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Enhancing Parent-Child
Communication about Drug Use:
Strategies for Professionals Working
with Parents and Guardians
A
By Keith A. King, Ph.D., C.H.E.S., and Rebecca A. Vidourek, Ph.D., C.H.E.S.
Adolescent drug use continues to pose a serious health issue that
contributes to a wide array of youth morbidity and mortality.
According to the most recent Youth Risk Behavior Survey, three
in four (73%) youth in the U.S. reported having ever tried alcohol
in their lifetime (Eaton et al., 2010). Regarding recent use, in the
past 30 days 41% of youth drank alcohol while 25% binge drank
(i.e., drank five or more alcoholic drinks in one occasion). One-third
(37%) reported having ever used marijuana while one-fifth (21%)
reported using marijuana in the past 30 days. In 2009, Monitoring
the Future data revealed that 20% of 8th graders, 36% of 10th
graders, and 47% of 12th graders reported having ever used any
type of illicit drug in their lifetime (Johnston et al., 2010).
Early age of first use is associated with increased risk of suicide,
violence, delinquency, and drug abuse (U.S. Department of Health
and Human Services [USDHHS], 2007). Those who drink before
age 14 are four times more likely to develop alcohol abuse and
dependence than those who begin drinking at age 21 (Grant &
Dawson, 1997). Youth drug use is also associated with impaired
brain functioning, impairment of memory and critical thinking
skills, and disruptions in normal growth patterns (USDHHS,
2007). The main purpose of this article is to provide professionals
working with parents and guardians strategies they can use to
enhance parent-child communication about drug use. Strategies
cited in this article are based on a comprehensive review of the
literature and are consistently used in the authors’ Family Based
Prevention Project, which is a statewide program providing
parents, guardians, and prevention specialists with practical
strategies to prevent drug use among youth.
FAMILY PROTECTIVE FACTORS TO YOUTH DRUG USE
©Nikolay Mamluke/iStockphoto.com
There are several factors that exist at the family level which protect
youth from involvement in drug use. Family protective factors
Parents could be considered the most
underutilized instruments in preventing
youth involvement in drug use.
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are essential aspects of youth drug abuse prevention since they
can reduce youth initiation and use of alcohol and other drugs.
Improving parent-child communication about drug use can be
helpful for all youth, including those who have already begun
experimenting with and/or using drugs. Youth are at increased
risk for drug use if they have parents who have permissive attitudes
toward drug use, low levels of parental monitoring and parental
involvement, and high levels of parental drug use (King et al., 2004;
Tucker, Ellickson, & Klein, 2008).
Family connectedness, which is defined as a sense of belonging,
is a leading protective factor for youth involvement in drug use
(Resnick et al, 1997). High levels of family connectedness tend to
reduce opportunities for youth to engage in risky behaviors such
as drug use while also increasing engagement in healthy behaviors.
Components of family connectedness include high levels of
parental involvement, parental monitoring, supportive parentchild relationships, and high levels of parent-child communication
(National Institute on Drug Abuse [NIDA], 2005).
As a primary component of family connectedness, parent-child
communication is an important facet of youth drug prevention
because it increases open and factual discussion of drug use and
also strengthens bonds between parents and youth. Research has
shown that parent-child communication about drug use tends to
reduce the likelihood youth will initiate alcohol and other drug
use (King & Vidourek, 2010a). In addition, the National Institute
on Drug Abuse (2005) has asserted that parent-child communication
is an important predictor of youth attitudes and behavioral
intentions toward alcohol and other drug use.
EFFECTIVE PARENT-CHILD COMMUNICATION
TO PREVENT YOUTH DRUG USE
Youth norms and beliefs related to drugs are largely developed as
a result of direct experiences with drugs and indirect experiences
with family, peers, and other social outlets (Marshal & Chassin,
2000). With this in mind, parents and legal guardians can have a
pronounced impact on their children regarding drug use decisions.
It is therefore of utmost importance that parents and guardians
talk to their children regarding drugs. While parents are the
individuals most likely to talk to their children about drugs (Kelly,
Comello, & Hunn, 2002), unfortunately, far too many never
engage their children in a conversation or series of conversations
on drug use. In light of such facts, parents could be considered the
most underutilized instruments in preventing youth involvement
in drug use.
