing, active modeling, family practice sessions, practical homework, videos illustrating suitable and unsuitable practices^{6, 18, 33, 37, 42, 43, 44}.
10. Recruiting motivated and competent counsellors : Who know the program well and have good relational skills (warmth, sensitivity, humour, empathy, guidance, communication, listening, flexibility, credibility, experience with children)^{33, 35}.
11. Planning a follow-up : Offering additional meetings or community references to families to maximize their achievements³³.

Because ... there are very few PSTP that exist specifically for families in which parents have an addiction to alcohol or drugs.

Because ... when parents with an addiction participate in PSTP with families presenting less or different problems, they often feel out of step with these other families. They are afraid of being judged.

Because ... parents with an addiction are suspicious toward counsellors and fear losing custody of their child⁴⁵. So offering a PSTP specifically designed for them facilitates recruitment and retention in the program.

Because ... simultaneously treating addiction and parenthood issues allows to take preventive action with children who are directly affected by the consequences of their parent’s addiction.

Because ... a specific PSTP for families where a parent has an alcohol or drug addiction provides a supportive environment where fears of being judged and stigmatized are less present^{46, 47}.

Because ... a specific PSTP for families in which parents have an alcohol or drug addiction helps such parents while also protecting their children.

Are you a counsellor who works with parents with an addiction and their children ?

Would you like to offer the Cap sur la famille program in your organization ?

The section Program training will provide you with all the necessary information on the program and training. All you need to do is sign up.

Do parents with an alcohol or drug addiction use the services of your organization ?

Would you like to refer these parents to the Cap sur la famille program in their area ?

The section Where is it offered ? will show you where the program is offered in each administrative region of the province of Quebec.

Here is leaflet to give to parents.

Do not hesitate to refer parents to the Parent section of the website. There, they will find information about the program, testimonials from families facing similar challenges, and tools to support them in their parenting.

1. Bertrand, K., Allard, P., Ménard, J.-M., Nadeau, L., Chamberland, C., Léveillé, S. et Trocmé, N. (2007). Parents toxicomanes en traitement : une réadaptation qui protège les enfants ? Enfants à protéger, parents à aider : des univers à rapprocher (p. 69-87). Québec : Presses de l’Université du Québec.

2. Conners, N. A., Bradley, R. H., Mansell, L. W., Liu, J. Y., Roberts, T. J., Burgdorf, K. et Herrell, J. M. (2003). Children of mothers with serious substance abuse problems: An accumulation of risks. The American Journal of Drug and Alcohol Abuse, 29(4), 743–758.

3. Kuperman, S., Chan, G., Kramer, J. R., Bierut, L., Bucholz, K. K., Fox, L., Hesselbrock, V., et al. (2005). Relationship of age of first drink to child behavioral problems and family psychopathology. Alcoholism: Clinical and Experimental Research, 29(10), 1869–1876.

4. Laventure, M., Ferland, F., Blanchette-Martin, N., Genois, R., Garceau, P., et Turcotte, S. (2018). Programme familial d’entrainement aux habiletés pour les parents ayant une dépendance à l’alcool ou aux drogues et leurs enfants âgés de 6 à 12 ans : caractéristiques des familles rejointes par le programme. Revue de psychoéducation, 47(2), 313-332.

5. Mayes, L. et Truman, S. (2002). Substance abuse and parenting. Handbook of parenting, 4, 329–359.

6. Centre canadien de lutte contre l’alcoolisme et les toxicomanies. (2011). Développer nos habiletés : Lignes directrices canadiennes pour les programmes de prévention de l’abus de substances axés sur les habiletés familiales. Ottawa, Ontario : Centre canadien de lutte contre l’alcoolisme et les toxicomanies.

7. Barrocas, J., Vieira-Santos, S., et Paixão, R. (2016). Parenting and drug addiction: A psychodynamic proposal based on a multifactorial perspective. Psychoanalytic psychology, 33(1), 161.

8. Jääskeläinen, M., Holmila, M., Notkola, I.-L. et Raitasalo, K. (2016). A typology of families with parental alcohol or drug abuse. Addiction Research & Theory, 24(4), 288–299.

9. Vitaro, F., Carbonneau, R. et Assaad, J.-M. (2006). Les enfants de parents affectés d’une dépendance : problèmes et résilience. Québec : Presses de l’Université du Québec.

