PACE is a therapeutic approach developed by Dr. Dan Hughes more than two decades ago, designed to help adults build safe, meaningful, and trusting relationships with children and young people who have experienced trauma. Rooted in attachment-focused family therapy, PACE encourages adults to think, feel, communicate, and behave in ways that help children feel secure. It is not a rigid, step-by-step procedure, but rather a flexible mindset that integrates four essential qualities: Playfulness, Acceptance, Curiosity, and Empathy.
Children who have lived through traumatic experiences often struggle with trust, connection, and emotional regulation. Their interactions with adults may be shaped by fear, defensiveness, or shame, making it difficult to form stable attachments. PACE aims to create an environment where these children feel safe enough to explore emotions, express themselves, and build resilience. By adopting PACE, adults can slow down their own responses, regulate their emotions, and remain engaged even during challenging moments. This emotional regulation is essential: when adults stay calm and supportive, children are more likely to mirror that stability, gradually learning to manage their own intense emotions.
Ultimately, PACE offers both children and adults a pathway toward understanding, connection, and healing. Instead of focusing primarily on correcting behaviours, it emphasises relationship-building and emotional safety. In this way, it equips caregivers, teachers, and social workers with strategies to guide children through difficult emotions and behaviours, without compromising their sense of self-worth.
Playfulness
Playfulness is the first element of PACE and serves as an important bridge to closeness without fear. Many children affected by trauma may withdraw from joyful experiences, having lost hope in the possibility of fun or shared enjoyment. For some, affection feels threatening, and hugs or overt displays of love may be rejected. A playful stance provides a gentler alternative, allowing warmth and closeness without overwhelming the child.
Playfulness reassures children that conflicts or separations in a relationship are temporary and not damaging to the connection. In tense situations, a light tone of voice, animated facial expressions, or humour can defuse defensiveness and create opportunities for reconnection. This is not about minimising serious misbehaviour but about keeping minor incidents in perspective. For instance, when a child resists transitioning between activities, introducing a playful game or role-play can reduce resistance and maintain cooperation.
Practical strategies for playfulness include storytelling tones rather than lecturing, softening facial expressions, lowering body posture to avoid intimidating presence, or transforming routine tasks into small games. These subtle adjustments communicate warmth and safety while maintaining the adult’s authority.
Importantly, playfulness is not about distracting from difficulties or denying a child’s struggles. Instead, it signals to the child that relationships can contain joy, even in the presence of challenges. For children who expect rejection or punishment, playfulness can be a powerful reassurance that their presence is valued. Over time, playful interactions rebuild a child’s belief in positive connection and create space for emotional growth.
Acceptance
Acceptance in PACE communicates to a child that their inner world—thoughts, feelings, and intentions—is safe from judgment. For many children, especially those shaped by trauma, the fear of being criticised or rejected for their feelings can prevent honest expression. Acceptance means separating the child’s identity and intentions from their behaviours. Adults can challenge unsafe behaviours while still affirming the child’s worth and humanity.
For example, when a child declares, “You hate me,” a typical adult instinct may be to deny or correct the statement. However, PACE encourages an accepting response such as, “I’m sorry it feels that way to you. That must be really painful.” This communicates understanding without dismissal, showing the child that their perspective matters, even if it is painful or inaccurate.
Through acceptance, children learn that conflict does not equal rejection. They discover that behaviours can be addressed and limited without threatening their relationship or self-worth. Adults may say, “I’m disappointed by what you did, but I know you were upset. It doesn’t change how much I care about you.” Such statements reinforce the difference between disapproving of behaviour and rejecting the child as a person.
This practice strengthens children’s confidence in relationships, making them more willing to share vulnerabilities. Acceptance fosters resilience by teaching children that they can be loved despite their mistakes, and that their feelings—whether anger, fear, or sadness—are valid and worthy of attention.
Examples or how to express acceptance:
“I can see how you feel this is unfair. You wanted to play longer” “You probably think that I don’t care about what you want” “You were letting me know that you were really scared when you ran away from me” “I can hear you saying that you hate me and you’re feeling really cross. I’ll still be here for you after you calm down”. “I’m disappointed by what you did, but I know you were really upset. It doesn’t change how much I care about you”.
Curiosity
Curiosity is the element of PACE that invites children to explore and reflect on the reasons behind their behaviours. Many children, especially those living with trauma, may recognise that their actions are inappropriate but lack the words or awareness to explain why. Instead of asking “Why did you do that?” in a demanding or accusatory way, curiosity involves gentle wondering, aimed at understanding rather than interrogating.
For instance, rather than scolding a child for breaking a toy, an adult might say, “I’m wondering if you broke the toy because you were feeling angry.” Such open-ended reflections give children the opportunity to recognise and articulate their emotions without fear of judgment. The tone is vital: curiosity must be communicated lightly, with compassion rather than frustration.
Curiosity helps children distinguish between their behaviours and their identities. When adults show genuine interest in the underlying feelings—such as sadness, fear, or confusion—children begin to understand that their behaviours are expressions of unmet needs rather than evidence of being “bad.” This reduces shame and defensiveness, replacing them with healthier emotions such as guilt, which can motivate positive change.
Examples of curiosity include phrases like, “I wonder if…,” “Could it be…?,” or “Tell me if I’m getting this wrong.” These sentence starters signal openness and a desire to understand, not to correct. Over time, curiosity builds children’s capacity for self-reflection and strengthens trust in their caregivers.
Examples of curiosity:
“I’m wondering if you broke the toy because you were feeling angry.” “I’m thinking you’re a little nervous about going back to school today, and that’s why you don’t want to get ready this morning”. “I’ve noticed that you’ve been using a really loud voice, and if you’re trying to tell me that you’re angry with me.” “I’m a little confused. Usually you love going for a walk, but today you don’t want to go. I’m wondering what’s different about today”. “When she couldn’t play with you today, I’m wondering if you thought that meant she doesn’t like you.”
Empathy
Empathy is the heart of PACE, ensuring children feel that they do not face struggles alone. Empathy involves actively recognising and validating a child’s distress, demonstrating compassion and solidarity. For traumatised children, empathy communicates that their emotions are not too overwhelming or burdensome for the adult to handle.
Showing empathy requires both words and actions. Adults might say, “That must have been so painful,” or “You are really upset right now, and that’s so hard.” Such statements acknowledge the child’s feelings without minimising them. Non-verbal cues, such as calm body language, gentle tone, and attentive presence, reinforce the message.
Importantly, empathy is not about pity or indulgence. It is about recognising that behaviours often stem from deeper struggles and showing willingness to share in those struggles. By doing so, adults demonstrate resilience and commitment, reassuring the child that the relationship remains intact even during difficult moments.
For example, when a child lashes out after feeling excluded, empathy might sound like: “It hurt so much when she didn’t ask you to play. That must have felt confusing.” This helps the child name their emotions and feel understood. Over time, empathy helps children build trust in relationships, knowing that their vulnerabilities will be met with care rather than criticism.
Examples of empathy: “You are SO upset about this right now. That must be really hard!” “It hurt so much when she didn’t ask you to play. You were probably thinking ‘Why did she do that?’ It was a real shock for you.” “You wanted to have another turn so badly. You were so excited about it and it’s so unfair that we ran out of time”. “It seems to you like he hates you. That must be really hard. I know you like him a lot, so this is pretty confusing”. “I know it’s hard for you to hear what I’m saying.” “Me saying ‘No’ has made you angry with me. I get why you don’t want to talk to me right now”
PACE in Practice
While PACE is simple in principle, applying it consistently in real-life situations can be challenging. Adults often feel the urge to correct or discipline, especially when confronted with disrespect or aggression. Yet practice shows that PACE-oriented responses defuse conflict and build stronger relationships.
Take, for instance, Emily, who becomes angry when denied a turn on the swings, yelling “I hate you!” A typical response might involve correcting her rudeness. A PACE-ful approach, however, acknowledges her anger with playfulness and empathy: “Wow, you’re really angry! It feels rubbish when you can’t do what you want.” Such responses validate her feelings while keeping the relationship intact.
