In this section:
- First steps to establishing a service to meet the needs of children whose parents or carers misuse alcohol
- Tools to help you get started.
Ask yourselves: What outcomes do you want to achieve and for whom? This question is vital to the initiation and development of an effective service. It will influence every decision you make from now on, including the staff you recruit, the premises you work from, the partners you will work with and how you will evaluate what you are achieving. In the model and checklist we have identified three kinds of outcomes:
- Community outcomes
- Agency outcomes
- Outcomes for children and families.
All three outcomes are interdependent. Your agency will deliver better outcomes for children and families if it is well connected to, and supported by, the wider community, and if it is well respected and sustainable.
Work with a small group of colleagues, service users’ groups and partners to consider what outcomes you want for families where parental alcohol misuse is causing or has the potential to cause harm to children. Remember that you may need to revisit these outcomes on the basis of a needs assessment. See also the two guides from the Institute for Research and Innovation in Social Services (IRISS) listed at the end of this section The outcomes most often identified by the Comic Relief projects are listed below: [See also Understanding outcomes]
Outcomes for children:
- Safety plan which children can put into practice when necessary
- A language with which to talk about what is happening
- Supportive networks among extended family, peers and community members
- Resilient children
- Reduced current and future hidden harm due to parental alcohol misuse.
Outcomes for parents:
- Advocacy on behalf of parents who misuse alcohol to enable them to access appropriate services promptly
- Reduced or nil alcohol use
- Other needs met such as housing, help for disability, mental health, domestic violence issues.
Outcomes for families:
- Improved communication within the family, including those who do not misuse alcohol
- Improved communication with supporting agencies such as adult alcohol services
- Improved communication with universal services such as schools, GPs and social services
- Functioning families: families which nurture and support children’s whole development.
N.B. These lists are not intended to be exhaustive but illustrate the kinds of outcomes you could consider. See also the IRISS guides from the Institute for Research and Innovation in Social Services.
Children’s outcomes appear first on the list because they are the most important. Everything your agency does rests on this key aspect: how can children’s lives be better in the future? It is clear from our findings that most of the outcomes for children depend to some extent on the parent’s and family’s outcomes being achieved.
Case study: Identifying children with needs
The service provided one to one support for some very vulnerable children and for some children the support they received led to lasting and positive change in relationships with their parents. However, these were isolated cases as there was no remit to work with the parents directly. Staff found that without working with parents it was very hard to achieve sustained changes in the lives of the children and young people they were supporting.
Another service aimed to work with the whole family, no matter what stage of alcohol misuse the parent was at. They offered a wide range of therapeutic approaches for adults and children including counselling, complementary therapies, parenting support and play therapy. Their host organisation also offered support for adults to reduce their drinking and maintain abstinence. Adult clients felt supported, and valued the wide range of options and the flexibility available to switch to another approach if they found something was not helping them. They also appreciated the opportunity to return for further support when the family encountered other challenges related to the alcohol misuse. Children and young people felt supported by a wider range of adults in the community and valued the changes they experienced in their family lives. Children whose parents did not engage with the service could not be reached by this particular service.
Remember your service does not have to set out to address all of the outcomes for the whole family where there are other agencies to whom you can refer adult or young clients. The importance of strong working relationships within large agencies and in partnership with other agencies which can complement your AHH service and meet diverse needs of clients is clear.
Case study : Making use of partnerships
The agency and its partners met regularly at a strategic level and practitioners also had a well organised network which worked closely to ensure young people could be referred seamlessly from one service to another.
Clients valued the one to one support of a practitioner who specialised in parental alcohol misuse, but also the opportunity to access the wide range of services to which they could be signposted or referred according to their needs. Adult clients also valued the opportunities for children to have some respite activities and to develop relationships with other adults to whom they could look for support. Children’s networks of support and social skills were improved as a result.
Despite the parallel structure of the delivery model, the vision of a whole family approach to alcohol hidden harm was clearly identifiable in discussions with senior managers. Both adult and child clients could access support even if the other was not participating, but good record keeping ensured that whole family work was encouraged. The shape of the service was focussed on achieving clearly identifiable outcomes, which were regularly monitored through internal reports.
We have identified family outcomes as important because the work funded by Comic Relief showed that children benefited when other members of the family were supported. Support could be for parents to reduce their drinking, or address their partner’s drinking, for their parenting or other needs or to enable the children to understand and reduce the impact of their parents’ drinking on their own wellbeing and development. The findings of the evaluation strongly suggest that children and young people are most likely to benefit if both adults and children get support, ideally from the same service, or partner agencies working closely together.
At the beginning of the Comic Relief funding none of the agencies set out with the primary aim of reducing parental alcohol misuse, even where this was causing harm to children. However, all projects recognised that when parents were able to reduce or stop drinking, the outcomes for the children were better.
When you have established what you want to achieve and for whom, you will be able to describe the broad aims of your service.