Family domain
Parents, guardians and carers play a critical role in a young person’s development, and they can take steps to help prevent - or delay - a young person’s initiation of alcohol and other drug use.
Please note: the research informing the risk and protective factors listed below focuses only on alcohol, not other drugs.
Parenting behaviours
Parenting behaviours and attitudes are key influencers of alcohol consumption by adolescents.
One systematic search identified 131 articles that considered the role of parenting factors in alcohol use and/or problems with alcohol in adolescence or adulthood.
Several factors were found to be associated with the age of alcohol initiation and/or alcohol-related problems in adolescence or adulthood.
Factors that increased the risk of adolescent alcohol use and/or alcohol problems in adolescence or adulthood included parental provision of alcohol, favourable parental attitudes towards alcohol and parental drinking.
Underage drinking was also likely to rise when a parent treated drinking as humorous or disclosed their own negative experiences with alcohol.12
Factors that were protective included parental monitoring, the quality of the parent-child relationship, parental support and parental involvement.12
Some evidence suggests that reductions in adolescent alcohol use over the past two decades may be associated with a corresponding reduction in favourable parental attitudes to adolescent alcohol use.13, 14
Empowering parents and carers with knowledge to boost their understanding about why their children shouldn’t drink during adolescence, and the supportive actions they can take, may reduce the likelihood that their child will drink and drink in harmful ways.
Creating a parental culture that recognises the harms of adolescent drinking may further help to create a community-level culture which disapproves of youth drinking. The message that adolescent drinking is unacceptable can be more effective when it is clearly and consistently repeated to young people both inside and outside their home. Given the role parenting factors play in alcohol use, parent-focused initiatives may seek to enhance protective factors and reduce risk factors.
Research shows that when parents give young people alcohol, or let them drink at home, that young person is more likely to start drinking earlier, drink more often, and drink higher quantities of alcohol.12
That young person will also be at a higher risk for experiencing problems with alcohol both in adolescence, and later in life.12
Some researchers have suggested that there is potential for education campaigns aimed at parents and the general community to helpmotivate parental behaviour change12 and several campaigns have been run in Australia with this objective.
One such campaign, ‘Stop the Supply’, aimed to increase knowledge of the laws around purchasing alcohol for minors (secondary supply) and encourage parents to think again about doing just that. This program is yet to be formally evaluated; however, a survey report found that 36% of respondents were not previously aware of the secondary supply legislation.15
Communities That Care, in partnership with Deakin University, is developing and trialing a social marketing campaign which seeks to educate parents and young people about the National Health and Medical Research Council’s drinking guidelines. The campaign objective is to convince parents and young people to make an agreement that parents will not supply alcohol to people under 18 years.16
Mentoring
Mentoring is a relationship between a person with less experience and a person with more experience, often a young person and someone who is slightly older.
The relationship is often focused on the older person (mentor) providing support and guidance to the younger person (mentee) based on their experience and skills.
The mentor is not paid or expecting personal gain in exchange for this support.17
While mentors may be either formal or informal, formal mentoring arrangements are typically the type that is subject to evaluation, therefore contributing to the evidence-base.
Mentoring programs may be run in a number of settings, such as through an in-school program, an after-school program, a weekly meeting in a community setting, or online. Mentoring programs may provide training and ongoing support for the mentor.
There is some evidence about the effectiveness of youth mentoring to prevent or reduce young people’s use of alcohol and other drugs, although some researchers have found that existing studies are at risk of producing biased results, and that individual studies have had mixed findings.17, 18
Generally, the research record for mentoring has produced inconsistent results and insufficient robust research has been conducted to enable a definitive conclusion about the effects and the circumstances in which the effect is found.
Although there is a dearth of research into Australian mentoring programs there is a body of resources that mentors can draw on to inform their work.19, 20
One research analysis of 46 studies published between 1970 and 2011 reported some positive benefits of mentoring on behavioural outcomes of young people, including AOD use.18 The authors could not identify the type of program that was more effective than others.
Another study examined the results of four studies that were of sufficient quality for analysis. Two of these found mentoring prevented alcohol use and one found mentoring prevented drug use.17
Other studies have variously found lower rates of alcohol and other drug initiation among mentees, reduced alcohol initiation (but not other drug initiation), no effect on alcohol or cannabis use, and no effect on ‘substance use’.17 The research suggested that a component which might make a mentoring program effective include a focus on the mentor providing emotional support.5
Parenting programs
The term ‘parenting program’, is often used interchangeably with other terms such as ‘parent education’ or ‘parent training’.
Parenting programs aim to provide parents with opportunities to enhance their knowledge, skills and understanding in order to improve both child and parent behavioural and psychological outcomes. Parent programs typically focus on social competence skills including communication, promoting parent-child connection, problem solving and conflict resolution on the grounds that a mutually close and trusting relationship will bond the child to the parents’ values and help the child to reject substance use.21
While many parenting programs focus on the parents of children younger than the demographic included in this paper, there are some iterations of parenting programs focused on older young people that could be targeted to parents of 12-17 year-olds – although these are less common.
High levels of parent-child connectedness and good quality communication/conversations (both general and substance-use specific) are protective against adolescent alcohol, tobacco and drug use.22 These conversations about drug use must be two-sided and involve explanations about health implications of using substances; rather than discussing rules and consequences.
The enforcement of rules – as opposed to just talking about them - also appears to lead to less substance use.22
The literature supporting parenting programs is mixed, both in terms of findings and the quality of research.23 Some experts have flagged the lack of robust studies into how family factors affect a young person’s health as a “striking knowledge gap”.24
However, some evidence still suggests that parenting programs can positively affect young people’s use of alcohol and other drugs.23
Programs don’t necessarily need to focus on substance use, either.
Elements that may make an initiative more likely to be successful are that the parents are actively involved, good bonds between parents and children are nurtured and there is good conflict resolution in the family.23
Developed in the USA, the Strengthening Families Program (SFP) seeks to improve parenting, family, and children's relationship skills.25 Since the 1980s, a number of iterations have been developed and run in multiple countries.25
Depending on which iteration of the program is being implemented, SFP involves different age brackets (e.g. 10-14 years, or 12-16 years) with a different number of sessions depending on the age group (e.g. 7-8, or 14). Sessions are typically broken into separate parent and child skill sessions, as well as a joint family skills session.
The extensive content of SFP-14 addresses adolescent development, listening and communications, rules and consequences, conflict resolution, problem
solving, peer pressure, stress management and family values, and the methods include discussions, role play, viewing videos, and games that are designed to build skills and strengthen positive connection between family members.26 SFP’s positive results are challenged by critics who believe its evaluation methodology has limitations.27
The program was trialled in Australia with 8 to 12 year-olds, who were at increased risk for mental health concerns.28 Both the eight session and the 14 session iterations of the program were included in the trial, with both achieving similar outcomes.
Although researchers were not looking for an effect on substance use, they did note positive improvements in mental health. Their findings suggest that the Australian version of SFP may be successfully implemented.
While this age bracket is otherwise out of scope for this paper, a Dutch adaptation of SFP, with 12 to 16 year-olds, also reported positive results.25