Many parents and guardians have basic questions regarding
how to effectively communicate with their children on sensitive
topics such as drug use. Professionals working to help parents
and guardians prevent youth drug use should encourage them
to utilize an array of strategies to convey clear and consistent
prevention messages (King, Wagner, & Hedrick, 2002). Such
strategies include using basic communication skills, active
www.TPRonline.org
listening, addressing peer pressure, and establishing a physical
environment conducive to quality communication. Table 3.1
provides a more expansive list of communication strategies that
professionals can encourage parents and guardians to use with
their child.
COMPONENTS OF QUALITY PARENT-CHILD COMMUNICATION
High quality parent-child communication is associated with positive
family functioning and includes talking frequently to children
and displaying open communication—sharing personal feelings,
addressing difficult issues, actively listening, and encouraging
children to ask questions and ask for help when needed (Boone &
Lefkowitz, 2007). Nevertheless, many parents do not frequently
talk to their children about drug-related issues (Miller-Day, 2008).
Van Der Vorst and colleagues (2010) recently found that parents
talked more frequently with their sons than their daughters and
that frequently talking about alcohol was counterproductive
for heavy-drinking adolescent males. Since others have shown
that high quality parent-child communication about alcohol is
associated with lower levels of adolescent alcohol use, Van Der
Vorst and colleagues speculated that perhaps some parents who
talk frequently about alcohol with their heavy-drinking sons
may tend to do so in a non-constructive manner. More research
is needed to determine specific communication patterns used
by parents with children who drink heavily or use other drugs.
Consistent parental adherence to quality communication patterns
(as listed in Table 3.1) should be encouraged by professionals
working with parents and guardians.
Peer Pressure Resistance
Parents feel their largest needs in preventing children from using
drugs are in teaching their children to resist peer pressure and to
effectively communicate with their children (King et al., 2002).
Research has shown that children who know effective ways to
resist negative peer pressure are less likely to succumb to such
pressure (Hawkins & Catalano, 1992). Therefore it is critical that
children learn effective resistance techniques. Professionals
working with parents and guardians may assist their clients by
offering trainings and educational information that provides
practical, action-oriented, research-based strategies to effectively
resist negative peer pressure. Professionals should consider using
role plays and mock peer pressure scenarios at training sites as a
means to identify and practice effective ways to “say no” to peer
pressure (King et al., 2002). In teaching peer pressure resistance,
professionals should introduce the skill; review specific steps
needed to perform the skill; model and explain each step; have
parents/guardians observe, practice and rehearse the skills; and
then provide parents/guardians with reinforcement and feedback
(Quackenbush, Kane, & Telljohann, 2004).
Parental Disapproval of Youth Drug Use
Parental disapproval of youth drug use tends to serve as a
protective factor against underage use (Ellickson et al., 2001).
A recent study indicated that youth who felt their parents
disapproved of them using alcohol were significantly less likely
to use alcohol or to engage in frequent episodic heavy drinking
within the past 30 days (King & Vidourek, 2010b). Another
study found that 6th grade students were more than twice as
likely to drink alcohol if they felt their parents would not be
angry (Simons-Morton, 2004). Parental disapproval of drug use
also protects youth from using drugs other than alcohol (NIDA,
2005). Therefore, professionals working with parents and guardians
should encourage families to consistently deliver clear messages
to their children regarding their disapproval of alcohol or other
drug use and the harmful effects of such use (King & Vidourek,
2010c). Children need to know where their parents/guardians
stand on these issues.
www.TPRonline.org Table 3.1
Strategies Parents/Guardians Should Use with Their
Child to Enhance Communication about Drug Use
BASIC COMMUNICATION SKILLS
• Begin talking to your child when he/she is young (5 to 6
years of age or younger)
• Tell your child that you love him/her unconditionally
• Talk at the child’s level to be best understood
• Avoid one-way lectures
• Keep the conversations brief
• Use open-ended questions
• Encourage honest reactions and opinions
• Use scenarios that cause children to consider “what would
they do if…”
• Avoid using put-down words that could prevent your child
from opening up
• Express clear parental/guardian expectations and values
• Voice clear and consistent disapproval of youth drug use
LISTENING SKILLS
• Actively listen to your child’s questions and comments
about drugs
• Let children know that their comments and concerns have
been heard
• Let your child know that you are interested in his/her
thoughts and concerns
• Let your child know that you want to help and be involved
in his/her health decisions
• Reinforce your child when he/she initiates a discussion on
how to be healthy and prevent alcohol and other drug use
• Be honest about your past involvement in drug use
accompanied by the physical, social, and emotional
consequences of such
PEER PRESSURE
• Discuss potential challenges and pressures from peers
to use
• Help your child to develop specific ways to refuse negative
peer pressure to use
ESTABLISH A CLIMATE CONDUCIVE
TO QUALITY COMMUNICATION
• Turn off the television, radio/music, computers, video
games, and other distractions during conversations or
when your child wants to talk
• Physically get down to your child’s level and do not stand
over him/her when talking
• To avoid potential embarrassment, try to hold one-on-one
conversations with your child
• Schedule regular family meetings and times to talk
Note: Professionals working with parents/guardians should encourage them to
use these strategies with their child to enhance parent-child communication.
