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A national newsletter on substance misuse management in primary care NETWORK


and this can result in poor attendance and a general loss of the spontaneity and freedom associated with childhood. Working within a school setting has been an excellent way to access groups of children who may never have had the support and resources to attend regular appointments. Peer support has reduced the children’s isolation. Feedback from the school has also indicated that after attending the group children were much more willing to approach a teacher to discuss their fears and ask for support.


The needs of children of substance misusing parents has quite rightly received


greater attention in recent years. However, aside from child protection services, there has been patchy development and investment in services for the children of substance users. It is our experience at Young Oasis that the provision of relatively low cost interventions can greatly enhance a child’s chances of achieving better outcomes. The therapeutic relationship can provide the child with encouragement, much needed attention, consistency, a sense of stability and the tools to develop meaningful relationships in future. Having the opportunity to find out about how other people respond to them and to explore their interests and skills safely are all important in


forming a sense of identity.


Children who are able to see themselves as separate from their families’ problems, rather than part of them are likely to have better outcomes. Helping them to make sense of where they have come from, mapping out a career, and exploring choices and different options can support this. If they are able to imagine plans for their future, they are likely to do well – with and without the rest of their family.


Jo-Anne Welsh, Director, Brighton Oasis Project


Elsa Browne outlines the National Treatment Agency’s approach to families in their business plan. Ed.


The National Treatment Agency business plan on families


Substance misuse by parents is a risk factor to children fulfilling their potential - particularly in terms of educational achievement - and is a frequent source of referral for child protection. On the other hand, having children is a motivating factor for adults who are experiencing problems with their drug and alcohol use to seek treatment, and having a parent in treatment is a protective factor for children. Parents do as well, or better, than the general treatment population.


The National Treatment Agency’s (NTA) updated business plan for 2010/11 1


puts adult drug and/or alcohol users in the context of being


part of a family, rather than as single individuals with no support or responsibilities. One in three of the treatment population have a child living with them for some of the time; more are parents but do not necessarily live with their children. Clearly, the adult drug treatment workforce is already working with this group. Adult substance misuse services and children/family services need to collaborate with each other on a range of interventions - from identifying need, through to assessment, referral, support and treatment progress - with the aim of improving the outcomes for families and children.


The NTA are working with the Department for Education (DfE) on this significant piece of work by mutually funding posts and sharing work programmes. Joint guidance was issued last year to encourage the development of local protocols between drug treatment and children/ family services. An audit was undertaken recently which revealed that of those that responded, 38 (26%) of partnerships already had protocols for working together in place, and another 66 (44%) are expected have systems for joint working in place by the end of this year. In addition, a number of areas have operational agreements.


1 http://www.nta.nhs.uk/uploads/nta_business_plan_2010_11%5B0%5D.pdf 13


Regional NTA teams are involved in assisting with the acceleration of this process, including the assurance of quality provision, by identifying examples of good practice and making these available.


Does the Partnership Have a Joint Protocol In Place?


A cultural shift, currently in progress, will reorientate services to have a strong focus on the whole family, rather than a focus only on treating individuals. The NTA and DfE are working together and provide strategic leadership to collaborations between drug treatment and family work, with a view to embedding a whole family approach within systems. The NTA has provided evidence to the Munro Review 2


which will publish its report in April 2011 and has as


a key objective the removal of bureaucracy from social work practice and will also consider effective and co-operative ways of working with other professionals. Safeguarding and family interventions will be embedded in the revised Models of Care for the Treatment of Adult Drug Users document.


Support will be provided for partnerships in determining local priorities for drug misusing parents, and opportunities for developing the skills and confidence of the drug treatment workforce will be maximised. The NTA business plan’s ambition for this area of work acknowledges the coalition government’s agreement to develop a new approach to families with multiple problems (including substance misuse) and to strengthen families and protect children by ensuring that people who come into contact with the treatment system benefit from a whole family approach.


Elsa Browne, SMMGP Project Manager 2 http://www.education.gov.uk/news/news/munroreview


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