Our second guest post comes from Lyndsay Fraser-Robertson, Family Outreach Worker for Circle – Circle offers a range of whole family support services that promote children’s healthy development and potential. They engage with families who face exclusion due to social injustice, poverty and health inequalities.


circle-logo_03I am a Family Outreach Worker for a charity called Circle, based in Edinburgh. I work in the Harbour Team who support children and families affected by parental substance use. Circle provide support to communities across central Scotland. Our aim is to support the most disadvantaged and vulnerable children and families to improve their lives, promote their healthy development and reach their potential.

Social injustice, poverty and health inequalities are associated with families experiencing drug or alcohol addiction, imprisonment, neglect and abuse, family breakdown, involvement with care services, and physical and mental health problems. Circle works with families to identify and build on their strengths and can support whole families.

Working in the Harbour Team I am based in a locality recovery service which has been designed as a one stop shop which offers a range of drug and alcohol treatment and support services. The service is run by a team made up of staff from voluntary sector, NHS and Social Work. The easiest way for most people to start to get support from their local Recovery Service is to come to a Drop-in session. At the Drop-in, the worker will listen, give advice and options, agree a plan and organise the first step of the plan.  All Drop-ins operate a “no wrong door” approach so people can come to any of them regardless of where they live in the city.

If an individual attending the drop in has dependent children they will be offered access to Circle as a family support service. Part of my role is to meet with the individuals who have agreed to find out more about our service and provide information on how Circle can support them and their children. We can work with a range of people who have been affected by their own current or historic substance use and as long as there is a rehabilitation plan we can work with families who have children in their care or are living temporarily away from home.

We offer a home visiting service which makes our service as easy as possible to access and staff are skilled at building trusting and positive working relationships with all families we work with. The Harbour Team offer a parenting program called Parents Under Pressure. The Parents Under Pressure (PuP) program combines psychological principles relating to parenting, child behaviour and parental emotion regulation within a case management model. The program is home-based and designed for families in which there are many difficult life circumstances that impact on family functioning. Such problems may include depression and anxiety, substance misuse, family conflict and severe financial stress. The program is highly individualized to suit each family. Parents are given their own Parent Workbook.

In 2017 I was awarded a Travelling Fellowship through the Winston Churchill Memorial Trust in the category of Early Years Intervention and Prevention. My project was entitled ‘Keeping Families Together Safely’ and I wanted to explore various services in the US for substance using pregnant and parenting women with a focus on residential services. Current community drug treatment services are not designed to provide support to individuals in their role as a parent and are built around the needs of predominantly male opiate users. Family support services are not designed to treat problematic substance use which results in the two issues being treated as separate entities

Evidence would suggest the most effective of interventions take place during pregnancy and childbirth and therefore I found several residential treatment facilities in operation for pregnant and parenting women in the United States. This type of facility does not exist in Scotland, so I wanted to learn more about the residential recovery models and how we might be able to use some of these to provide mothers and children with more choice in their recovery journey, whilst remaining together.  Separating children from their primary care giver can be damaging and the effects long lasting to the relationship.

Women as primary care givers who use substances are often vilified and judged as bad mothers. We know however from the generational cycle these women who use substances are more likely to have grown up with parents who used substances in a childhood characterized by abuse, neglect, violence and criminal activity. These mothers go on to have their own children and parent the only way they know, based on how they were parented.

I travelled to Seattle and New Haven visiting a variety of services, both residential and community services. I had four main objectives:

Objectives

  1. Demonstrate the benefits of different holistic models of care for women and children affected by parental substance use
  2. Increase the likelihood of babies remaining safely in their mother’s care who have been addicted to substances
  3. Evidence best support models for mothers who have used substances to become more confident when parenting their children
  4. Reduce barriers to mothers and children accessing recovery services

I grouped my findings and recommendations into four main themes with details of how my recommendations could be implemented and the challenges what may come with them:

Major Findings

  1. Family interventions for working with parental substance use include integrated substance use treatment
  2. Residential facilities provide safe environments for women and children
  3. Pregnant & parenting women benefit from longer periods of support
  4. Powerful dynamics in peer support and group work

 Recommendations

  1. Family support services should include substance use treatment
  2. Residential recovery facilities should be available for women and children in Scotland
  3. Support should be offered for longer periods of time based on the individual needs of the family
  4. A peer parenting mentor program should be piloted.

The main benefit I found regarding residential options for women and children is the provision of allowing mothers and their children to recover in a safe, stable and supervised environment. Many of the mothers I met, both on my travels had experienced abuse, neglect, violence, homelessness, poverty and other traumatic circumstances by the time they presented for a residential recovery option. Many mothers report unhealthy relationships throughout their lives so being able to parent in a healthy way is contradicting what they have learned. By allowing mothers time we are allowing the opportunity to start from scratch in respect to sobriety and parenting. Nurturing the Mother-child relationship is important when considering effective interventions for keeping families together safely and when residential treatment is not an option, situations involving parental substance use become risky to manage and can make workers understandably anxious. However, by providing intensive and evidence based parenting interventions alongside treatment, allows for necessary monitoring, evaluation and supervision whilst causing the least disruption to the mother-child relationship. Allowing mother and child to maintain a positive attachment to each other will influence how the child goes on to form other attachments in their life.

 

You can read my full report for more information through the link below: http://circle.scot/hot-off-press-keeping-families-together-safely-findings/

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