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A national newsletter on substance misuse management in primary care NETWORK


Is it possible for public sector organisations to have a family centred approach? Phil Merrick, Debbie Lloyd, Barbara Jones, describe how Telford and Wrekin’s Family Intervention Project is meeting this challenge, and Sophie Kershaw describes how a Family Drug and Alcohol Court pilot in London is pioneering a new way of working with offenders. Ed. For the full articles visit www.smmgp.org.uk


Family Intervention Project


Partnership working is pivotal to the strategic direction of Think Family, a cross departmental programme run by the previous government which has encouraged the formation of Family Intervention Projects (FIP) and a team around the family approach. In Telford & Wrekin FIP works due to the marrying of Children and Adult Services – FIP has a Substance Misuse Worker and Mental Health Workers to assess, offer interventions and provide a bridge to mainstream services. Telford & Wrekin has four FIPs:


■ Youth Crime Action Plan ■ Housing Challenge Anti Social Behaviour ■ Women Offender ■ Children In Care – returning home


A family with multiple problems will typically cross services ranging from universal to targeted. They are responsible for a disproportionate amount of time and effort required from public services such as police, schools, social care, and health due to issues such as offending, anti social behaviour, domestic violence, truancy, and poor parenting.


FIP works with the consent of the family; it is voluntary. The following are believed to be key to ensuring its success:


Whole family working whole family as well as individual assessment of need, family agreements/contracts to secure commitment to change and a team around the family approach to multi professional working


Family key-workers with the skills to work in a respectful but persistent way with families and small and protected caseload (6 families per 12 months)


Assertive support and sanction approach using appropriate sanctions/legal measures as a form of behaviour management control that will harness support and ensure positive lifestyle changes.


What works


Alongside a variety of backgrounds (police, housing, children’s services) with relationships to partner agencies, the approach is one of working with families where they are and working with family need proactively, persistently and truthfully. Family need is met promptly with the aim of the family becoming independent of statutory intervention – we focus very much on capabilities of families whilst recognising and addressing needs. The approach is one of family need, not of professional or service alignment. FIP Workers support families flexibly using their 37 hour employment time to deliver support over 7 days a week to meet the needs of the family, often seeing the family several sessions per week.


What we need to work on


FIP is a pilot project and is providing learning for family work. It has been fully operational for four months now and we’re looking at how we can mainstream our support for families with partner agencies. We have drawn up protocols for working with both Adult and Children Services – our challenges are around organisational silos and supporting those with statutory responsibilities to think family.


Phil Merrick, Debbie Lloyd, Barbara Jones, Telford and Wrekin FIP


11


The Family Drug and Alcohol Court Pilot – a new


way of working


The Family Drug and Alcohol Court (FDAC) is based on a model widely used in the US for the last 12 years. An American evaluation found outcomes were better for families attending specialist drug and alcohol courts; more children were reunited with their parents and quicker decisions were made for out of home care if reunification was not possible. The results were attributed to the fact that more parents took up and completed substance misuse treatments than in traditional courts and services.


District Judge Nick Crichton, in collaboration with the Local Authorities Camden, Islington and Westminster, found funding to set up a three-year pilot. The pilot’s funding came from the Department of Children Schools and Families, the Ministry of Justice, the Home Office and the participating councils. The government recently announced that it is extending the pilot’s funding until April 2012 as they are impressed with the innovative work we are doing.


How does FDAC work?


FDAC offers parents with substance misusing problems: ■ help to stabilise or stop using drugs/alcohol ■ intensive assessment and support from the specialist team ■ quicker access to community services ■ better coordination between child and adult services ■ help from ‘parent mentors’ ■ a problem solving court.


The pilot court is supported by a multi-disciplinary team (the FDAC team) which includes professionals from social work, nursing, substance misuse and psychiatry. This is provided by the Tavistock and Portman NHS Foundation Trust and the charity Coram, who coordinate the process and intervention plans.


Parent mentors


The parent mentor is an innovation of the FDAC. Parent mentors give the families support, encouragement and advice. They are not trained professionals – just people who’ve been through similar experiences. They can share invaluable informal and practical support. They will understand the issues the families are facing and have a good knowledge of the treatment services, the court and social services.


Strengths of the FDAC model


The FDAC team believe that the strength of their model is that it emphasises the parent’s strengths. They believe that, with the right support, provided quickly and effectively, parents can change their substance misuse. The combination of the court, the specialist team and the parent mentors motivates parents to address their difficulties in the timescales of the child.


If you are interested to find out more about FDAC log onto the Tavistock and Portman website: http://www.tavistockandportman.nhs.uk/familydrugandalcoholcourt And for the Research reports go to: http://www.brunel.ac.uk/research/centres/iccfyr/fdac


Sophie Kershaw, Service Manager of the Family Drug and Alcohol


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