Fetal alcohol spectrum disorders (FASD) is an umbrella term covering a range of conditions related to prenatal alcohol exposure. In Sweden, only the most severe of these conditions, Fetal alcohol syndrome (FAS), is used as a medical diagnosis. The aim of this study was to analyze the Swedish discussion on whether or not FASD conditions (other than FAS) should be actively diagnosed/identified. The data consisted of a webpage material from a FASD interest organization and a report from a Swedish authority. The analysis was informed by Fairclough’s critical discourse analysis and strived to pay attention to which discourses that were drawn upon, and how these discourses related to each other, and to a broader social context. The discussions on whether or not FASD should be actively diagnosed/identified were structured by three main discourses. These were: a scientific discourse, a pragmatic discourse, and an ethical discourse, with the scientific discourse taking a special position, often being present also when other discourses were drawn upon. Taken together, there is not yet any consensus around what the status of the FASD conditions should be in Sweden, neither regarding the usefulness of diagnosing/identifying, nor regarding the causality between prenatal alcohol exposure and FASD.

Pregnancy for women who use substances has sometimes been referred to as a “window of opportunity” for lifestyle change. In this article, the aim is to analyze professional accounts of the transition of substance-using pregnant women into parenthood. Focus groups were carried out with professionals working at specialized maternity care units in Sweden. The analysis is guided by the discursive psychological concept of “ideological dilemma” and focuses on contradictory elements of commonsense-making in the participants’ discussions. The results suggest that professionals articulate two, partly contradictory, ideals: on the one hand, “believing in the patient” and, on the other, “being realistic.” In their descriptions of their work with patients, professionals emphasize the significance of adjusting the self-image of the patients and increasing their awareness of their “abuse” problems in order to prevent future clashes between high expectations and reality. At the same time, they also underline that interacting with and treating those patients with the most serious problems as individuals with unforeseen strengths and resources is a matter of professional duty.

The aim of this scoping review was to give an overview of efficacy research on psychosocial interventions aimed at substance-abusing parents with children of up to the age of three. Throughout the overview, there was a focus on underlying assumptions and how the problem descriptions motivating the interventions corresponded with the solutions, i.e. the interventions in question. The data consisted of peer reviewed intervention studies (n = 22) identified through literature searches in online databases. Randomised controlled trial studies as well as quasi-experimental and pre-post studies were included. The results showed that all the studies included bar one focused exclusively on women as parents. Moreover, while the problem descriptions in the studies tended to be quite broad, framing parental substance abuse as a problem influenced by social and structural conditions, the solutions presented in the form of interventions generally had a narrower focus, addressing the individual parent from a psychological perspective only. In conclusion, the review points out the need for developing and evaluating interventions aimed at substance-abusing fathers as well as mothers, and also underscores the importance of these interventions being focused on a broader range of factors rather than just addressing deficits at the level of the individual.

Aim: The aim of this study was to explore how people with earlier substance use problems narrated their experiences of becoming and being parents. The literature in this area is limited. Method: The study participants, all active members of the 12-step movement, were interviewed about their experiences of substance use problems, recovery, and parenthood. The data were analysed using a narrative theoretical framework seeking to answer the questions of how the parents narrate their experiences of parenthood within the frame of a classic 12-step storyline and how they present themselves as parents through these narratives. Results: The results show that, on the whole, the narratives conformed to a classic 12-step storyline. For example, the narratives’ turning points were often built up around experiences of “hitting rock bottom”, when the negative consequences of substance use culminated in dramatic events forcing the narrators to see the seriousness of their problems. At the same time the motivational potential of having or expecting (or wishing for future) children was downplayed by several study participants, who instead said that positive driving forces such as human relationships were not enough to break through their denial of their substance use problems. Finally, all study participants described how the process of working towards sobriety had been a transformative experience through which they had come in better contact with their feelings and emotions, and they defined this as an important resource in their everyday lives as parents. Conclusion: The results showed that the parents, when narrating their experiences within the frames of a classic 12-step storyline, were also able to present themselves as competent parents, empowered rather than stigmatised by their earlier experiences.