Similarly, when Tom swears at his dad after school, a typical response might be punishment. But with PACE, his dad could say, “I can see you’re really angry. I’m wondering if something happened at school.” This curiosity and empathy create space for Tom to share his feelings rather than escalating conflict.
These examples illustrate how PACE transforms discipline into connection. Instead of viewing behaviours as personal attacks or defiance, adults see them as expressions of inner struggles. By responding with playfulness, acceptance, curiosity, and empathy, adults guide children toward emotional regulation, resilience, and trust.
Example: Emily asks Mum if she can play on the swings. Mum says she can’t as they need to be home soon. Emily gets very upset and angry and starts yelling “that’s so unfair, I hate you. You’re horrible!!!!” Typical response: “Emily, don’t be so rude!” “Life’s unfair!” “I am not horrible and you don’t hate me.” PACE-ful response: “OH WOW [in an animated voice], you’re feeling REALLY ANGRY [with a concerned expression]….you think I’m being mean by not letting you go on the swings when you really want to go…I’m saying no and you really want to go and that feels rubbish…it’s so frustrating when someone says we can’t do something that we want to do!” “I’m really sorry you feel that I hate you Emily that must feel awful – no wonder you’re so angry and upset if you think I hate you! I’d want to scream and shout too…” “It’s rubbish that we can’t do the things we enjoy right now…I’m missing the swings too…maybe we could all have a think about what other games we could on our way home…”
The 4 R’s of Responding with PACE
To support practical application, PACE can be aligned with the “4 R’s of Responding”: Regulate, Relate, Reason, and Repair. These steps provide a framework for managing challenging behaviours while maintaining emotional safety.
Regulate involves calming both the child and the adult. Adults must notice their own emotional state, ensuring they remain calm, compassionate, and engaged. They also help the child regulate by addressing immediate safety concerns and using soothing, light-hearted approaches.
Relate comes next, where adults seek to understand the meaning behind the child’s behaviour. Using curiosity and empathy, they explore the child’s motives, fears, or frustrations, showing genuine interest in their experience.
Reason follows, when the adult and child can discuss the behaviour rationally. Logical consequences may be introduced here, but always in a way that separates the behaviour from the child’s worth.
Repair is the final step, ensuring the relationship remains strong. This might include offering a hug, doing something enjoyable together, or using words and actions to affirm ongoing love and connection.
For example, if a child breaks a jar in a supermarket, a PACE-ful process would involve regulating emotions first, then relating by wondering what feelings triggered the act. Once calm, the child can reason about consequences, such as writing a letter of apology. Finally, repairing the relationship reassures the child that the incident does not damage their bond with the adult.
This structured yet compassionate approach ensures that discipline is balanced with emotional safety, turning difficult incidents into opportunities for growth.
Conclusion
PACE offers a trauma-informed, attachment-based framework for supporting children and young people. By integrating Playfulness, Acceptance, Curiosity, and Empathy into everyday interactions, adults can build stronger, safer, and more trusting relationships. The approach recognises that behind every challenging behaviour is an unmet need, an unspoken emotion, or a legacy of trauma. Instead of focusing narrowly on behaviour management, PACE invites adults to engage with the whole child, affirming their worth and supporting their healing journey.
Through consistent practice, PACE not only helps children regulate emotions but also strengthens the resilience of caregivers, teachers, and social workers. The “4 R’s of Responding” provide a practical framework for applying these principles, ensuring that discipline and connection go hand in hand. Ultimately, PACE reminds us that children are not problems to be fixed but individuals to be understood, supported, and valued.
Adverse Childhood Experiences (ACEs) are stressful or traumatic
experiences that can have a huge impact on children and young people
throughout their lives.
The ten widely recognised ACEs, as identified in a US study from the 1990s, are:
Abuse:
physical
sexual
verbal
Neglect:
emotional
physical
Growing up in a household where:
there are adults with alcohol and drug use problems
there are adults with mental health problems
there is domestic violence
there are adults who have spent time in prison
parents have separated
As well as these 10 ACEs there are a range of other types of
childhood adversity that can have similar negative long term effects.
These include bereavement, bullying, poverty and community adversities
such as living in a deprived area, neighbourhood violence etc.
We are committed to addressing all types of childhood adversity, and this is anchored in our long-standing, national approach of Getting it right for every child.
Why ACEs matter
Childhood adversity can create harmful levels of stress which impact
healthy brain development. This can result in long-term effects on
learning, behaviour and health.
Evidence from ACE surveys in the US, UK and elsewhere demonstrates
that ACEs can exert a significant influence throughout people’s life.
ACEs have been found to be associated with a range of poorer health
and social outcomes in adulthood and that these risks increase as the
number of ACEs increase.
Research from Wales found that people who reported experiencing four or more ACES are:
4x more likely to be a high-risk drinker
16x more likely to have used crack cocaine or heroin
6x increased risk of never or rarely feeling optimistic
3x increased risk of heart disease, respiratory disease and type 2 diabetes
15x more likely to have committed violence
14x more likely to have been victim of violence in the last 12 months
20x more likely to have been in prison at any point in their life
Consideration of ACEs is therefore crucial to thinking about how to
improve the lives of children and young people, to support better
transitions into adulthood, and achieve good outcomes for all adults.
What are we doing to address ACEs
As set out in the Programme for Government 2018 to 2019,
we are committed to preventing ACEs and helping to reduce the negative
impacts of ACEs where they occur and supporting the resilience of
children, families and adults in overcoming adversity.
We are take forward action in four key areas:
1. Providing inter-generational support for parents, families and children to prevent ACEs
2. Reducing the negative impact of ACEs for children and young people
3. Developing adversity and trauma-informed workforce and services
4. Increasing societal awareness and supporting action across communities
We held an ACEs ministerial event
in March 2018 in Glasgow involving people working across a wide-range
of related sectors and Year of Young People Ambassadors. This explored
what was working well, where further action is needed and opportunities
for collaboration.
Through our Getting it right for every child approach,
families and children can be supported by services to prevent and
reduce adversity and the negative outcomes associated with it.
We will build on our existing policies, including:
focusing on achieving equity in education through the Scottish Attainment Challenge and, in combination with the Pupil Equity Fund, allocating funding directly to schools to close the poverty-related attainment gap
putting children’s wellbeing first through the Child Protection Improvement Programme, keeping them safe from abuse and neglect by ensuring effective child protection procedures are in place
Our policies in the following areas are also relevant:
Addressing ACEs is also about better supporting adults who have been through adversity and trauma.
We are working with NHS Education for Scotland and have announced £1.35 million funding to deliver a national trauma training programme.
This will help Scotland’s current and future workforce develop skills
and services that respond appropriately to people’s adverse childhood
experiences and other traumatic experiences.
Consideration of ACEs is increasingly informing the development of national policy. For example, the Justice in Scotland: Vision and Priorities 2017 to 2020
identified ACEs as a key issue. A range of actions are being taken to
reduce their impact e.g. measures to reduce parental incarceration by
moving to a presumption against short prison sentences.
We are also working with the Scottish ACEs Hub (co-ordinated by NHS Health Scotland) which aims to raise awareness and understanding about ACEs and progress national action. For example, the Scottish ACEs Hub, in conjunction with Education Scotland, held a conference in March 2018 on addressing childhood adversity to support children’s learning and wellbeing.
Children involved in child welfare services (CWS) are often positioned as vulnerable individuals in need of protection. While the right to be heard is a fundamental aspect of child welfare policy, many young people receiving services find themselves excluded from the very decisions that shape their lives. This article explores the experiences of thirty-three young people in Nova Scotia, Canada, revealing a striking pattern of feeling unheard, uninformed, and uninvolved. Through qualitative research, it becomes clear that meaningful child participation is often an aspiration rather than a reality. The findings indicate that including young people in decision-making processes fosters trust, improves cooperation, and enhances well-being both during and after their time in care.