10. Dunn, M. G., Tarter, R. E., Mezzich, A. C., Vanyukov, M., Kirisci, L. et Kirillova, G. (2002). Origins and consequences of child neglect in substance abuse families. Clinical Psychology Review, 22(7), 1063–1090.

11. Hien, D. et Honeyman, T. (2000). A closer look at the drug abuse—Maternal aggression link. Journal of Interpersonal Violence, 15(5), 503–522.

12. Street, K., Whitlingum, G., Gibson, P., Cairns, P. et Ellis, M. (2008). Is adequate parenting compatible with maternal drug use ? A 5-year follow-up. Child: care, health and development, 34(2), 204–206.

13. Estefan, L. F., Coulter, M. L., VandeWeerd, C. L., Armstrong, M. et Gorski, P. (2013). Relationships between stressors and parenting attitudes in a child welfare parenting program. Journal of Child and Family Studies, 22(2), 199–208.

14. Wlodarczyk, O., Schwarze, M., Rumpf, H.-J., Metzner, F. et Pawils, S. (2017). Protective mental health factors in children of parents with alcohol and drug use disorders: A systematic review. PloS one, 12(6), e0179140.

15. Arria, A. M., Mericle, A. A., Rallo, D., Moe, J., White, W. L., Winters, K. C. et O’Connor, G. (2013). Integration of parenting skills education and interventions in addiction treatment. Journal of Addiction Medicine, 7(1), 1.

16. Itäpuisto, M. S. (2014). Helping the children of substance-abusing parents in the context of outpatient substance abuse treatment. Addiction Research & Theory, 22(6), 498–504.

17. Lundahl, B., Risser, H. J. et Lovejoy, M. C. (2006). A meta-analysis of parent training: Moderators and follow-up effects. Clinical psychology review, 26(1), 86–104.

18. Nix, R. L., Bierman, K. L. et McMahon, R. J. (2009). How attendance and quality of participation affect treatment response to parent management training. Journal of Consulting and Clinical Psychology, 77(3), 429.

19. Normandeau, S. et Venet, M. (2000). Comment intervenir auprès et par l’entremise des parents. Prévention de problèmes d’adaptation chez les jeunes (Vol. 1-1, p. 141‑188). Québec : Presses de l’Université Laval.

20. Reid, M. J., Webster-Stratton, C. et Baydar, N. (2004). Halting the development of conduct problems in Head Start children: The effects of parent training. Journal of Clinical Child and Adolescent Psychology, 33(2), 279–291.

21. Comeau, L., Desjardins, N., Poissant, J., Chan, A., Beauregard, D., et Laverdure, J. (2013). Avis scientifique sur les programmes de formation aux habiletés parentales en groupe. Québec : Direction du développement des individus et des communautés, Institut national de santé publique du Québec.

22. Brook, J., McDonald, T. P. et Yan, Y. (2012). An analysis of the impact of the Strengthening Families Program on family reunification in child welfare. Children and Youth Services Review, 34(4), 691–695.

23. Gainey, R. R., Haggerty, K. P., Fleming, C. B. et Catalano, R. F. (2007). Teaching parenting skills in a methadone treatment setting. Social Work Research, 31(3), 185–190.

24. Haggerty, K. P., Skinner, M., Fleming, C. B., Gainey, R. R. et Catalano, R. F. (2008). Long-term effects of the Focus on Families project on substance use disorders among children of parents in methadone treatment. Addiction, 103(12), 2008–2016.

25. Johnson-Motoyama, M., Brook, J., Yan, Y. et McDonald, T. P. (2013). Cost analysis of the strengthening families program in reducing time to family reunification among substance-affected families. Children and Youth Services Review, 35(2), 244–252.

26. Chen, M. et Chan, K. L. (2016). Effects of parenting programs on child maltreatment prevention: A meta-analysis. Trauma, Violence, & Abuse, 17(1), 88–104.

27. Niccols, A., Milligan, K., Sword, W., Thabane, L., Henderson, J., et Smith, A. (2012). Integrated programs for mothers with substance abuse issues: A systematic review of studies reporting on parenting outcomes. Harm reduction journal, 9(1), 14.

