The Family Drug and The Family Drug and Alcohol CourtAlcohol Court

Sophie KershawSophie KershawService ManagerService Manager

Copyright presentation: FDAC TeamTavistock and Portman NHS Foundation Trust and Coram

Genesis of the Family Drug & Alcohol Court Pilot

American model

Judge Nick Crichton

£1.3M over 3 years Her Majesty's Court Service, Dept of Children Schools and

Families, Ministry of Justice & Home Office Camden, Islington & Westminster local authorities

Nuffield funding an evaluation by Brunel University (Prof Judith Harwin)

Provided by the Tavistock in collaboration with Coram

Main Aims of the FDAC To test out whether the FDAC model improves outcomes for

children - if there are better outcomes for children in terms of either rehabilitation or earlier placement outside the family if parents fail to engage

To see whether parents are successful in controlling or giving up their substance misuse and whether there is greater engagement and retention with substance misuse services - as opposed to parents not able to access the FDAC – aim to get parents engaged with services not to go through a range of assessments

To increase the Court’s confidence in making decisions without the need for receiving reports from a wide range of external experts aim for fewer requests for expert assessments or reports and fewer repeated assessments

To test out whether more timely decision making for the most vulnerable children takes place

Time limited trial for change with intensive Time limited trial for change with intensive support & compulsionsupport & compulsion

The H Family’s Journey through The H Family’s Journey through FDACFDAC

The Local Authority initiated care The Local Authority initiated care proceedings an altercation with another proceedings an altercation with another couple where Ms H head-butted the other couple where Ms H head-butted the other woman who was holding a baby.woman who was holding a baby.

In the background was a 14 year history of In the background was a 14 year history of neglect and violence in the context of neglect and violence in the context of parental substance abuseparental substance abuse

The Local Authority removed the children The Local Authority removed the children and asked the Father to move out of the and asked the Father to move out of the family homefamily home

Engagement & AssessmentEngagement & Assessment

The FDAC team (parent mentors and The FDAC team (parent mentors and multidisciplinary professional team) multidisciplinary professional team) met the family in court on the first met the family in court on the first day of proceedings and invited them day of proceedings and invited them to join the projectto join the project

In the same week the family were In the same week the family were visited at home and spent the day at visited at home and spent the day at the FDAC team base at Coram Fieldsthe FDAC team base at Coram Fields

History: parentsHistory: parents

Father is a 40 year old man with a 20+ year Father is a 40 year old man with a 20+ year history of poly-substance misuse and alcohol history of poly-substance misuse and alcohol dependence. He also has a history of violent dependence. He also has a history of violent crimes against members of his family, the public crimes against members of his family, the public and police.and police.

Mother is in her late 30s she has had problems Mother is in her late 30s she has had problems with depression, amphetamine misuse and with depression, amphetamine misuse and hazardous non-dependent drinking. Abstained hazardous non-dependent drinking. Abstained during pregnancy and first 2 years of life for during pregnancy and first 2 years of life for youngest son (c)youngest son (c)

History: childrenHistory: children

16-year-old daughter (A) was sexually 16-year-old daughter (A) was sexually abused by a babysitter aged 4. abused by a babysitter aged 4. Oppositional behaviour emerged in teens, Oppositional behaviour emerged in teens, promiscuous, substance misuse and under-promiscuous, substance misuse and under-achieving academically achieving academically

14-year-old son (B) has ADHD, head injury 14-year-old son (B) has ADHD, head injury (with personality change), persistent (with personality change), persistent aggression and school failureaggression and school failure

3 1/2-year-old son (C) apparently doing well3 1/2-year-old son (C) apparently doing well

Parent’s goalsParent’s goals

Abstain from drugs and alcohol and Abstain from drugs and alcohol and overcome their dependence on overcome their dependence on substancessubstances

Address their problems with violenceAddress their problems with violence For the couple to be reunited and for For the couple to be reunited and for

the youngest child (C) to be returnedthe youngest child (C) to be returned

Initial prognosisInitial prognosis

Substance misuse: poorSubstance misuse: poor Violence: poorViolence: poor Meet their children’s needs: poorMeet their children’s needs: poor

Intervention AlgorithmIntervention Algorithm

Supported rehabilitation for the family

Timely permanency elsewhere for the child

Y

N

Intervention AlgorithmIntervention Algorithm

Starting recovery from substance misuse: Can the parents (in the child’s timeframe)a)Abstain from street drugs and alcohol? b)Create a safe enough environment?c)Begin to address the issues driving the substance misuse?

Starting recovery from substance misuse: Can the parents (in the child’s timeframe)a)Abstain from street drugs and alcohol? b)Create a safe enough environment?c)Begin to address the issues driving the substance misuse?

Supported rehabilitation for the family

Timely permanency elsewhere for the child

Y Y

N

Child’s needs: Has the child: a) Suffered ‘Significant Harm’ b) Any special needs with respect

to parenting, healthcare, & education

Child’s needs: Has the child: a) Suffered ‘Significant Harm’ b) Any special needs with respect

to parenting, healthcare, & education

Either

Or

Starting recovery from substance misuse: Can the parents (in the child’s timeframe)a)Abstain from street drugs and alcohol? b)Create a safe enough environment?c)Begin to address the issues driving the substance misuse?

