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The burden of care: a focus group study of healthcare practitioners in Scotland talking about parental drug misuse

Whittaker, Anne; Williams, Nigel; Chandler, Amy; Cunningham-Burley, Sarah; McGorm, Kelly; Mathews, Gillian


Anne Whittaker

Nigel Williams

Amy Chandler

Sarah Cunningham-Burley

Kelly McGorm

Gillian Mathews


Parenting and family support are key prevention and intervention strategies for improving outcomes for children and families affected by parental drug misuse. However, little is known about the delivery of parenting support for drug-dependent parents, particularly within universal healthcare services. This study aimed to explore the way healthcare practitioners engage with this challenging agenda. Four multidisciplinary focus groups involving a purposive sample of 18 experienced healthcare professionals were conducted in Scotland. Participants included general practitioners, midwives, public health nurses and addiction staff who work together to provide care for vulnerable families. A focus group topic guide was developed to explore the views and experiences of these healthcare professionals in relation to providing parenting support for drug-using parents, predominantly those receiving opioid substitution therapy. Data were analysed using a constant comparison method and thematic approach. The overarching narrative which united the focus group discussions was about the ‘burden of care’ that these families pose for frontline healthcare professionals. Recurring themes centred on three key issues: the problematic nature of drug-using parents themselves; clinical challenges in living up to the ideals of professional practice; and the wider context in which current practice is governed. Professionals expressed ambivalence over their parenting support role; anxiety over responsibility for intervening with this ‘hard-to-engage’ population; and concern over ‘dwindling’ resources and lack of organisational support. Nevertheless, strategies and opportunities for providing parenting support were acknowledged and there was consensus about the need for further skills training. Despite a proliferation of policy and good practice guidance on the delivery of parenting support for drug-dependent parents, the findings of this study suggest that significant challenges remain. Notably, our findings raise questions about whose role it is to provide parenting support to drug-using mothers and fathers, especially those who are not involved in the child protection system.

Journal Article Type Article
Acceptance Date Mar 23, 2015
Online Publication Date May 4, 2015
Publication Date 2016-09
Deposit Date May 12, 2015
Print ISSN 0966-0410
Electronic ISSN 1365-2524
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 24
Issue 5
Pages e72-e80
Keywords Public Health, Environmental and Occupational Health; Health Policy; Social Sciences (miscellaneous); Sociology and Political Science
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