The concept of child participation is widely recognized in social work. The United Nations Convention on the Rights of the Child, which Canada ratified in 1991, guarantees children the right to be heard in matters that concern them. Despite this, child protection systems frequently emphasize safeguarding over empowerment. Social workers, bound by legal and procedural obligations, often view children as passive recipients rather than active participants. This perspective not only limits children’s agency but also exacerbates their sense of isolation and powerlessness within the system. Additionally, bureaucratic barriers, high caseloads, and risk-averse policies contribute to an environment where social workers prioritize procedural efficiency over meaningful engagement with young people.
One of the most prominent themes emerging from the study is that children feel unheard by their caseworkers and other professionals. Many young people report that, even when encouraged to share their concerns, their voices are dismissed or their experiences questioned. One participant, an eighteen-year-old male, described how he was invited to express himself but found that nothing changed as a result. Others recounted being outright accused of lying when attempting to discuss issues with their social workers, teachers, or therapists. This lack of trust and belief in their experiences led to growing resentment and detachment from the system meant to support them. The perception that social workers act as gatekeepers rather than advocates reinforces a cycle of disengagement, as children lose confidence in the system’s ability to address their concerns.
The problem extends beyond not being heard—many children are also uninformed about critical aspects of their care. Young people in the study frequently expressed frustration at being left out of key decisions, such as where they would live or when they could see their families. Some recounted experiences of being suddenly moved to new placements without prior notice or explanation. In extreme cases, young people were subjected to traumatic transitions, such as being taken into care without understanding the circumstances, placed in residential facilities without prior knowledge of what to expect, or having their case files lost due to administrative errors. The absence of clear communication left many feeling powerless and confused. This systemic failure to provide timely, accurate, and child-friendly information further alienates youth from their own case planning.
Feeling uninformed naturally leads to a broader sense of being uninvolved in one’s own life. Many participants in the study felt that they had little to no control over major decisions. Some reported being forced into therapy against their will, while others were pressured to accept adoption despite their objections. The lack of agency in these deeply personal decisions reinforced a feeling of helplessness, making them question whether their preferences and opinions mattered at all. This detachment not only impacts their emotional well-being but also their long-term ability to navigate adulthood successfully, as they are deprived of opportunities to develop critical decision-making skills.
Faced with these challenges, young people developed various coping strategies to regain a sense of control. Some withheld information from their caseworkers, providing only minimal details in an effort to protect themselves from perceived manipulation. Others adopted more overtly defiant tactics, such as pretending to cooperate with treatment plans in order to expedite their release from care. In extreme cases, some youth attempted to run away, seeing it as their only means of asserting autonomy over their lives. These coping mechanisms highlight a deeper systemic failure: when young people do not feel included in their own care, they resort to strategies that ultimately undermine their well-being and disrupt the very services meant to support them. The cycle of mistrust and disengagement only serves to reinforce negative outcomes, including homelessness, mental health struggles, and involvement with the justice system after aging out of care.
The study’s findings underscore a fundamental need for systemic change in child welfare services. Meaningful participation should not be an afterthought but an integral part of the care process. Social workers and policymakers must actively work to ensure that young people are consistently informed, consulted, and given genuine opportunities to shape the decisions that affect them. Training for caseworkers should emphasize the importance of treating children as active agents rather than passive subjects. Additionally, standardized guidelines should be implemented to guarantee that all children, regardless of their circumstances, are given a voice in their care. More accountability measures should also be put in place to ensure that professionals who neglect to involve youth in decision-making are held responsible for their actions. Furthermore, investing in independent advocates or youth advisory boards could offer additional support in ensuring that children’s perspectives are taken seriously.
This research highlights the stark contrast between the ideals of child participation and the lived realities of young people in the child welfare system. While policies exist to protect children’s rights, their implementation remains inconsistent. The voices of young people must be central to any reform efforts, ensuring that child welfare services not only safeguard their well-being but also empower them to take an active role in shaping their futures. Without deliberate and meaningful structural changes, the disempowerment experienced by young people in care will continue, perpetuating cycles of mistrust and disengagement that undermine the very goals child welfare services aim to achieve.
Janice Mitchell’s exploration of the third object technique, as described in “Letters from a Kangaroo,” presents an innovative method of engaging with pre-school children in social work practice. Her approach underscores the importance of creative strategies to facilitate communication and build trust with young children, particularly those who have experienced disruption or instability in their lives. By adopting a third object—a letter-writing kangaroo named Joey—Mitchell demonstrates how such a medium can act as a bridge, fostering meaningful interactions between the social worker and the child.
Mitchell begins by addressing a gap in social work literature, noting that it often focuses more on the inhibitors of communication rather than providing practical tools for engaging young children. To address this, she turned to her own experiences and literature on early language and concept development, finding that young children often understand far more than they can express verbally. This realization became the foundation for her innovative third object technique, which she tested during a placement at a Children’s Centre in Edinburgh. This setting, catering to children from six weeks to five years old, provided her with an opportunity to observe and interact with children directly, outside of the typical adult-mediated communication often found in social work contexts.
The cornerstone of Mitchell’s approach was the introduction of Joey, a nursery-aged kangaroo who communicated with children through letters filled with illustrations and simple messages. This method drew inspiration from established social work theories and practices, such as Clare Winnicott’s emphasis on the importance of third objects in engaging children and D.W. Winnicott’s recognition of the therapeutic value of play and imagination. Joey’s letters were not just a novelty; they provided a “safe and neutral area” where children could freely express themselves without the pressure of direct questioning. The letters were tailored to the children’s developmental levels and interests, incorporating images of Joey engaging in familiar activities like painting or visiting the zoo. Each child was invited to reply to Joey’s letters, often through drawings or dictated messages, creating a reciprocal and dynamic interaction.
The responses from the children were overwhelmingly positive. Even the youngest participants, some as young as eighteen months, displayed enthusiasm and engagement with the letters. The older children, aged four and above, quickly grasped the concept of writing letters and developed a sense of connection with Joey, often referring to him as a friend and asking thoughtful questions about him. For example, one child wondered if Joey was scared of ghosts, while another speculated about Joey’s size. This imaginative engagement not only made the sessions enjoyable but also provided insights into the children’s thoughts and emotions.
For younger children or those with limited verbal skills, the letter-writing sessions offered an alternative means of expression. Some children preferred drawing or tracing around a model kangaroo, while others used the sessions to enact imaginary scenarios. Mitchell observed that these activities often led to spontaneous sharing of personal experiences or anxieties. One child, who was often ostracized by peers, spoke about his lack of friends at his previous nursery but expressed happiness in having Joey as a “special friend.” Another child, struggling with fears of “ghosties” and “bogeymans,” used the sessions to articulate her nighttime anxieties. These examples highlight how the third object technique can create a non-threatening environment where children feel safe to explore and communicate their feelings.
The technique also revealed the importance of individualized attention in a nursery setting. Staff members noted the children’s excitement and engagement with the sessions and recognized the value of providing similar one-on-one interactions in their daily routines. Mitchell herself found the experience deeply rewarding, noting that the structured yet flexible nature of the sessions made them more manageable than traditional interviews. She emphasized the need for patience and a willingness to follow the child’s lead, allowing the conversation to flow naturally rather than imposing adult expectations or questions.
Mitchell’s reflections underscore the broader implications of her work for social workers. She argues that building a trusting relationship with a young child is essential, particularly when the social worker may need to make significant decisions affecting the child’s life. The third object technique, such as the use of Joey’s letters, offers a practical and effective way to achieve this, even for social workers who may initially feel uncertain about engaging with pre-school children. By providing a structured yet child-centered approach, this method helps bridge the gap between professional expertise and the child’s unique perspective.