Starting recovery from substance misuse: Can the parents (in the child’s timeframe)a)Abstain from street drugs and alcohol? b)Create a safe enough environment?c)Begin to address the issues driving the substance misuse?

Competent parenting: Can the parents (in the child’s timeframe):a)Sustain recovery? b)Create a child-centered lifestyle? c)Meet their child’s needs?

Competent parenting: Can the parents (in the child’s timeframe):a)Sustain recovery? b)Create a child-centered lifestyle? c)Meet their child’s needs?

Supported rehabilitation for the family

Timely permanency elsewhere for the child

Y Y

N

Child’s needs: Has the child: a) Suffered ‘Significant Harm’ b) Any special needs with respect

to parenting, healthcare, & education

Child’s needs: Has the child: a) Suffered ‘Significant Harm’ b) Any special needs with respect

to parenting, healthcare, & education

Either

Or

Intervention AlgorithmIntervention Algorithm

Initial planInitial plan

Detoxification under medical Detoxification under medical supervision for Fathersupervision for Father

Stabilise Mother in the communityStabilise Mother in the community TestingTesting Assessment of the children’s needsAssessment of the children’s needs Parenting skills course Mo and Child Parenting skills course Mo and Child

C C

ProgressProgress

Mother stopped drinking and amphetamines, Mother stopped drinking and amphetamines, regularly attended contact, teenage children said regularly attended contact, teenage children said she was ‘more herself’she was ‘more herself’

Father had difficulty making any progress in the Father had difficulty making any progress in the first 3 months and so went into residential first 3 months and so went into residential detoxification and rehabilitationdetoxification and rehabilitation

Couple celebrated Father getting into Couple celebrated Father getting into detoxification by having a drinkdetoxification by having a drink

Agreed with parents unable to meet A & B’s Agreed with parents unable to meet A & B’s needs but might manage C (who then returned)needs but might manage C (who then returned)

Prognosis nowPrognosis now

Substance misuse: Mother fair, Substance misuse: Mother fair, Father still poorFather still poor

Violence: UncertainViolence: Uncertain Meeting C’s needs: Mother fair, Meeting C’s needs: Mother fair,

father poorfather poor

Next stepNext step

Father returns home to Mother and Father returns home to Mother and child Cchild C

Domestic violence groupDomestic violence group Mother knows she may have to go it Mother knows she may have to go it

alonealone

What’s different about the What’s different about the FDAC?FDAC?

Therapeutic relationships with the FDAC team including the JudgeTherapeutic relationships with the FDAC team including the Judge We have met relatively few families who don’t want to overcome their We have met relatively few families who don’t want to overcome their

problems and stay together, however they need guidance on how to problems and stay together, however they need guidance on how to achieve their goalsachieve their goals

Assessment, prognosis, referrals and drug/alcohol testing via the FDAC Assessment, prognosis, referrals and drug/alcohol testing via the FDAC Specialist Team within 2/3 weeks of first hearingSpecialist Team within 2/3 weeks of first hearing

FDAC team promotes the family’s problem solving capacities, parents FDAC team promotes the family’s problem solving capacities, parents are part of the planning, collaborative workingare part of the planning, collaborative working

FDAC team continue to support the family and coordinate, review and FDAC team continue to support the family and coordinate, review and amend the interventions for up to a yearamend the interventions for up to a year

TransparencyTransparency Testing and rapid interventionTesting and rapid intervention Parent Mentors provide credible role models of resilience and changeParent Mentors provide credible role models of resilience and change Network of CollaboratorsNetwork of Collaborators

FDAC sits at the centre of a vast network of court, social care, health, FDAC sits at the centre of a vast network of court, social care, health, housing, etc serviceshousing, etc services

FDAC broker, co-ordinate and monitor the best possible intervention FDAC broker, co-ordinate and monitor the best possible intervention package with package with efficiencyefficiency and and within tight timescaleswithin tight timescales

Less adversarial court process which parents find fair, motivating and Less adversarial court process which parents find fair, motivating and supportivesupportive

Other BenefitsOther Benefits

•All parents in FDAC are working with community treatment services. High retention rates

•Increased involvement in community family-orientated services

•Parents are changing their lifestyles and moving away from criminality. High rates of reduced recidivism

•Parents are developing aspirations for education and employment

•Decrease in expert reports being directed on FDAC cases - savings are being made

•Emphasis on problem solving and Collaborative working across 3 London Boroughs and across adult and children’s services

•Increased knowledge for social workers about addiction – increased safety for children

•Improving relationships between families and the Local authority social workers

•Intergenerational cycle of harm and dysfunction being broken

What the Interim report said?

The FDAC team – is proactive Seeing swift assessments Substance misuse services provided form the start Team facilitates access to community drug and alcohol services Linking parents to other services, such as DV and housing

The Judge Non traditional role, engaging directly with the parents High rate of attendance at reviews Judges are using a problem solving approach Parents value the role of the Judge and seeing the same Judge

Proactive Case Management Swift decision making if parents are not making progress Overcoming substance misuse and demonstrating good parenting

takes time Some cases taking 1 year.

Key messages

FDAC is very different from standard care proceedings

The early results are encouraging Model still evolving Final report in October 2010

To download full interim report:www.brunel.ac.uk/fdacresearch

To contact the FDAC team – 0207 278 5708Skershaw.fdacteam@coram.org.uk

What the parents say?

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