In this section

  • Quick start guide
  • Purpose of this Toolkit
  • Who will find it useful
  • What’s in the Toolkit
  • Toolkit features
  • Feedback
  • Where this Toolkit comes from
  • The Comic Relief projects

Quick start guide

We suggest that you start with the Quick Healthcheck – this consists of ten quick questions which enable us to suggest which parts of the Toolkit you may want to look at first. Also, take a look at the Service Provider Checklist (SPC) and model for an effective service provider.

Purpose of this toolkit

The aim of this toolkit is to indicate the features of effective services for children whose parents misuse alcohol. Whether you are commissioning or developing a new service or reviewing an existing service we hope you will find valuable information and suggestions to help you improve the outcomes for vulnerable children.

What this Toolkit is

The Alcohol Hidden Harm Toolkit (AHHT) is a series of short modules focusing on different aspects of designing, planning and delivering an alcohol hidden harm service.

Alongside the ten modules, there is a series of ‘extras’ which are intended for use in conjunction with the modules. Most of the content is text based, but there are video and audio clips to explain some of the content and introduce concepts in more detail.

There’s a glossary to explain terminology, and a resources list for further reading and investigation.

Each module is based on action learning – containing discussion, activities, case studies and suggestions for further reading. Overall this toolkit offers a wide range of tools for use in the process of designing, planning and delivering a better AHH service.

Who will find it useful

  • Funding providers and commissioners;
  • Host organisations establishing or delivering services for children whose parents misuse alcohol;
  • Project leaders with responsibility for developing, improving and sustaining services for children whose parents misuse alcohol;
  • Agencies working in partnership with those who are developing or delivering services for children whose parents misuse alcohol;
  • Trainers working with organisations to develop or deliver services for children whose parents misuse alcohol;
  • Managers working with staff and volunteers to deliver services for children whose parents misuse alcohol.

What’s in this Toolkit

The Toolkit core content is divided into ten sections:

  1. Agreeing outcomes
  2. *Needs assessment
  3. Evaluation
  4. *Leadership
  5. *Management
  6. *Partnership
  7. *Service qualities
  8. *Practitioner qualities
  9. *Intervention style
  10. *Understanding outcomes: community, agency and family

The sections marked with * are summarised in the service provider checklist (SPC). In the SPC each section is broken down into components, each of which is accompanied by a brief description. You will find it useful to become familiar with the checklist before you begin to work through this toolkit. Each component represents a key finding from the evaluation of the five Comic Relief projects (see below): an aspect of an alcohol hidden harm service which made an important contribution to the overall outcomes for children and their families.

The checklist relates closely to a model of an effective service provider. The model shows the relationship of each component in the SPC to the others, and to the overall aim of improved outcomes for children. The model is included to help with the planning, auditing and quality assurance of your service.

Together, the checklist and model will provide you with an audit tool for your service, whether it is a new service, or one you are hoping to develop further. You can use the checklist to identify gaps or give your service a ranking for each item. Ideally you will involve service users and other critical friends in this process so that you get a balanced view.

Although all the sections are intended to help with the planning and delivery of effective alcohol hidden harm services,some users will find some sections more useful than others. For example:

  • Those with responsibility for leading organisations which have overall responsibility for these services will find ‘Getting started’ and ‘Needs assessment’ particularly useful, with their focus on clarifying outcomes for clients, as well as the sections specifically dealing with ‘Leadership’ and ‘Outcomes’.
  • Managers and those responsible for developing partnerships will find the sections on ‘Management’ and on ‘Partnership’ useful.
  • Those responsible for recruiting, training and retaining workers and volunteers will find the section on ‘Service’ and ‘Practitioner qualities’ helpful.
  • All those involved in developing, delivering and sustaining alcohol hidden harm services will find the section on ‘intervention style’ of value.

You will find it helpful to work through some of the sections as a team and also with members of service user groups and other agencies with whom you work, to help you to develop a better understanding of the issue of alcohol hidden harm and a stronger, more joined up approach to reducing alcohol hidden harm in your community.

Each section of the toolkit has some suggestions for actions you can take to help develop, or improve a service for children whose parent(s) misuse alcohol. You will also find links to other resources, examples and case studies from the five services funded by Comic Relief.

Each section can be printed out direct from the page - just click on the printer symbol at the beginning of the section. You may want to enable duplex printing if your printer supports this as the sections are often several pages long.

Toolkit features

  • Quick Healthcheck Where to start? This quick quiz collects some information about where you think you are on a number of scales, then suggests the modules you might like to look at first. It’s not prescriptive, and you can take as much or as little notice of the suggestions as you like. We hope it’s a help in getting started.

  • Section-by-section guide to an effective service Ideally you’ll work through all the sections. Probably not all at once, and probably not in any particular sequence. They’re not interdependent – so you don’t have to have looked at one before you can make sense of another. Each section has a video clip by the author introducing the section and explaining what it contains.

  • Case studies feature in most sections, and are taken from the evaluation of the five Comic Relief projects, so they are real-life examples from recent experience and reflecting the reality of delivery AHH services. They can be used as a discussion starter, more here

  • Logic models and a detailed explanation how to use them with an example and a blank template to download.

  • Resource list and web links. This includes a Practitioner resource guide by Wendy Robinson – this resource is intended mainly for practitioners.

