Problematic substance use in the family: professionals’ and adolescents’ perspectives on identification and help. A qualitative study

Aims: The aim of this study was to explore how professionals within the child health, education and welfare sectors perceive the process of identification and how they care for children and young people (CYP) living with problematic substance use (PSU) in their families. We also sought to understand the perceptions of engagements and needs of adolescents living with PSU in their families. Methods: We combine five focus group interviews with professionals and six individual interviews with adolescents. We employ systematic text condensation in a cross-case thematic analysis and discuss our findings, considering Bronfenbrenner’s bioecological model. Results: Professionals face barriers to identifying affected CYP on multiple levels and uncertainty about signs of adversities, corresponding to the experiences of adolescents who emphasise a need for vigilant adults. However, the results also suggest the school setting as an enabling arena for identification, follow-up and interdisciplinary collaboration. Both parties request a community of experience in support groups with peers for CYP and increased knowledge on how substance use affects family members. Conclusions: School can be an important arena for identifying CYP affected by PSU and interdisciplinary collaboration in the effort to attend to their needs. There is an identified need to educate professionals and CYP on living with substance use in the household and to promote peer support opportunities for CYP.