Recovery from Hidden Harm: Drug and Alcohol Abuse

September is ‘Recovery Month’ and this year the Waltham Forest Safeguarding Children’s Board, the Safeguarding Adults Board, the Health & Wellbeing Board and SafetyNet have focused their September newsletter on the hidden harm caused by drug and alcohol abuse by parents and carers. Their aim is to draw attention to the signs of parental substance abuse early on, to help prevent risk escalation. Find out more about this important topic below.

What is ‘Hidden Harm’?

In its broadest sense, ‘hidden harm’ is abuse which is being experienced but is unseen. It is usually hidden behind closed doors and often goes unrecognised or unreported. Pressures on families arising from periods of social isolation during the pandemic have increased the risk of mental and physical harm to children and young people, but these signs of harm have been harder to detect due to the lack of usual face-to-face interaction.

Why is it important to recognise hidden harm?

Referrals from Children’s Social Care are increasing. Recognising hidden harm and the impact of alcohol and drug abuse on children helps to centre the voice of the child, sharing their views and wishes.

Reported concerns which can impact children as hidden harm:

  • Parental alcohol dependency and domestic violence
  • Parental cannabis use and mental health deterioration
  • Parental opiate use: parents struggling to engage/stay on script

Supporting children and young people in Waltham Forest

Until recently, the emphasis has been on working with the person (parent or carer) using substances, and the needs of their children have been ‘hidden’ from treatment services and drug policy.

Change Grow Live (CGL) Young Person’s Service is striving to change that, by working directly with young people in a person-centered way, and helping children build their resilience through the support of a hidden harm lead.

What are the responsibilities of a hidden harm lead?

A hidden harm lead will support children and young people (between 6 and 18 years old) who may have been affected by a parent or loved one’s drug / alcohol misuse.

Together with the young person, a hidden harm lead will assess needs using an outcome scaling tool and make a goal-oriented plan to address these. The assessment explores multiple areas of support need including wellbeing; impact of substance use; safety and support networks.

Every young person is given a safe place to explore their feelings about a situation they may not feel they have much control over. Leads help them to identify their own goals and achieve their full potential, using age-appropriate activities such as games, arts and crafts and emotional wellbeing resources to help them make sense of their experiences.

Interventions for children and young people include:

  • Communicating with young people by text and by phone, providing a safe place to discuss worries and concerns
  • Partnership work with Waltham Forest CGL Adult substance misuse service to ensure the needs of the young person are included in adult support packages
  • Open support group for parents focused on strengthening families / understanding the impact on children
  • Age-appropriate activities: story-telling, drawing, collage-making, games to evoke conversation e.g. Question Jenga
  • Access to in-house counselling support.

Supporting a parent or carer who is abusing drugs and alcohol

CGL Waltham Forest is a free, safe and confidential drug and alcohol service for all adults, children and young people who are residents of the London Borough of Waltham Forest.

CGL provides:

  • One-to-one key working
  • Group programme
  • Medical assessment for opiate substitute treatment and on-site prescribing
  • One-to-one counselling
  • Alcohol treatment including detoxification
  • Support for parents and carers including counselling
  • Advice and information
  • Harm reduction including needle exchange, BBV testing and vaccination
  • Family interventions and hidden harm work
  • Multiagency support with mental health, social care, hostels and other teams.


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