  • The Service Provider Checklist and Model of Effective Service Development are at the heart of the Toolkit, and are derived from the learning taken from the evaluation of the five AHH projects. The SPC is a distillation of the learning from the evaluation of the five Comic Relief funded AHH projects (see Where this Toolkit comes from, below). It is closely allied to the Model of effective Service Development. Both these items have audio introductions by the authors, and can be downloaded and printed in PDF and Word formats.The model for an effective service provider has been described as the scaffolding you need to build a house – once the house has been built; you no longer need the scaffolding. The SPC, on the other hand could be described as the maintenance manual for the house. It helps you to monitor and assess the structure and integrity of the building on an on-going basis. You may need to reinstate the scaffolding from time to time to make changes or to carry out repairs. So it’s essential to become familiar with both these documents. You can download and print them out in pdf or Word formats but you can also use the Word version of the SPC to carry out an audit of your service or ensure a new service is developing on the right lines.

  • Glossary – explains commonly-used terms that occur in the Toolkit.

All these features can be easily printed out for use with teams, colleagues etc. Just look for the printer symbol at the top of the section. You may want to enable duplex printing if you have it available to reduce paper consumption.


We would be really interested to know what you think of this Toolkit, its contents and features and any suggestions you may have for development or new features. You can get in touch by using the Contact us form, and if you leave your name and email address we will be keep you informed about any future developments to the Toolkit.

Where this Toolkit comes from

In 2007 Comic Relief invited organisations to bid for funds to deliver services to improve outcomes for children with one or more parents who misuse alcohol. Five Alcohol Hidden Harm services were initiated in April 2009. From the beginning, Comic Relief described the Alcohol Hidden Harm programme as a ‘learning project’ with the aim of understanding as much as possible about the kinds of services and interventions which could make a difference to children. The ambition for the programme as a whole was to improve resilience among children whose parent or parents misuse alcohol. Resilience was defined as‘a universal capacity which allows a person, group or community to prevent, minimize or overcome the damaging effects of adversity.

To maximise the learning from the investment, Comic Relief also commissioned an evaluation of the services over three years. The evaluation team adopted a case study approach, using a variety of methods to understand the way the services, which were all new and in different kinds of communities, developed and the impact they had on children, their families and communities. A summary version of the evaluation report is available here. This toolkit is based on the lessons learned from that evaluation.

Broadly, the evaluation found that while all services had some success in supporting children, those that were most likely to bring about observable changes were:

  • Child focussed;
  • Whole family oriented (worked with more than one members of the family including the child if over 5 years old);
  • Therapeutic (i.e. were not solely respite or leisure focussed);
  • Evidence/experience based;
  • Long term (engaged with clients over a minimum of 5-6 months, sometimes for longer);
  • Flexible (adapted to the expressed and felt needs of the clients);
  • Involved universal services, especially schools. The evaluation team is grateful to all those who contributed to the evaluation and, indirectly, to the development of this toolkit, including project staff, partner agencies, parents and children. We hope funders and service providers will find it useful in planning and developing new services and auditing and sustaining their existing work, to improve the outcomes for vulnerable children.

The Comic Relief projects

The five AHH projects funded by Comic Relief, which were the subject of the evaluation, were:

Bristol Drug Project (BDP)

When BDP secured funding from Comic Relief they began to work with children and young people whose parents were misusing alcohol by:

  • Expanding their family therapy work,
  • Extending their mentoring programme for 9-15 year olds;
  • Introducing a new programme of group work for 5-9 year olds.

CASA Family Service

When CASA secured funding from Comic Relief, they were already offering an existing programme of support to families, where parental alcohol misuse is an issue, CASA aimed to use the Comic Relief funding to:

  • Develop the capacity of generic children and family services in Islington to address the impact of alcohol hidden harm;
  • Reduce the perceived stigma associated with an ‘alcohol and drugs service’ by developing the capacity of other agencies to respond to hidden harm;
  • Increase referrals for families who are not in contact with Children’s Social Care or adult treatment provision and provide direct services to children and young people in families referred via this route.

DISC (Developing Initiatives Supporting Communities)

When DISC secured funding from Comic Relief, they were not offering an existing programme of support to families where parental alcohol misuse was an issue. With the Comic Relief funding they intended to:

  • Deliver an eight week programme for parents misusing alcohol to support them in identifying the impact of their drinking on their children;
  • Deliver an 8 week programme to the children of these parents –with a dedicated children’s worker who seeks to enable them to voice their needs;
  • Bring parents and children together for a joint activity at the end of the programme.


When CoreKids secured funding for HertSpeak from Comic Relief, they were already offering an existing programme of support to families where parental drug misuse was an issue. With the Comic Relief funding CoreKids work sought to:

  • Develop family-focused support packages for those affected by parental substance alcohol use.
  • Develop parenting support via 1:1 and group programmes across community-based treatment.
  • Increase referrals into treatment/support for parents/families where children and young people are at risk.
  • Offer family therapy, couples counselling, and filial play coaching, parenting support and child/play therapy sessions.

Lifeline – Step2

With the Comic Relief funding Lifeline intended to develop a partnership project primarily aimed at children who are not known to substance misuse agencies but who are affected by alcohol hidden harm. The project was intended to be delivered with and through four partner agencies who themselves work with vulnerable groups affected by domestic violence, young carers and young homeless people including runaways and refugee and asylum seekers. Lifeline planned to offer one-to-one and group work for children and young people.

While the five projects each had distinct aims and objectives, while also sharing the aim set out by Comic Relief in its original tender to increase resilience among children whose parents misuse alcohol.

As with all ‘learning projects’, not everything went according to plan, and all the projects experienced setbacks and difficulties. It is a tribute to the spirit of shared learning adopted by the services that they have all agreed to the inclusion of case studies in this Toolkit which illustrate both what went well,and what went not so well, so that others can learn from their experience. The individual services have not been identified in the case studies.