In conclusion, “Letters from a Kangaroo” illustrates the potential of creative and imaginative techniques in social work practice with young children. Mitchell’s use of Joey as a third object not only facilitated communication but also highlighted the rich inner lives of pre-school children and their capacity for connection and expression. Her work serves as a reminder that effective social work requires not only theoretical knowledge but also a willingness to experiment, adapt, and engage with children on their own terms. By doing so, social workers can build the trust and understanding necessary to support children through challenging times and help them navigate their worlds with greater confidence and resilience.
As children, we experience a whirlwind of strong emotions that can sometimes feel overwhelming. Learning to navigate and regulate these emotions is an essential part of growing up, and it is during these formative years that we begin to develop the tools needed to live and work harmoniously with others. This process is known as emotional containment. It refers to the way in which adults provide the emotional support children need to process and manage intense feelings in a healthy way.
While emotional containment is vital in childhood, it is just as crucial throughout adulthood. In this article, we will explore what emotional containment is, the effects of lacking it, and how adults can support children in learning to manage their emotions effectively.
What is Emotional Containment?
Emotional containment is a concept that describes the emotional support adults provide to help children manage overwhelming feelings. It is about offering a safe space where children can feel their emotions without fear of judgment or reprisal, while also teaching them how to regulate those emotions in a healthy way. The term “containment” suggests that the child feels held and protected, both physically and emotionally.
Psychologists often trace the origins of emotional containment back to early infancy. In these early stages of life, when a baby is distressed, the primary caregiver responds to those needs with comfort, whether through soothing gestures like cuddling, feeding, or diaper changes. These comforting actions help the baby feel safe and secure, and teach them that their emotional needs can be met.
In recent years, the global pandemic has stripped many of us of the communal emotional containment that we once relied on. Social isolation, loss, and grief have left many people feeling disconnected and unsupported. For both children and adults, emotional containment has become more necessary than ever.
The Effects of a Lack of Emotional Containment
When children are deprived of emotional containment, either because it is inconsistent or absent altogether, the long-term effects can be profound. In childhood, the lack of this emotional support can lead to:
Difficulty recognizing or expressing their own emotions
Disrupted sleep and eating patterns
Compulsive behaviors
Increased vulnerability to addiction
Anxiety and panic attacks
Low self-esteem and poor self-worth
Difficulty expressing their needs
Feelings of being undeserving of emotional support
Separation anxiety
Children who do not receive emotional containment may also struggle with managing intense feelings, as unresolved emotions from the past can resurface in stressful situations. This can lead to emotional outbursts or destructive behavior, which are often reactions to deeper unresolved pain.
How Can Adults Support Emotional Containment?
Supporting emotional containment involves creating a safe, nurturing environment where children feel validated and understood. As adults, we play a crucial role in helping children learn that feeling difficult emotions is okay, and that they don’t have to be afraid of those feelings. Below are some ways adults can provide emotional containment to children:
1. Validate Their Emotions
When a child experiences anger, frustration, or sadness, the first step is to acknowledge their emotions. Rather than dismissing or downplaying their feelings, let them know you understand what they are experiencing. For example, if a child is upset about not getting a toy they want, an adult might say:
“I see you’re feeling really angry because I didn’t let you have that toy. I understand that it’s hard, but it’s not safe for you to play with it right now. How about you try this toy instead? I know you’re frustrated, but we can work through this together, and we don’t have to let it ruin the day.”
While a child may not understand every word you say, the tone of voice and the calm, reassuring manner in which you speak will help them feel safe. This creates a space where emotions can be expressed, but without causing harm to the child or those around them.
2. Lead by Example
Children often learn how to handle their emotions by observing the adults around them. When you, as an adult, model healthy emotional regulation, children are more likely to adopt similar strategies. For example, when faced with a stressful situation, instead of reacting impulsively or angrily, demonstrate how to calm down and express frustration in a constructive manner. This teaches children that strong emotions don’t have to result in negative consequences.
3. Consistency is Key
Children will often test boundaries to see if adults will consistently support them emotionally. This is a natural part of their development, and it’s essential to be consistent with emotional containment. When a child sees that the adult is reliably there to provide support, they begin to trust that their emotions are valid and can be handled in a safe, controlled manner. This trust strengthens the emotional bond and helps the child feel secure enough to explore and express their emotions in the future.
4. Provide Clear Boundaries
While emotional containment is about providing a safe emotional space, it’s also important to set clear, consistent boundaries. This helps children learn the difference between acceptable and unacceptable behavior. Emotional containment does not mean allowing children to act out in harmful ways. Instead, it involves offering guidance on how to express emotions appropriately, while ensuring that the child knows the boundaries for behavior.
5. Teach Coping Strategies
Helping children develop emotional resilience is a key aspect of emotional containment. When children are upset, it’s important to guide them toward healthy coping strategies, such as deep breathing, taking a break, or talking about their feelings. These skills will serve them well into adulthood, helping them manage emotions in a balanced, constructive way.
Conclusion
Emotional containment is vital for a child’s development, teaching them how to understand, express, and regulate their emotions in a healthy way. Adults play a central role in providing emotional support, offering validation, consistency, and guidance. By fostering a safe, nurturing environment where children’s emotions are recognized and contained, we help them grow into emotionally intelligent, resilient individuals who can form healthy relationships and manage the challenges life brings.
This study conducts a systematic review to examine the impact of social support on the mental health of single fathers, a demographic often overlooked within family dynamics. The research aims to expose the challenges single fathers face in accessing social support and the implications for social work practice. Despite the rising prevalence of single father households, traditional gender roles and societal norms often marginalize these fathers within caregiving contexts, limiting their access to needed support systems.
A comprehensive search across five online databases led to the identification of 14 studies that fulfilled the eligibility criteria. The critical analysis of these papers, encompassing responses from 4,174 single fathers, reveals that while single fathers generally exhibit better financial stability than single mothers, they face significant mental health challenges due to job-insecurity and limited workplace support. These challenges result in higher psychological distress and poorer health outcomes compared to partnered fathers. Socio-economic status plays a crucial role, with single fathers benefiting less from informal social support networks and more from financial stability.
The review identifies two main themes: “Family Structure” and “Buffer against Socio-cultural and Economic Factors.” The first theme explores how gender, household composition, and socio-economic support influence the well-being of single fathers compared to single mothers and partnered fathers. The second theme highlights the role of social support in mitigating mental health challenges, particularly during the COVID-19 pandemic, which exacerbated socio-economic and cultural stressors for single fathers.
The findings emphasize the need for targeted interventions and policy measures that enhance social support networks and alleviate economic pressures for single fathers. Social work practice must consider the varied socio-economic and mental health challenges single fathers face, promoting resilience through strong support networks and flexible employment policies. This comprehensive approach can enhance the well-being of single fathers and contribute to healthier family dynamics. Future research should focus on identifying specific intervention areas to ensure support mechanisms are responsive to the evolving needs of single parents.
This study explores the realm of single fathers’ mental health by conducting a systematic review of existing research. It seeks to shed light on what the literature reveals about the impact of social support on the mental well-being of single fathers and examines the implications for social work practice. Single fatherhood represents a significant but often overlooked demographic within the broader landscape of family dynamics (Barker, 1994; Katz, 1979; Shorey & Pereira, 2023). Existing definitions of single fatherhood vary (Letablier and Wall, 2018), depending on the context, marital status, legal and residential arrangements, financial responsibility, parental involvement, cultural and social factors and personal circumstances. Based on UK government definitions (ONS, 2016, 2023), in this paper single fathers are considered as fathers who undertake primary caregiving responsibilities for their child(ren) without the presence of a spouse or partner in the household. Regardless of the expanding number of single-father households, societal norms and institutional practices often perpetuate traditional gender roles, relegating fathers to secondary caregiving roles and prioritising mothers as primary caregivers (Christie, 2006; Featherstone, 2009).