The Prevention Researcher
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Enhancing Parent-Child Communication about Drug Use: Strategies for Professionals Working with Parents and Guardians, continued
©digitalskillet/iStockphoto.com
parenting is the most nurturing and tends to produce children
who are the most socially adjusted, competent, self-assured, and
confident, all of which are protective factors against youth drug
use (Baumrind, 1978). Conversely, children raised by parents who
use nonauthoritative parenting styles tend to be more likely to
develop and exhibit unhealthy behaviors (Kauffman et al., 2000).
Positive parenting and a positive home environment directly
impacts healthy child development.
Effective parent-child communication
on drug use is associated with decreased
youth involvement in drug use.
Parental Monitoring of Youth Behaviors and Rule/Limit Setting
High levels of parental supervision and parental support are strong
correlates to decreased drug use (Griffin et al., 2000). Interestingly,
Simons-Morton and Chen (2004) found that over time parental
involvement, monitoring, and expectations protected against
early adolescent drinking and drug progression and limited the
number of friends who used. Such findings illustrate the positive
continued effect and importance of positive parenting practices.
Youth with parents who do not consistently set and enforce clear
rules concerning drug use tend to feel that occasional use is not
harmful and cannot lead to dependence or abuse (Tucker, Ellickson,
& Klein, 2008). This can be problematic since a sizeable percentage
of youth do not feel that alcohol and other drug use is harmful
(Johnston et al., 2010). Not surprisingly, students most likely to
have recently used alcohol and other drugs tend to be those who
report that their parents never/seldom talk to them about drug
use dangers, do not set clear drug use rules, and do not punish
them when drug rules are violated (King & Vidourek, 2010a).
In addition, a recent study of seven different types of parental
strategies to prevent youth drug use revealed that the most
effective strategy on deterring drug use was a “no tolerance rule”
(Miller-Day, 2008). Professionals working with parents/guardians
should share with them the facts that parental control of youth
drug use, ongoing supervision, clear expectations and limits,
enforcement of set limits, and open parent-child communication
are all correlated with decreased youth drug use. Parents and
guardians should provide their children with clear rules and
expectations about drug use and inform them why such rules have
been set. Once rules have been established and explained, parents
and guardians need to consistently enforce them with their children
and deliver appropriate consequences when they are broken.
Using Authoritative Parenting
Parenting style also plays an essential role in youth drug use (King
et al., 2004). Baumrind (1978) described four parenting styles that
were characterized by differing levels of demandingness (parental
setting of expectations) and responsiveness (providing care and
emotional support). Authoritative parenting involves high levels
of demandingness and high levels of responsiveness; authoritarian
parenting involves high levels of demandingness and low levels
of responsiveness; indulgent/permissive parenting involves low
levels of demandingness and high levels of responsiveness; and
neglectful parenting involves low levels of demandingness and
low levels of responsiveness. Of the four parenting styles, research
has shown authoritative parenting to be associated with decreased
youth involvement in drug use (Baumrind, 1978). The use of
authoritative parenting, characterized by open communication,
high emotional support, and clear and reasonable expectations,
helps to establish a positive home environment. Authoritative
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Specifically related to drug use, parents who successfully adopt
an authoritative model of parenting clearly communicate their
expectations regarding youth drug use and are clear in showing
their unwavering and unconditional emotional support for their
children through verbal and nonverbal means. The positive home
environment created by authoritative parenting and authoritative
parent-child communication helps to increase the likelihood for
children to develop trust, autonomy, initiative, industry, and positive
emotional development, which all further serve to protect youth
from risky behavioral involvement (Barnes et al., 2000). Thus,
professionals working with parents and guardians should fully
support and encourage the use of authoritative parenting skills
by all adults who interact with children. Professionals should inform
parents and guardians of the basic components of authoritative
parenting. Similar to teaching about peer pressure resistance,
professionals should teach parents and guardians how to
authoritatively parent by providing informational handouts,
demonstrating role-play scenarios that parents/guardians may
encounter with their child, discussing challenges frequently
experienced by parents/guardians, providing parents/guardians
with take-home strategies to try with their child, and encouraging
parents to report back on how these strategies worked.
