Gretchen Precey - Lessons about Safeguarding Children when there are Drugs/Alcohol in the family


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Gretechen Precey - Independent Social Worker

Lessons about Safeguarding Children when there are Drugs/Alcohol in the family
from The Road to Recovery Brighton Oasis Project Annual conference 2013

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Gretchen Precey - Lessons about Safeguarding Children when there are Drugs/Alcohol in the family

  1. 1. Lessons about safeguarding children when there are drugs/alcohol in the family The Road to Recovery Conference Brighton Oasis Project 5 September 2013 Gretchen Precey: Independent Social Worker
  2. 2. Lessons about safeguarding • Risk is inevitable • Parental substance misuse can be fatal for children- the story of Child T • Reducing risk by improving professional practice • Parental substance misuse: what’s the damage to children? • The contribution of women only substance misuse projects to safeguarding
  3. 3. CRI Safeguarding Training 3 The risk infested waters of decision making in child protection
  4. 4. There is no absolute criteria on which to rely when judging what constitutes significant harm Judgements on how best to intervene will often and unavoidably entail an element of risk Working Together to Safeguard Children 4CRI Safeguarding Training
  5. 5. Risk management cannot eradicate risk; it can only try to reduce the probability of harm. The big problem for society (and consequently for professionals) is working out a realistic expectation of professionals’ ability to predict the future and manage risk of harm to children and young people Munro 2011 2.32 5CRI Safeguarding Training
  6. 6. Reading SCR Seminar 7 Chronology of events • 10/03 case opened by Reading CS on referral by Eire SEHB • 09/10/03 Child T born • 01/04 assessment begun by Family Support Team • 01/05 case closed • 03/05 case re-opened: serious Domestic Violence and T said to be ‘dirty’ • 06/05 T in police protection and foster care for 5 days • 07/05 CP conference registers T on grounds of neglect • 10/06 Legal Planning Meeting called due to escalating concerns about T’s care and parental domestic violence and substance misuse • 24/10/06 Decision to replace application for care proceedings with ‘intensive’ support package • 29/10/06 T dies
  7. 7. Reading SCR Seminar 8 Relevance of practice and procedural issues to the case of Child T • ‘Start Again Syndrome’ • Eligibility criteria and thresholds for action • Information Sharing • Working with Neglect
  8. 8. Reading SCR Seminar 9 Start Again Syndrome • Used as a defence by workers to overwhelming information and feelings of hopelessness • Each pregnancy or birth presented as a ‘fresh start’ • Parents fail to engage with agencies/ agencies fail to engage with parents • Focus is on the present not on the family history, lack of progress not taken into account • Growing evidence base that short-term, behavioural approaches are not likely to succeed with families with long standing, complex problems
  9. 9. Reading SCR Seminar 10 Eligibility Criteria • Confusion and misunderstanding about thresholds • Pre-occupation with eligibility criteria for services rather than a primary concern about the child or children with whom they were working • Rectifying long standing problems with thresholds will be a key test of LSCB’s
  10. 10. Reading SCR Seminar 11 Information Sharing • It is what is done with information, rather than its simple accumulation, that leads to more analytic and safer assessments • Communication problems were common • Direct verbal communication more immediate and effective way to share concerns • Lack of confidence, knowledge, experience, status resulted in failure to challenge information
  11. 11. Reading SCR Seminar 12 Practitioners should be encouraged to be curious and to think critically and systemically. Being aware of the way in which separate factors can interact to protect from harm or cause increased risk of harm is vital. Many of these families were also known to adult services, the well being of children and families must also be a priority for those working in services for adults
  12. 12. Reading SCR Seminar 13 Understanding neglect • In these families parents tended to avoid agencies, but agencies tended to avoid or rebuff parents • Most likely to be affected by the ‘start again syndrome’ • Family history is complex, confusing and overwhelming for practitioners • Risk of recurring abuse is higher with neglect than other types of maltreatment
  13. 13. Reading SCR Seminar 14 Responding to neglect • Debilitating impact on professionals must be recognised • Clear mechanisms for reporting risks and protective factors • Long term plans of intervention over an extended period is necessary • ‘it’s never too late to start again’ mentality (ref Think Family) can be counter-productive when working with neglect