Existing literature (Bradshaw & Miller, 1991; Greif, 1992; Janikowski, 2021; Shorey & Pereira, 2023) underscores the challenges faced by single fathers in accessing support and recognition within social work systems, which are critical for their mental health outcomes, well-being and resilience (Chiu et al., 2018; George & Wilding, 1972; Louie & Crombrugghe, 2017). Despite evolving societal attitudes towards father involvement, deep-rooted biases and stereotypes persist, leading to a lack of visibility and engagement with single fathers in social work practice (Janikowski, 2021; Shapiro & Krysik, 2010). Research indicates that social work services tend to focus predominantly on mothers, with fathers being marginalised and excluded from meaningful participation in decision-making processes (Ashley et al., 2006; Brewsaugh, Masyn & Salloum, 2018). Moreover, single fathers are often subjected to societal narratives that portray them as inadequate caregivers or financial burdens on the state (Bradshaw & Miller, 1991; La Rossa & La Rossa, 1981), further complicating their mental health challenges (Garner, 2009). Such narratives exacerbate the challenges faced by single fathers in seeking support for their mental health needs. Despite the increasing acknowledgment of the importance of social support, single fathers continue to encounter barriers in accessing and utilising support services. Socio-economic disparities, cultural stigma, and institutional biases often inhibit help-seeking behaviours and limit access to support networks (Eickmeyer, 2017; Shapiro & Krysik, 2010).
In light of these findings, there is a pressing need to understand and address the relationship between social support and the mental health needs of single fathers within the social work context. This review will highlight the existing gaps, biases, and the impact of socio-economic and cultural factors on their mental well-being. Thus a literature review to explore how social support impacts the mental health of single fathers has been undertaken.
The research question was developed based on the PICO framework (Booth et al., 2022; Johnson et al., 2020; Maher et al., 2018; Taylor et al., 2015) to create specific search terms and the systematic search strategy. This approach facilitated a preliminary scoping search to identify the impact of social support on single fathers’ mental health (Karolinska Institutet University Library, 2022). Table 1 outlines the key concepts and search terms used, providing a clear framework for the literature search.
This revealed significant research gaps in the literature; therefore this dissertation investigates how social support affects the mental well-being of single fathers and examines the implications for social work practice.
Search Strategy:
The search strategy employed systematic methods to comprehensively summarise and synthesise evidence on the research question using predefined approaches and relevant databases (CINAHL, MEDLINE, APA PsycInfo, and Social Science Premium Collection) (Booth et al., 2022; Creswell & Creswell, 2018; Taylor et al., 2015). Clear inclusion and exclusion criteria guided the search and selection process. The search terms, determined through a preliminary scoping review, included “single father,” “social support,” and “mental health,” with social support defined as emotional, informational, and instrumental assistance from social networks (Cohen & Wills, 1985; Cohen et al., 2000; Kent et al., 2018). Boolean operators and truncation symbols were used to enhance search outcomes (Shorey et al., 2023). Table 2 lists the key terms and articles found in the process.
The PRISMA Flow Diagram (Table 3) illustrates the article screening procedure, beginning with an initial abstract scan and progressing to a thorough review of full articles as inclusion and exclusion criteria were implemented (Booth et al., 2022; Johnson et al., 2020; Maher et al., 2018; Paige et al., 2020). It also highlights the inclusion and exclusion of the articles, providing the rationale for these decisions. This process involved assessing the data points to ensure they were relevant to the research question.
Studies considered for analysis:
The selected papers presented diverse perspectives on how social support impacts the mental health of single fathers, adhering to the research question and highlighting key themes (Booth et al., 2022; Taylor et al., 2015). The journal articles were organized in the EndNote 20 reference management tool (The EndNote Team, 2013). Key themes were identified to gain a comprehensive understanding of the topic (Booth et al., 2022; Naeem et al., 2023).
Eligibility Criteria:
Eligible studies were contemporary – prior 10 years, peer-reviewed primary research in English due to the researcher’s language barrier. Inclusion criteria were single fathers regardless of age, geographic location, socio-economic status (SES), education, sexual orientation, race and ethnicity, length of single parenthood, raising children of any age, divorced, separated, widowed, or never-married, with any custody percentage, and living alone with their children. Excluded were secondary and correlational research, thesis papers, conference proceedings, books, editorials, and reports (Shorey et al., 2023).
Quality Appraisal:
The researcher appraised the selected articles using the Critical Appraisal Skills Program (CASP) checklist (Appendix 1) for systematic reviews (Critical Appraisal Skills Programme, 2018), evaluating study objectives, methodologies, researchers’ reflexivity, ethical considerations, data analysis rigor, findings, and overall research value (Shorey et al., 2023). Despite varying degrees of relevance, all studies were included to enhance the rigor of the review (Walsh & Downe, 2005).
Data Extraction:
Led by the PRISMA checklist (Liberati et al., 2009), the researcher extracted study details—such as author, publication year, study location, methods, analysis and data collection, population and main findings. Then, themes were identified through a detailed coding process, where each article was read thoroughly. This involved using both digital and paper notes, connecting themes, and integrating them into a comprehensive document (Booth et al., 2022; Shorey et al., 2023; Naeem et al., 2023; Taylor et al., 2015).
Ethical Considerations:
Systematic reviewers must accurately represent the perspectives of authors and participants to identify missing viewpoints and evaluate the relevance of their findings to specific contexts. This involves considering how publication and search biases may influence results and reflecting on their own biases during the review process. Selective and informed inclusion should guide decision-making, and transparency is crucial for ethical impact (Suri, 2020). Publication bias occurs when study results are not published due to their findings’ direction or strength, often because researchers lack access to necessary literature, leading to biases that affect evidence synthesis (Dickersin & Min, 1993). To mitigate researcher bias, the CASP checklist was utilised (Critical Appraisal Skills Programme, 2018).
Limitations:
This review acknowledges potential omissions due to unclear titles or abstracts, inadequate indexing, and various restrictions. It highlights the lack of research on racial and ethnic differences in single-fatherhood experiences, suggesting future studies in this area (Shorey et al., 2023). Limitations include small sample sizes, cross-sectional designs, biases from self-reported data, and demographic or geographic restrictions (Booth et al., 2022; Creswell & Creswell, 2018). Thematic analysis, while flexible, may lead to inconsistency and incoherence in theme formulation and cannot assert conclusions about language usage (Braun & Clarke, 2006; Holloway & Todres, 2003; Nowell et al., 2017).
From the database and manual searching 298 studies were identified. After removing 130 duplicate studies and excluding 75 studies due to their publication dates, 93 studies remained for title and abstract screening by the researcher. During this screening, 55 studies were excluded for being irrelevant to the research question. Subsequently, the full texts of the remaining 38 studies were assessed against the eligibility criteria, resulting in the exclusion of 24 more studies (Shorey et al., 2023). The 14 selected studies were peer-reviewed, primary research, conducted in Canada (n=1), Germany (n=3), Iceland (n=1), Israel (n=1), Japan (n=1), New Zealand (n=1), South Korea (n=2), Sweden (n=1), United Kingdom (n=2), and United States (n=1). A total of 4,174 single father’s responses were analysed.
The critical review of the selected literature shows single mothers face poorer mental health, higher unemployment, and greater socio-economic deprivation than single fathers, who are generally more financially stable. However, single fathers face significant mental health challenges due to job-insecurity and limited workplace-support, leading to higher psychological distress and poorer health outcomes than partnered-fathers, with SES playing a crucial role. These findings were described in two main themes and five subthemes below.
Theme 1: Family Structure
This theme highlights how gender, household-composition and socio-economic support impacts the well-being of single fathers in comparison to single mothers and partnered-fathers.