Using Active Listening
An authoritative parenting style encourages youth to open up
and talk about their feelings and concerns. This requires parents
to actively listen to their children, a skill which takes much practice
and patience to display. Active listening is more effective than
passive listening when dealing with interpersonal communication
because, by definition, it requires feedback (Blonna, Loschiavo,
& Watter, 2011). Active listening, an important part of effective
communication, involves several steps that should be continuously
and consciously practiced when communicating with others in
Table 3.2
Characteristics of Active Listening
Parents/Guardians Should Use When
Talking with Their Child about Drug Use
• Maintain culturally appropriate eye contact
• Lean toward the child as he/she talks
• Encourage the child to talk openly
• Encourage the child to discuss feelings and beliefs
regarding drug use
• Show interest in the child’s comments
• Ask clarifying questions, such as “What do you mean by…?”
• Probe for additional comments and questions
• Paraphrase statements
• Use reflections and summarizing statements
• Use a neutral to interested tone of voice
Note: Professionals working with parents/guardians should encourage them
to use these strategies to increase active listening when talking to their child
about drugs.
www.TPRonline.org
©Willie B. Thomas/iStockphoto.com
CONCLUSION
Professionals working
with parents and
guardians are in an
ideal position to
enhance parentchild communication
on drug use by
providing practical,
realistic, and easyto-understand
strategies.
order to achieve competency and effectiveness. Such steps include
both nonverbal and verbal forms of communication and range
from basic demonstration of positive body language (i.e., leaning
toward the child as he/she talks) to offering encouraging statements
(i.e., encouraging the child to talk openly and to discuss his/her
feelings about drug use). Table 3.2 provides a detailed list of active
listening skills that professionals should encourage parents and
guardians to use when communicating with their child. At first
glance, these active listening skills may appear quite simplistic;
however, many individuals fail to use such skills on a daily basis.
Such staples of quality communication should not be overlooked
when considering how to improve parent-child conversation on
youth drug use prevention.

Keith King
Rebecca Vidourek
Keith A. King is a Professor of Health Promotion and Education at
the University of Cincinnati. He also serves as the Director of Family
Based Prevention in Cincinnati. His research and teaching emphases
include adolescent health promotion and violence, suicide, and
substance abuse prevention. He regularly collaborates with local,
regional, and national organizations aimed toward positive youth
development. He is dedicated to assisting children and adolescents
in developing positive connections as a means to increase their
overall engagement in healthy behaviors. He can be reached at
[email protected].
Rebecca A. Vidourek is an Assistant Professor of Health Promotion
and Education at the University of Cincinnati. Her research and
teaching emphases include adolescent health promotion, school
health education, substance abuse prevention, and positive youth
development. She remains committed to helping schools, parents,
and communities in building protective factors in youth.
Copyright © 2011, Integrated Research Services, Inc.
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www.TPRonline.org Effective parent-child communication on drug use is associated
with decreased youth involvement in drug use. Professionals
working with parents and guardians are in an ideal position to
enhance parent-child communication on drug use by providing
practical, realistic, and easy-to-understand strategies. Research
has shown that parent-directed intervention can have a positive
impact on parent-child communication concerning alcohol and
other drugs (Beatty, Cross, & Shaw, 2008). Our statewide Family
Based Prevention programming which is delivered to parents,
guardians, educators, and prevention specialists has consistently
shown increases in parents’ knowledge, attitudes, and perceived
self-efficacy in talking to their children about drug use and other
risky behaviors. It appears that while most parents and guardians
want to discuss health-related issues with their children, many
often lack the knowledge and overall confidence in how to most
effectively address such issues. For these reasons, professionals
working with these individuals should share the various strategies
offered within this article. A parent-child communication approach
that utilizes a diverse array of strategies and one which is aimed
at enhancing family connectedness is strongly recommended. 

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