28. Serketich, W. J. et Dumas, J. E. (1996). The effectiveness of behavioral parent training to modify antisocial behavior in children: A meta-analysis. Behavior therapy, 27(2), 171–186.

29. Catalano, R. F., Gainey, R. R., Fleming, C. B., Haggerty, K. P. et Johnson, N. O. (1999). An experimental intervention with families of substance abusers: one-year follow-up of the focus on families project. Addiction, 94(2), 241–254.

30. Moreland, A. D. et McRae-Clark, A. (2018). Parenting outcomes of parenting interventions in integrated substance-use treatment programs: A systematic review. Journal of Substance Abuse Treatment, 89, 52-59.

31. Alvarado, R. et Kumpfer, K. L. (2000). Strengthening America’s families. Juvenile Justice, 7(2), 8-18.

32. Webster-Stratton, C. et Taylor, T. (2001). Nipping early risk factors in the bud: Preventing substance abuse, delinquency and violence in adolescence through interventions targeted at young children (0-8 years). Prevention Science, 2(3), 165-192.

33. Wilson, J. J., Backman, L. et Nunes, E. V. (2007). The identification prevention and treatment of vulnerabilities among children of alcohol or drug-dependent parents. Dans J.J. Wilson. (dir.). Mental health interventions and services for vulnerable children and young people (p. 203-232). London : Jessica Kingsley Publisher.

34. Kumpfer, K. L. (1996). Selective Prevention Interventions: The Strengthening Families Program. Dans R.S. Ashery, E.B. Robertson et K.L. Kumpfer (dir.), Drug Abuse Prevention Trough Family Intervention (p. 160-207). Rockville, MD : National Institute on Drug Abuse Research, US Departement of Health and Human Services.

35. Kumpfer, K. L. et Alvarado, R. (1998). Effective family strengthening intervention. Office of Juvenile Justice and Delinquency Prevention, novembre, 1-15.

36. Kumpfer, K. L., Alvarado, R. et Whiteside, H. O. (2003). Family-Based Interventions for Substance Use and Misuse Prevention. Substance Use & Misuse, 38(11-13), 1759-1787.

37. Kumpfer, K. L. et Alvarado, R. (2003). Family-Strengthening approaches for the prevention of youth problem behaviors. American Psychologist, 58(6/7), 467-465.

38. Patterson G. R. et Narrett, C. M. (1990). The development of a reliable and valid treatment program for aggressive young children. International Journal of Mental Health, 19(3), 19- 26.

39. Kumpfer, K. L. et Alder, S. (2003). Dissemination of research-based familiy interventions for the prevention of substance abuse. Dans Z. Sloboda et W.J. Bukoski (dir.), Handbook of drugs abuse prevention (p. 75-119). New-York : Kluwer Academic/Plenium.

40. Barnard, M. et McKeganey, N. (2004). The impact of parental problem drug use on children: what is the problem and what can be done to help ? Addiction, 99(5), 552-559.

41. Kumpfer, K. L., Alvarado, R., Tait, C. et Turner, C. (2002). Effectiveness of school-based family and children's skills training for substance abuse prevention among 6-8- year-old rural children. Psychology of Addictive Behaviors, 16(4 suppl.), 65-71.

42. Nixon, R., Sweeney, L., Ericson, D. B. et Touyz, S. W. (2003). Parent-child interaction therapy: A comparison of standard and abbreviated treatments for oppositional defiant preschoolers. Journal of Consulting and Clinical Psychology, 71(2), 251-260.

43. Small, S. A., Cooney, S. M. et O’Connor, C. (2009). Evidence-Informed Program Improvement: Using Principles of Effectiveness to Enhance the Quality and Impact of Family-Based Prevention Programs. Family Relations, 58(1), 1-13.

44. Webster-Stratton, C. (1994). Advancing videotape parent training: A comparison study. Journal of Consulting and Clinical Psychology, 65(3), 93-105.

45. Hogan, D. et Higgins, L. (2001). When parents use drugs: key findings from a study of children in the care of drug-using parents. Dublin : Children’s Research Centre.

46. Charbonneau, R. (2011). Famille et toxicomanie : la problématique du recrutement (Essai de maîtrise en psychoéducation). Université de Sherbrooke, Québec.

47. Klee, H., Jackson, M. et Lewis, S. (dir.) (2002). Drug misuse and motherhood. London; New York : Routledge.