Mind Matters: Exploring Gender and Economic Differences in Single Parenthood
Research comparing the mental health of single parents reveals significant differences in their experiences and outcomes. Collings et al. (2014) found that single mothers endured significantly poorer mental health compared to single fathers, due to higher rates of having preschool-aged children, unemployment, and socio-economic deprivation. Kong et al. (2017) highlighted higher rates of depression and suicidal ideation in single mothers, while single fathers showed higher prevalence of alcohol dependence, influenced by SES. Chiu et al. (2017) noted that while single fathers tended to have a less healthy lifestyle and diet, they were also less likely to be diagnosed with mood or anxiety disorders than single mothers. However, Rattay et al. (2017) found no significant differences in self-rated health between single parents, suggesting that partner status impacts health similarly across genders, which may downplay the nuanced challenges single mothers face. Fritzell et al. (2019) indicated that health disparities were more pronounced among single parents than in two-parent families, with greater differences observed among mothers. Quantitative analysis of parental social support, depression, anxiety, and parenting stress (Prokupek, 2023) revealed similar outcomes for both mothers and fathers. Results indicated that fathers typically experienced positive reactions from others, with negative feedback being rare and isolated. Overall, fathers exhibited good well-being and received comparable levels of social support to mothers in similar circumstances (Jones et al., 2022).
Collings et al. (2014) showed that single fathers have higher homeownership and lower socio-economic deprivation when compared to single mothers (Kong et al., 2017). Single fathers are also more likely to be employed, whereas single mothers are twice as likely to have a preschool-age child and work part-time (Chum et al., 2022) and benefit more from informal social support (Chiu et al., 2017; Chum et al., 2022). Single fathers face greater challenges receiving employer support for childcare responsibilities, while single mothers benefit from greater workplace flexibility due to traditional gender roles and often working low-skill jobs. However, single fathers in high-skilled employment adapt better to work-caring responsibilities (Itzayeva, 2021). Chum et al. (2022) noted that single fathers experience more significant mental-health decline with job-insecurity compared to single mothers. SES is linked to increased alcohol-dependence risk among single mothers and poor mental health among single fathers (Kong et al., 2017). Foreign-born single mothers, with sole custody arrangements, face the poorest socio-economic conditions and the highest rates of mental health issues, exacerbating their vulnerabilities (Fritzell et al., 2019).
Fatherhood in Contrast: Unpacking Mental Health and Socio-economic Differences between Single and Partnered Fathers
Research consistently indicates poorer mental health of single fathers compared to their partnered counterparts. Collings et al. (2014) found single fathers experienced higher psychological distress due to lower home-ownership rates and inadequate social support. Kong and Kim (2015) noted severe stress, depressive symptoms, and poorer quality of life among them, exacerbated by demanding socio-economic conditions. Chiu et al. (2017) and Dhungel (2023) highlighted lower educational attainment, higher unemployment and poorer health behaviours, correlating with their prevalent mental health issues. The prevalence of depression and suicidal ideation was notably higher, with poor SES being a significant factor (Kong et al., 2017). Frisch-Volkert et al. (2020) reported higher levels of mental disorders and psychopathological symptoms, supporting findings from Thorsteinsdottir et al. (2018) and Rattay et al. (2017) regarding escalating anxiety and depression and custodial father’s high levels of anxiety and worry (Fritzell et al., 2019). Despite these difficulties, Tsfati et al. (2022) found that they experienced benefits such as reduced family conflict and stronger relationships with their children. Overall, single fathers face greater mental-health challenges than their partnered peers due to deep-rooted socio-economic disparities and limited social support (Collings et al., 2014; Chiu et al., 2017; Dhungel, 2023; Frisch-Volkert et al., 2020; Kong et al., 2017; Kong & Kim, 2015; Rattay et al., 2017; Thorsteinsdottir et al., 2018; Tsfati et al., 2022). Single fathers face greater socio-economic and financial challenges than partnered parents, as illustrated by Collings et al. (2014), with home-ownership rates of 37.7–45.4% and 72.9–74.1%, respectively. Single fathers, experience pronounced social disadvantages, such as lower educational accomplishment, lower income, and higher unemployment rates (Chiu et al., 2017). These factors contribute to a troublingly higher incidence of poor self-rated well-being among single fathers when compared to partnered fathers (Chiu et al., 2017). The economic strain on single fathers is further compounded by lifestyle; namely unhealthy diet and sparse medical examinations, correlating with increased psychological distress (Dhungel, 2023).
Theme 2: Buffer against socio-cultural and economic factors
This theme highlights how social support cushion single fathers’ mental health against social, economic and unforeseen pandemic related stressors.
Community Armour: Protecting Single Fathers from Socio-Cultural Strains and Parental Stressors
Research shows that single fathers are disproportionately affected by negative socio-cultural factors, resulting in a significantly poorer quality of life compared to married fathers. This disparity is driven by lifestyle, precarious employment status, lower education, and profound lack of formal support (Chiu et al., 2017; Collings et al., 2014; Dhungel, 2023; Itzayeva, 2021; Kong & Kim, 2015; Kong et al., 2017; Tsfati et al., 2022). Additionally, being a foreign-born single father may heighten the risk-factors regarding their well-being (Fritzell et al., 2019). They experience higher rates of anxiety (Thorsteinsdottir et al., 2018) depression, stress (Tsfati et al., 2022), back pain, smoking, lack of physical activity, neglected dental health (Rattay et al., 2017) and challenges due to perceived male gender norms as providers and caregivers (Itzayeva, 2021, Tsfati et al., 2022). Although, strong social networks are essential for helping single parents navigate the complexities of solo parenting and mitigate stressors, single fathers often find themselves with severely limited access to these essential resources (Collings et al., 2014; Jones et al., 2022;; Tsfati et al., 2022; Thorsteinsdottir et al., 2018). This lack of support not only heightens their vulnerability but also amplifies the stigma and discrimination they face (Jones et al., 2022).
Strength in Numbers: How Social Support Fortifies Single Fathers against Socio-economic Stressors
Social support is essential, but often insufficient for single parents, acting as a fragile buffer against the overwhelming socio-economic stressors that significantly undermine their physical and mental health (Kong et al., 2017). Research consistently demonstrates that single fathers often face substantial challenges, such as job-insecurity, low income, and inadequate social benefits, which significantly impact their quality of life and mental well-being (Chum et al., 2022; Collings et al., 2014). For instance, they are significantly more likely to experience stress, depressive symptoms and poorer mental health compared to their married counterparts, largely due to socio-economic disadvantages (Chiu et al., 2017; Dhungel, 2023; Kong & Kim, 2015). The absence of robust institutional support during crises, like the pandemic, further exacerbates their stress-levels (Tsfati et al., 2022). Single fathers, who are able to afford and obtain supportive networks can better manage parenting stress and combat feelings of stigma and isolation (Jones et al., 2022). Social benefits, although less utilised by single fathers compared to single mothers, provide a financial buffer that can alleviate some economic pressures, which can improve their well-being (Chum et al., 2022). Moreover, single fathers with higher-income jobs are likely have better access to flexible work arrangements and quality childcare, which can help balance work-caregiving responsibilities, thus reducing stress (Iztayeva, 2021; Jones et al., 2022). However, this reliance on individual circumstances reinforces systemic inequalities, since not all single fathers can access high-income jobs or supportive networks, highlighting the urgent need for structural changes to better support this vulnerable population.
Resilient Together: The Role of Social Support in Mitigating Mental Health Challenges during the COVID-19 pandemic.
Various papers (Iztayeva, 2021; Prokupek, 2023; Tsfati et al., 2022) show the critical role of social support in buffering single fathers against mental health challenges, particularly during the pandemic. Before, they often relied on extended family for childcare, especially those in low-skill jobs who found formal childcare unaffordable (Iztayeva, 2021). However, the pandemic disrupted these informal support systems and exacerbated pre-existing stressors such as financial insecurity and social isolation, leading to increased psychological strain (Tsfati et al., 2022). Despite these challenges, the availability of support networks played a critical role in mitigating negative impacts. Support from mental health professionals and community networks helped alleviate feelings of loneliness, mitigated their vulnerability and improved their well-being (Tsfati et al., 2022). The single parents who already relied on social support prior to the lockdown, showed stable employment and only moderate changes in external childcare, potentially due to emergency provisions that reduced the need for additional support. This enabled single fathers to educate and spend quality time with their children, while experiencing similar levels of stress (Prokupek, 2023). This increased involvement with their children during lockdowns provided an unexpected source of emotional support and a sense of fulfilment, highlighting the dual role of single fathers as both caregivers and financial providers (Tsfati et al., 2022). Therefore, the presence of robust social support systems significantly cushioned the impact of pandemic-related stressors on single fathers’ mental health and well-being, yet it also highlights the precarious nature of their reliance on such support.
