Children of parents with alcohol problems performing normality: A qualitative interview study about unmet needs for professional support

Abstract

BackgroundChildren of parents with alcohol problems are at risk for serious long-term health consequences. Knowledge is limited about how to recognize those in need of support and how to offer respectful services.MethodFrom nine interviews with adult children from families with alcohol problems, we explored childhood experiences, emphasizing issues concerning potentially unmet needs for professional support. Smart's perspective on family secrets and Goffman's dramaturgical metaphor on social order of the family focusing on the social drama and the dramaturgy enacted by the children supported our cross-case thematic analysis.FindingsThe social interaction in the family was disrupted during childhood because of the parent's drinking problems. An everyday drama characterized by tension and threats, blame and manipulation was the backstage of their everyday life. Dealing with the drama, the children experienced limited parental support. Some children felt betrayed by the other parent who might trivialize the problems and excuse the drinking parent. Family activities and routines were disturbed, and uncertainty and insecurity was created. The children struggled to restore social order within the family and to act as normally as possible outside the family. It was a dilemma for the children to disclose the difficulties of the family.ConclusionAltogether, the children worked hard to perform a normally functioning family, managing a situation characterized by unmet needs for professional support. Adequate support requires recognition of the children's efforts to perform a normally functioning family.

Growing up with parental substance use disorder: The struggle with complex emotions, regulation of contact, and lack of professional support

“…As our informants pointed out that this lack of professional attention in childhood had great impact on their coping as adults. This is consistent with other research on adult children of parents with SUD who experience demanding periods and situations as adults due to their childhood (O'Connor et al, ; Werner & Malterud, ; Wiig et al, ). Interdisciplinary support in these families, with professionals who receive supervision in dealing with this double challenge of inadequate parenting due to SUD, could contribute to making these families more visible.…”

“…Children's mixed emotions towards their parents with SUD are well documented (Backett-Milburn et al, 2008;Gullbrå, Smith-Sivertsen, Rortveit, Anderssen, & Hafting, 2016;Werner & Malterud, 2016a;Wilson et al, 2012). These children often have strong emotional tensions concerning their parents and feel both betrayed and loved at the same time (Backett-Milburn et al, 2008).…”

“…Recent research emphasizes the need for professionals to help children of parents with SUD to cope during childhood, in order to cope as adults (Bath, 2015;Reupert & Maybery, 2014;Werner & Malterud, 2016a;Werner & Malterud, 2016b). Children want confident professionals who listen, explain, and give advice (Freake, Barley, & Kent, 2007).…”

“…They continue to use despite negative consequences in physical and mental health, family relationships, and social function. Parental SUD is often associated with shame and fear of intervention by child protection services (Backett‐Milburn, Wilson, Bancroft, & Cunningham‐Burley, ; Werner & Malterud, ; Wilson, Cunningham‐Burley, Bancroft, & Backett‐Milburn, ). Therefore, many families try to conceal their problems and avoid contact with social and health care services.…”

“…Family represents relationships of love and commitment but may also include secrets and betrayal (Smart, ; Wiig, Haugland, Halsa, & Myhra, ). Hence, an understanding of how children construct meaning and the emotional significance of these parent–child relationships can help us to support children growing up in such situations (Reupert et al, ; Smart, ; Werner & Malterud, ; Wilson et al, ). The aim of the study was to explore young people's experiences of growing up with parents with SUD, in order to understand more about their everyday life, their relationships with their parents, and conversations they had about SUD during childhood and adolescence.…”