  14. 14. ESCB Enhancing Professional Practice 15 Findings from Biennial Analysis of Serious Case Reviews The children (189) • 2/3 under 5; ½ under 1 • 60% of children died • 17% subject to child protection plans • 13% were on care orders or accommodated • 45% of families highly mobile • 50% of parents had criminal record • 75% affected by DV, mental illness, substance misuse • 75% did not cooperate with services The professionals • Overwhelmed professionals/overwhelmed families • Lack of clarity about procedures and confidentiality • Assumptions about involvement of others • Over emphasis on strengths • Fixed thinking: neglect and ‘rough handling’ • Dearth of information about fathers and men • Unrealistic expectations about capability of less experienced staff (CAF)
  15. 15. The chaotic behaviour in families was often mirrored in professional’s thinking and actions. Many families and professionals were overwhelmed by having too many problems to face and too much to achieve. These circumstances contributed to the child being lost or unseen. The capacity to understand the ways in which children are at risk of harm is complex and requires clear thinking. Practitioners who are overwhelmed, not just by the volume of work but also by its nature, may not be able to do simple things well. Brandon et al 2009 16ES LSCB Learning Event
  16. 16. 17 Invisible Children Overwhelmed, chaotic families, ‘negative’ support, drugs, violence, mental ill health, criminality Fixed views about family (e.g. men) fixed assessment Views (e.g. neglect) Efforts not to be judgemental, Whole picture missed, separate ‘specialisms’ offer support Too much to achieve, Low expectations, ‘success’ Is getting through the door, muddle about confidentiality ES LSCB Learning Event
  17. 17. New Learning from Serious Case Reviews 2012 • Throughout the studies there was a sense of disconnection from the children themselves:- not paying attention to children’s emotional development and not thinking about what it’s like to be a child living in that family or beyond the school setting; seeing the disability not the child; and most powerfully holding back from knowing the child as a person. ES LSCB Learning Event 18
  18. 18. Oasis Presentation Reading 20 Problem drug and alcohol use figures in 25% of all children with a Child Protection Plan
  19. 19. Oasis Presentation Reading 21 Hidden Harm (ACMD 2004) • 250,000 - 350,000 children of problem drug users in the UK • Equivalent of 3 - 5% of all children under 16 • Not all drug use is incompatible with being a good parent • 64% of children of problem drug users live with their parents • Most of the rest live with relatives • 5% are in care
  20. 20. Oasis Presentation Reading 22 “We need to have a variety of thresholds in responding to the impact of parental substance misuse. If all we possess in our threshold „tool-kit‟ is the „hammer‟ of child protection, then we tend to respond to every demand as though it is a nail, when often it may be a screw, a tack or even a drawing pin”. Murphy and Harbin 2003
  21. 21. 23 Impact of Substance Misuse on Family Life • Uncertainty and chaos • Children witnessing parental drug use • Criminal activity • Disrupted education • Children as carers • Fear of censure and separation CRI Safeguarding Training
  22. 22. Barriers to talking to children about parental substance misuse • Secrecy • Shame • Fear of being removed from home • Loyalty • Professionals lack of confidence/awareness 24CRI Safeguarding Training
  23. 23. Oasis Presentation Reading 25 Problematic Substance Misuse and Parenting • Poor sensitivity • Unresponsiveness to children‟s emotional cues • Heightened physical provocation and intrusiveness • Some ambivalence about having / keeping children
  24. 24. Oasis Presentation Reading 26 Adverse effects on children • Failure to thrive / developmental delays • Blood borne virus infections • Poor health care • Emotional, cognitive, behavioural and psychological problems • Early substance misuse • Offending behaviour • Poor educational achievement
  25. 25. Risk of Foetal Alcohol Syndrome Disorder 27 • Lifelong condition not subject to ‘detox’ after birth • Learning disabilities • Behaviour problems • Distinctive facial features • Scale of children with FASD only beginning to be recognised CRI Safeguarding Training
  26. 26. 28CRI Safeguarding Training
  27. 27. If there had been an Oasis Project in Reading would Trae-Bleu have survived?
  28. 28. Oasis Presentation Reading 30 Underpinning Principles • Drug use cannot be tackled in isolation from women‟s other needs • Women-centred / needs-led • Motivational, harm minimisation / solution- focused approaches • Trust and therapeutic alliance • Acknowledging, accepting and containing maternal ambivalence toward change in illicit drug use and parenting responsibility • Relational and attachment-based interventions
  29. 29. Oasis Reading Presentation 31 POCAR approaches • Work on recognising own emotional regulation - maternal reflective functioning and separation of experiences • Work on representations of child / parenting • Work on inferences about children‟s emotional needs / intentions, within a child development context • Work on developing sensitive responses to cues / needs • Emphasis on harmony and emotional regulation: reciprocal calm states • Investment shift from craving to care-giving