Understanding the well-being of single fathers is essential in addressing the broader implications of family structure on mental health and socio-economic stability. This systematic review explored the nuanced differences in mental health outcomes and socio-economic challenges faced by single fathers in comparison to single mothers and partnered fathers. The contrasting experiences of these demographics reveal the critical influence of gender, household composition, and socio-economic support on mental health. While single fathers often struggle with less flexible workplace support and higher job-insecurity, they benefit from social networks and financial stability, which can offset some mental health stressors. Conversely, single mothers frequently struggle with higher rates of unemployment and depression, exacerbated by socio-economic deprivation and childcare responsibilities. Analysing these dynamics through the lens of status characteristic theory (Berger et al. 1977; Wagner and Berger 1997), which suggests that men typically receive a fatherhood bonus due to their higher social status (Berger et al. 1977), we can discern how societal biases shape these outcomes. Single fathers, despite facing job-insecurity, are often perceived more favourably in professional environments, receiving implicit socio-economic advantages. On the other hand, single mothers endure a motherhood penalty, as caregiving is devalued and deemed “women’s work” (Folbre, 2018), leading to systemic disadvantages such as increased unemployment and severe mental health challenges (Correll et al. 2007; Ridgeway and Correll 2004). Additionally, the role of social support networks emerges as a key buffer against socio-economic stressors, particularly evident during crises such as the COVID-19 pandemic. This analysis emphasises the importance of fostering supportive environments and tailored interventions to enhance the well-being of single parents across different socio-economic landscapes.
The relationship between socio-economic deprivation and poorer mental health has been recognised in the general population (Oakley-Browne et al., 2006), with the emphasis on single parents (Crosier et al., 2007; Hope et al., 1999; Kim and Kim, 2012). This aligns with Avison and Davies (2005) and Collings et al. (2014) findings, that single mothers generally experience higher degrees of psychological distress compared to single fathers, largely due to socio-economic deprivation. Conversely, Wade et al. (2011) found that while single mothers had a higher risk of psychiatric disorders compared to single fathers, SES accounted for a larger proportion of this risk in fathers (37%) than in mothers (14%).
Within the general population, single fathers earn more than single mothers (Grall, 2020; Livingston, 2013), and the latter receive more social support (Grall, 2020; Hertz & Ferguson, 1997). Chum et al., (2022) found that job-insecurity impacted partnered parents and childless individual’s mental health less than lone fathers, while lone mothers were unaffected. They argued that limited resources play a critical role managing the possibility of job loss, which is linked to increased stress. This indicates that job-insecurity is linked to poorer mental health outcomes, as shown previously (Abbafati et al., 2020; Andrea et al., 2009; Burgard et al., 2009; Ferrie et al., 1998; Ferrie et al., 2002; Lassalle et al., 2015; Meltzer et al., 2010; Rugulies et al., 2006; Rugulies et al., 2010; Watson & Osberg, 2018).
Therefore, while single mothers are more exposed to psychological distress, the impact of socio-economic factors on mental health may be more pronounced in single fathers. For instance, increased financial instability and lack of social support, particularly in economic downturns, can exacerbate mental health issues, such as mood, substance disorders and suicidal ideation (Tobias et al., 2009) in single fathers (Artazcoz et al., 2004; Berk et al., 2006; European Commission, 2013). Studies by Klose and Jacobi (2004) and Wade et al. (2011) reported no significant gender differences in the impact of single parenthood on mental disorders, a finding supported by Chiu et al. (2017), who described no disparities in self-rated well-being between single mothers and fathers. However, several research articles argue that insufficient financial and social support among single parents contribute to higher depression rates (Cairney et al., 2003; Crosier et al., 2007; Targosz et al., 2003; Wade et al., 2011) worse self-rated health (Curtis & Phipps, 2004; Rousou et al., 2013) and key predictors of mental illness (Honkalampi et al., 2005). Likewise, studies highlight significant health inequalities that persist after accounting for socio-economic variables (Benzeval, 1998; Fritzell & Burstrom, 2006; Rahkonen et al., 2005; Siahpush, 2004; Wang, 2004) or social support (Rahkonen et al., 2005; Wang, 2004). For instance, substance use disorders are more prevalent among men (Kessler et al., 2005), they have four times less healthcare appointments per year than women (Hippisley-Cox & Vinogradova, 2009) due to various socio-economic and day-to-day challenges, which may postpone diagnoses of significant health problems (Banks & Baker, 2013).
In comparison to partnered parents, lone fathers lack the resources and opportunities to mitigate their economic vulnerabilities or develop their career further (Abu et al., 2018; Backhaus et al., 2002; Collins et al., 2001). Similarly, Crosier et al., (2007) and Kim et al. (2001) reported that single fathers have endured more adverse socio-economic conditions and well-being (Cooper et al, 2008; Kim & Kim, 2012; Meadows, 2009; Wade et al., 2011; Westin & Westerling, 2006) in comparison to other demographics. Furthermore, they present worse quality of life, depression, stress (Kong and Kim, 2015), and more prevalent mental disorders (Cooper et al., 2008).
Child custody, raising more than two children, (especially if they are under 10 years old) linked to depressive symptoms of single parents (Song, 2007; Yoon et al., 2009). DeKlyen et al. (2006) reported that fathers experience anxiety and depression at rates similar to or higher than their female counterparts, while studies (Collings et al., 2014; Kim et al., 2015; Wade et al., 2011) show higher rates of depression and suicidal ideation in single mothers, followed by single fathers and partnered fathers. In contrast, men are at a higher risk of suicide and often have under-diagnosed or hidden depression (Brownhill et al., 2005; Kilmartin, 2005), possibly due to traditional masculinity roles (Courtenay, 2000, Galdas, 2013; Veskrna, 2010) or because single fathers frequently under-report mental disorders or are unaware of them, therefore they are undiagnosed and remain untreated (Addis & Mahalik, 2003; Angst et al., 2016; Brown et al., 2019; Emslie et al., 2006).
Regarding self-rated health, there are no substantial differences shown amongst single fathers and mothers, implying that partner status similarly affects health across genders (Rattay et al., 2017). Similarly, Wade et al. (2011) also reported comparable rates of mood, anxiety, substance-use disorders and psychological distress (Kamp Dush, 2013) among lone parents, which had a higher prevalence than their partnered counterparts. Consistent with a limited body of research on solo parents (Carone et al., 2020; Golombok et al., 2016; 2021), both groups exhibited high psychological adjustment levels, aligning with general population standards for health measures. These findings above imply that single father’s mental health is better than single mothers, but worse than their partnered counterpart (Benzeval, 1998).
Our findings show the importance of social support, especially for men in relation to their mental health. It is essential for adaptability (Dunn et al., 2001; Jackson and Kiehl, 2017; Manning et al., 2011; Martin-West, 2019; Prokupek, 2023; Wierda-Boer et al., 2008), mitigating stress, risk (Cairney et al., 2003, Oppermann et al., 2021), loneliness and isolation (De Jong Gierveld et al., 2016; Hawkley and Cacioppo, 2010). It also linked to good physical and mental health (Fagan and Lee, 2011; Luo et al., 2012) and economic welfare (Henly et al., 2005). As one of the themes indicates, social support plays a key role as a buffer against challenges and stressors (Degarmo et al., 2008), for instance mitigating parenting stress (Parkes et al., 2015).
