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Family Reunification and
Drug Use by Parents
Dr Frank Ainsworth and Adele
Summers
The Drug Problem in Australia
• The AIHW reported in their June 2000 publication:
• between 6% and 11% of Australians have a
hazardous or harmful drinking pattern.
• approximately 23% of Australians reported using
illicit drugs in the past 12 months.
• the mean age of illicit drug users was 29 years,
with 69% unemployed and 43% with a prison
history.
• anti-depressants were the most commonly used
pharmaceutical drugs.
Child Care and Protection and
Parental Drug Use - Australia
• Few Australian attempts to determine the extent to which
child abuse and neglect and substance abuse interact.
• Angus and Hall (1996) - 22% of substantiated cases of
emotional abuse in NSW (1994-95) resulted from
parental substance abuse.
• DHS Victoria (1994) - for 41.5% of cases there was
concern about the contribution of substance abuse.
• Elliot (2001)-Census of social workers’ caseloads from
Cannington office found an average of 50% of cases
included alcohol and/or drug use.
Child Care and Protection and
Parental Drug Use - US.
• In the US, 11% of children, 8.3 million children, live with
at least one parent who is in need of treatment for an
alcohol or illicit drug use problem (Huang et al, 1998).
• At least 50% of substantiated child abuse and neglect
reports in the U.S. involved parental alcohol or drug
abuse (CWLA, 1998).
• Children whose parents have substance abuse problems
are younger, more likely to the victims of severe and
chronic neglect and remain in care longer than other
children in the system (DHHS, 1999).
Parental Substance Abuse
and Family Reunification
• Festinger (1994, 1996) - Key predictors of a child’s
return to care were the parents’ lack of knowledge of
child development, limited parenting skills, poor
behaviour management skills and lack of social support.
• Frame et al (2000) - Maternal substance abuse was
associated with a manifold increase in the likelihood of a
child’s re-entry to care.
• There is an almost total absence of Australian studies of
family reunification.
Departmental Managers,
Supervisors and Clinical Staff
• Estimates of the proportion of family reunification cases
involving drug use were between 25% and 75%.
• The majority of staff suggested the type and level of drug
use was not important. The issue is the impact of drug
use on parenting ability.
• There was diversity in responses regarding the
indicators for and against family reunification, the level of
acceptable risk of repeated neglect or harm and the
number of acceptable attempts at family reunification in
parental drug use cases.
Non-Government
Management Staff
• There was a very high level of agreement regarding the
indicators for and against family reunification in parental
drug use cases.
• All respondents agreed that some level of risk of
repeated neglect or harm should be accepted.
• All respondents agreed that there should be more than
one attempt at family reunification.
Drug Agency Staff
• The majority of respondents suggested that neglect was
more prevalent in parental drug use cases than abuse
and neglect was more difficult to work with than abuse.
• There was a high level of agreement regarding the
indicators for and against family reunification in parental
drug use cases.
• There was disagreement regarding the level of
acceptable risk of repeated neglect or harm and the
number of acceptable attempts at family reunification.
Departmental Direct Service
Staff
• The majority of respondents agreed that drug use by
parents rarely occurs in isolation and these families have
multiple issues.
• Important indicators for family reunification were stated
as a willingness by parents to work on their problems,
parental appearance and satisfactory parent-child
interactions.
• Limitations of the current system were mentioned to be a
lack of funding and foster carers willing to support
increased contact between children and their natural
parents.
Non-Government Direct
Service Staff
• Respondents agreed that drug use by parents is a issue
that often occurs with other issues, commonly mental
illness.
• Limitations of the current system were stated as a lack of
flexibility in drug treatment programs for parents to have
contact with children, a lack of practical help for families,
and the outdated Child Welfare Act.
• Respondents agreed that more interagency training and
interagency consultation is required.
Themes from the WA
Consultations
• All groups agreed that polydrug, heroin and
amphetamine use are the most prevalent drugs used by
parents. Marijuana use is of little concern.
• All groups agreed that there needs to be greater
collaboration between drug agencies and child welfare
agencies.
• There was agreement that neglect is more prevalent
than abuse in drug use by parents cases.
• There was agreement that parents do not need to be
drug free to be able to protect their children.
Indicators for Family
Reunification
• The positive indicators for reunification in parental drug
use cases were reported as:
• the presence of a stable marital or de facto
relationship not involving drug use,
• a non-drug abusing family support system,
• a non-drug abusing friendship network,
• regular attendance at a drug treatment program, and
• awareness of the impact of drug taking on the child.
Indicators Against Family
Reunification
• The indicators against reunification in parental drug use
cases were reported as:
• parental heroin or polydrug use at the point of the
child’s admission to care,
• presence of a stable or unstable marital or de facto
relationship involving drug use,
• parental mental health issues,
• suspicion that others living in the household are
using, selling or manufacturing illicit drugs,
• child physical or mental health issues, and
• a drug abusing friendship network.
The Level of Acceptable Risk
• Responses to the question of what level of risk is
acceptable in family reunification cases varied between
0% and 30% risk.
• It was suggested that the standard was about ‘the
balance of probabilities’ rather than being ‘beyond
reasonable doubt’.
How Many Attempts at
Reunification?
• Three attempts at family reunification was commonly
regarded as the number of times this approach to care
should be considered.
• Respondents recognised that full reunification was not
necessarily the best option for all children.
• Shared care was suggested as a better arrangement for
some parents and children.
The Interstate Consultations
• The issue of family reunification and parental drug use is
a common issue across all Australian states and
territories.
