Degree Name

Doctor of Clinical Psychology


School of Psychology


This dissertation presents three papers and is divided into five chapters. Chapter 1 provides a review of the literature linking complex posttraumatic stress, attachment and parental self-efficacy in the context of parental substance abuse. Parental drug use is associated with harmful effects on children. Substance abusing parents experience significant conflict between meeting the needs of their children and sustaining their addiction, compromising their ability to care for them and to serve as appropriate role models. These parents often have multiple, interrelated and complex problems. The Chapter provides a general introduction to the needs of fathers in residential alcohol and other drug treatment centres and describes the studies that form the major components of the thesis.

Chapter 2 presents the first empirical study that explores current trauma-related psychological symptoms, adult attachment anxiety and the relationship of these variables to parental self-efficacy, in 100 fathers with substance abuse problems. Fathers receiving residential treatment for substance abuse completed self-report measures of trauma symptoms, adult attachment and parental self-efficacy. The study tested whether attachment style mediated the relationship between trauma and parental self-efficacy. Avoidant and Disorganised attachment (the latter operationalised as Helplessness) mediated the association between trauma symptoms and parental self-efficacy. Results support theoretical accounts implicating attachment disruptions in the pathway from the experience of trauma to impaired parental self-efficacy.

Chapter 3 describes a systemic, trauma and attachment informed model for a parenting program for fathers, embedded in residential substance abuse treatment. This paper emphasises the complex nature of delivering parenting programs in such a treatment context and the importance of going beyond the simple linear principles of reward and punishment, upon which many other parenting programs are predicated. Using the findings of the cross-sectional study described in Chapter 2, the paper also emphasises the importance of addressing issues of trauma and attachment disruption in any program aimed at this population.

Chapter 4 describes the feasibility of supplementing residential substance abuse treatment for fathers with a brief group parenting program called the Black Box Parenting program. This parenting program aims to improve parental self-efficacy, quality of father-child relationships and motivation to engage in parenting help. The program focuses on the particular issues of trauma and attachment disruption found to be inhibiting healthy parenting in these fathers (as described in Chapter 2). The Black Box Parenting Program was offered to eight programs with three agreeing to trial it. Ultimately, four groups were conducted involving 19 participants. Feasibility was assessed by describing demand, acceptability, implementation, integration within existing services and preliminary efficacy. Pre and post quantitative measures were taken as well as conducting qualitative interviews to understand the impact of the program on fathers’ views of their parenting. Pre to post intervention assessments revealed significant increases in fathers’ satisfaction in parenting. Fathers reported feeling motivated to attend further parenting groups. Satisfaction with treatment was related to changes in parenting self-efficacy and closeness with their child.

Chapter 5 of the dissertation provides concluding remarks and conceptual model to summarise the findings of the research.