However, men usually lack a large support network, as they often rely on their intimate partner (Carr, 2004; Carr and Pudrovska, 2012; Crowley, 2018), which limits the quality and quantity of support single fathers have access to (Carr and Pudrovska 2012; Haxton and Harknett 2009). According to Jones et al., (2022), while this support is generally positive and supportive, single fathers experience various stressors, such as stigma and prejudice (Bock, 2000; Mayer, 1995, 2013). Regarding social support, especially from other single parents, fathers emphasised its significance in reducing their vulnerability and loneliness, and improving their well-being (Tsfati et al., 2022). This corroborates with previous research, linking informal support to parents’ health during the Covid-19 lockdown (Brown et al., 2020; Craig & Churchill, 2021). However, practitioners should be mindful that even without a global epidemic, most parents exposed to various stressors due to their parenting role (Griffith, 2020), which can lead to parental burnout (Griffith, 2020; Mikolajczak et al., 2019).
The evidence underscores the complex relationship between SES, gender, and mental health among single parents. While single mothers generally experience higher levels of psychological distress, socio-economic factors seem to have a more pronounced effect on the mental health of single fathers, exacerbating their vulnerability to depression, substance disorders, and suicidal ideation. The disparity in earnings and social support between single mothers and fathers highlights the critical role of financial stability and social networks in mitigating mental health risks. Despite the gender differences in mental health outcomes, single parents face significant challenges that stem from their unique SES and limited support systems. This calls for targeted interventions and policy measures that address the specific needs of single parents, enhance social support networks, and alleviate economic pressures. Ensuring access to mental health services and promoting gender-sensitive support mechanisms can help improve the overall well-being of single parents and their children, ultimately fostering a more equitable and supportive societal framework.
This chapter synthesises this systematic review’s key points on the mental health and socio-economic challenges faced by single fathers worldwide, compared to single mothers and partnered fathers. Research indicates that single mothers experience poorer mental health, higher unemployment, and greater socio-economic deprivation than single fathers, who generally enjoy higher financial stability. However, single fathers face significant mental health challenges due to job-insecurity and limited workplace support, with higher rates of psychological distress and poorer health behaviours than partnered fathers. SES heavily influences these outcomes, with single mothers benefiting more from informal social support networks, while single fathers rely on financial stability and social networks to mitigate stress.
The COVID-19 pandemic further exposed these vulnerabilities, with single fathers facing heightened financial insecurity and social isolation. However, those with robust social support networks, both formal and informal, were better able to manage stress and maintain well-being. The presence of supportive communities and institutional backing emerged as crucial for buffering against socio-economic and pandemic-related stressors. Despite these supports, single fathers often contend with societal stigma and limited access to comprehensive social networks, exacerbating their mental health struggles.
The analysis highlights the importance of tailored interventions and supportive environments for single parents. Gender-sensitive policies and access to mental health services are essential to address the unique challenges faced by single fathers and mothers. Ensuring financial stability and enhancing social support systems can significantly improve their overall well-being and that of their children. This calls for targeted policy measures that recognize the distinct needs of single parents, fostering a more equitable and supportive societal framework. Understanding these dynamics is crucial for social work practice in Scotland. Practitioners must consider the varied socio-economic and mental health challenges single parents face and provide holistic support that addresses both immediate and long-term needs. By promoting resilience through strong support networks and flexible employment policies, social workers can help mitigate the adverse effects of socio-economic stressors on single parents. This comprehensive approach can ultimately enhance the well-being of single fathers and mothers, contributing to healthier family dynamics and more stable communities. Future research should focus on identifying specific areas where intervention can be most effective, ensuring that support mechanisms are responsive to the evolving needs of single parents in different socio-economic contexts.
Adverse Childhood Experiences (ACEs) are stressful or traumatic
experiences that can have a huge impact on children and young people
throughout their lives.
The ten widely recognised ACEs, as identified in a US study from the 1990s, are:
Abuse:
physical
sexual
verbal
Neglect:
emotional
physical
Growing up in a household where:
there are adults with alcohol and drug use problems
there are adults with mental health problems
there is domestic violence
there are adults who have spent time in prison
parents have separated
As well as these 10 ACEs there are a range of other types of
childhood adversity that can have similar negative long term effects.
These include bereavement, bullying, poverty and community adversities
such as living in a deprived area, neighbourhood violence etc.
We are committed to addressing all types of childhood adversity, and this is anchored in our long-standing, national approach of Getting it right for every child.
Why ACEs matter
Childhood adversity can create harmful levels of stress which impact
healthy brain development. This can result in long-term effects on
learning, behaviour and health.
Evidence from ACE surveys in the US, UK and elsewhere demonstrates
that ACEs can exert a significant influence throughout people’s life.
ACEs have been found to be associated with a range of poorer health
and social outcomes in adulthood and that these risks increase as the
number of ACEs increase.
Research from Wales found that people who reported experiencing four or more ACES are:
4x more likely to be a high-risk drinker
16x more likely to have used crack cocaine or heroin
6x increased risk of never or rarely feeling optimistic
3x increased risk of heart disease, respiratory disease and type 2 diabetes
15x more likely to have committed violence
14x more likely to have been victim of violence in the last 12 months
20x more likely to have been in prison at any point in their life
Consideration of ACEs is therefore crucial to thinking about how to
improve the lives of children and young people, to support better
transitions into adulthood, and achieve good outcomes for all adults.
What are we doing to address ACEs
As set out in the Programme for Government 2018 to 2019,
we are committed to preventing ACEs and helping to reduce the negative
impacts of ACEs where they occur and supporting the resilience of
children, families and adults in overcoming adversity.
We are take forward action in four key areas:
1. Providing inter-generational support for parents, families and children to prevent ACEs
2. Reducing the negative impact of ACEs for children and young people
3. Developing adversity and trauma-informed workforce and services
4. Increasing societal awareness and supporting action across communities
We held an ACEs ministerial event
in March 2018 in Glasgow involving people working across a wide-range
of related sectors and Year of Young People Ambassadors. This explored
what was working well, where further action is needed and opportunities
for collaboration.
Through our Getting it right for every child approach,
families and children can be supported by services to prevent and
reduce adversity and the negative outcomes associated with it.
We will build on our existing policies, including:
focusing on achieving equity in education through the Scottish Attainment Challenge and, in combination with the Pupil Equity Fund, allocating funding directly to schools to close the poverty-related attainment gap
putting children’s wellbeing first through the Child Protection Improvement Programme, keeping them safe from abuse and neglect by ensuring effective child protection procedures are in place
Our policies in the following areas are also relevant:
Addressing ACEs is also about better supporting adults who have been through adversity and trauma.
We are working with NHS Education for Scotland and have announced £1.35 million funding to deliver a national trauma training programme.
This will help Scotland’s current and future workforce develop skills
and services that respond appropriately to people’s adverse childhood
experiences and other traumatic experiences.
Consideration of ACEs is increasingly informing the development of national policy. For example, the Justice in Scotland: Vision and Priorities 2017 to 2020
identified ACEs as a key issue. A range of actions are being taken to
reduce their impact e.g. measures to reduce parental incarceration by
moving to a presumption against short prison sentences.
We are also working with the Scottish ACEs Hub (co-ordinated by NHS Health Scotland) which aims to raise awareness and understanding about ACEs and progress national action. For example, the Scottish ACEs Hub, in conjunction with Education Scotland, held a conference in March 2018 on addressing childhood adversity to support children’s learning and wellbeing.
With the threat of offenders using online live streaming platforms increasing there is a need to educate children about the associated risks. NCA-CEOP want to help parents and carers protect their children from online offenders like Sam, the fictional narrator of the animation, who targets children online and quickly builds trust with them.
The animation highlights the importance of parents and carers talking openly to their children about being safe online, about healthy relationships and encouraging them to speak out if anything happens online that worries them or doesn’t feel right.
NCA CEOP’s Thinkuknow programme provides information for children, young people, parents and carers about staying safe from sexual abuse and exploitation online. Parents and carers can visit http://www.Thinkuknow.co.uk/parents for advice on keeping their children safe.
Beyond Barriers 