• Mainstream services seem to be carrying the
responsibility for these cases.
• There is a move towards the use of risk assessment
checklists/instruments, but none have been validated.
• There appear to be no targeted family reunification
projects for cases where drug use by parents is an issue.
• Some states have made attempts to start to address the
issue of parental substance abuse.
The Interstate Consultations
• NSW: A departmental working group has held a number
of meetings about parental drug abuse. The
Departmental position is that this is a ‘case planning’
issue and court ordered treatment is unnecessary.
• ACT: Drug and alcohol practitioners have been invited to
case conferences for the last 6 months, but have as yet
not attended. There is cooperation between health and
child protection authorities in regard to urine analysis.
• Victoria: There has been considerable joint working
between health and human services, for example joint
training and use of health facilities for court ordered
parental urine testing.
New Service Models 1
• The recent Adoption and Safe Families Act (1997) in the
US requires that permanency plans be subject to judicial
review once a child has been in care for 12 months.
• The state must file for termination of parental rights if a
child has been in out-of-home care for 15 of the previous
22 months.
• These time frames impose a need for accurate drug use
assessments and immediate access to treatment
services.
• A number of service innovations have been developed in
an attempt to address the problem.
New Service Models 2
• DHHS Sacramento: Requires all employees to be
intensively trained in substance abuse and addiction,
including how to use diagnostic tools.
• New Jersey Division of Youth and Family Services:
Use certified drug and alcohol counsellors to work in
tandem with workers handling cases involving
parental substance use.
• Maryland Child Welfare Services: Three level model
of practice to achieve treatment compliance by drug
abusing parents.
• Connecticut Department of Children and Families:
Substance Abuse Family Evaluation (SAFE) project.
New Service Models 3
• Legal activists are attempting to work with child welfare
agencies and drug agencies on this issue.
• Techniques for challenging parental behaviour in order to
generate treatment compliance and the use of sanctions
when this is not forthcoming have been introduced.
• Parental participation in a drug treatment program is a
requirement prior to reunification.
• Given the aggressive termination of parental rights
approach in the U.S., where there is continuing
substance abuse adoption is back on the child welfare
agenda.
Towards a Model of
Reunification Practice
• Collaboration between drug agencies, the department
and the non-government sector is imperative.
• There is a case for the formalisation of a three phase
model of family reunification.
• There is a need to revise current methods of
individualised service and to develop more empowering
methods of reunification practice, such as parental peer
groups and parallel activity based children’s groups.
Three stage model of family
reunification
Approach
Intervention
•
Agency
involvement
____________________________________________________________
•
Phase 1
Persuasion/voluntary
Casework
•
Phase 2
Direction/required
Treatment/
State/NGO/DA
Group program
•
Phase 3
Compulsory/imposed
Court order
State/NGO
State/NGO/DA/
Court
* NGO = Non government organisation, DA = Drug and Alcohol authority
Developing a Risk Index to
Underpin the Practice Model
• Instruments that can be used for family assessment
purposes may be of use to family reunification workers.
• ‘Assessment frameworks for children in need and
their families’ package from the U.K. (DOH, 1999).
• Family Assessment: Resiliency, Coping and
Adaptation research and practice inventories
(McCubbin et al, 1996).
• There are also a number of substance abuse
instruments.
• Measures for Clinical Practice Vol 2 (Fisher and
Corcoran, 1994).
• Index of Drug Involvement (Hudson, 1996).
Developing a Risk Index to
Underpin the Practice Model
• There does not appear to be any published instruments
that relate directly to family reunification.
• An index could be constructed from responses to the
questions given by the various groups interviewed for
this project.
• This index could be completed at regular intervals in
order to track changes in the family.
Testing the Model of
Reunification Practice
• A small scale pilot project should be mounted testing the
proposed model against existing practice.
• Reunification cases could be randomly assigned to the
Enhanced Reunification Service or Regular Reunification
Service.
• It would be possible to establish which types of families
responded best to which service model.
Conclusion
• A three-phase model of enhanced family reunification
services is proposed.
• Family assessment instruments and substance use
assessment instruments may be of use.
• Formulation and implementation of a risk index specific
to drug use by parents cases may be possible.
• There is a need for high-level commitment to policy and
practice changes that embrace collaboration at both a
policy and case level with drug agencies.
• A plea for research on the topic of ‘family reunification
and drug use by parents’.
Postscript 1
• A prospective 6-year study of children reunified
from foster care (n=149, aged 7-12 years
(Taussig et al, 2001).
• Compared with youth not reunified - reunified
youth showed more evidence of selfdestructiveness, substance abuse, risk taking
behaviours, arrests, suspensions, school dropout, poor grades and pregnancies.
Postscript 2
• Poverty and unemployment are - more likely to
lead to maltreatment among parents whose
parenting capacity is weakened by factors such
as - lack of support from a partner, a weak social
network, psychological disorders, substance
abuse, prior history of maltreatment, lack of
parenting skills and the presence of a
maladjusted or disabled child - but not otherwise
(Weatherburn and Lind, 2001, p. 42)
Postscript 2 cont.
• When using poverty, single parent families,
crowded dwelling, neighbourhood delinquency,
neglect and abuse as predictor variables the
result is as follows. Neglect has a greater causal
effect on juvenile participation in both property
crimes and violent crime. For juvenile
participation in property crime the coefficient is
(0.55), for abuse it is (0.15). For juvenile violent
crime the coefficient for neglect is (0. 44) and for
abuse (0.07) (Weatherburn and Lind, 2002, p.
94).