Parenting, emotional regulation and substance use: investigating the process of change

Abstract

Improving family functioning and child outcome in families with a multitude of problems – such as parental substance misuse, mental health problems and parental childhood maltreatment – is essential if we are going to change an intergenerational pattern of adversity. Parents with extensive substance use histories face enduring problems with self-regulation and impulsivity. These add complexity to one of the most challenging jobs in the world: raising young children. It is not surprising then, that traditional approaches to improving family functioning that predominantly involve teaching parenting skills is increasingly recognised as insufficient in complex families. The capacity to regulate emotions and develop inhibitory control is both a predictor and a consequence of substance misuse. Combined with enduring adversity, parenting of young children can easily become insensitive and at times, hostile. In this presentation I will provide an overview of the Parents under Pressure (PuP) program with a focus on the development of emotional regulation strategies. The PuP program was developed specifically for families facing multiple adversities. The two central tenets of the PuP program are a focus on emotional regulation and the enhancement of safe and nurturing caregiving relationships within the family. PuP has been delivered by over 400 non-government and government agencies in Australia and the UK. There is a growing evidence base for effectiveness of the PuP program across a range of populations that demonstrate improvement for families engaging in the PuP program. Notably, however, not all families show improvement. Thus, extending the evaluation of whether PuP is effective to a more nuanced analysis of determining who may respond best to PuP (moderator analyses) and causal mechanisms drawing from the PuP program logic (mediator analyses) is essential for further development of the program and informs future tailoring of this and other interventions.