PERCS Conversation Guide: Working with substance affected parents

Emerging Minds, Australia, September 2021

Studies have shown around 4 out of 10 people in Australia either smoked daily, drank alcohol at harmful levels, or used illicit drugs over a 12 month period (Australian Institute of Health and Welfare, 2017). This suggests that many parents who present to adult services will also have substance use issues. Parental alcohol or drug (AOD) use can affect children negatively from conception through to adulthood. But many practitioners lack confidence in talking with substance affected parents – particularly pregnant clients – about these impacts.

The PERCS Conversation Guide is a free psychosocial discussion tool for professionals working with parents. It supports collaborative, respectful conversations around the impact of substance use and other adversities on children’s daily lives. Two versions of the guide are available: one for working with substance affected parents, and one specifically designed for supporting pregnant clients with substance use issues.

The guide provides example questions to help you explore five important domains in a child’s life:

  • Parent-child relationship
  • Emotions and behaviours
  • Routines
  • Communication and meaning-making
  • Support networks

Though the questions in the pregnancy conversation guide may appear to focus more on the parent’s wellbeing, anything that is supportive of a pregnant parent’s health and wellbeing also directly benefits their unborn child. These questions also focus on engagement, as stigma and other complexities can make it difficult for pregnant parents to engage with AOD services. Not engaging with, and connecting to, services that support pregnancy outcomes can have lifelong impacts on the unborn child.

It can be easy to assume that men may not be interested in talking about their substance use and children’s mental health. However, practitioners are encouraged to work with fathers and mothers equally when using the guide for working with parents. Inviting someone to think about themselves as a father can open up a new ‘narrative’ and give them confidence to make positive changes to benefit their children’s wellbeing.

Substance use is often accompanied by other conditions such as mental and physical health concerns, intellectual and learning disabilities, cognitive impairment and chronic pain. Families experiencing these issues often face a range of other complexities related to social disadvantage and exclusion, such as family and domestic violence (FDV), poverty, insecure housing and low educational attainment. The PERCS Conversation Guide is designed to help you to recognise the strengths and hopes of substance affected parents, despite the adversities they are facing, and identify opportunities to support and improve children’s mental and physical health, resilience and wellbeing.

Whether you’re an AOD worker or a generalist practitioner in an adult-focused service, the tools and understandings provided in this guide will benefit your work with both adults and children. Download a free copy of the PERCS Conversation Guide via the link above. If you want to learn more, take our free e-learning course, Parental substance use and child-aware practice.


Note: The term ‘substance use’ (a non-judgemental alternative to ‘substance abuse’ or ‘substance misuse’) includes the use of illegal drugs such as cannabis, amphetamines and heroin, as well as legal substances such as prescription drugs, alcohol, nicotine, caffeine, cough medicines, solvents and inhalants.



Australian Institute of Health and Welfare. (2017). National Drug Strategy Household Survey 2016: Detailed findings. Drug Statistics series no. 31. Cat. no. PHE 214. Canberra: AIHW

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