Mapping Family Support for Drug Intervention Programme users and their children

Transcription

1 Mapping Family Support for Drug Intervention Programme users and their children Rebecca Jones Drug Intervention Programme Family Interventions Development Worker RhYC C Y M R U D I P W A L E S

2 Contents This is a report for the Welsh Assembly Government conducted by the Barnardo s Cymry Policy Research and Development Unit. The report is structured as follows: Page Introduction 1 Executive Summary 2 Methodology 3 Findings 4 Conclusions and Recommendations 10 Appendices 11 Acknowledgements 14 References 15

3 Introduction The research reported here was undertaken by Barnardo s Cymru in 2008/09 as a result of work funded by the Welsh Assembly Government and the Drug Intervention Programmes (South Wales, Dyfed Powys and Gwent). The aim of the research was to map service provision for children affected by parental substance misuse whose parents are service users of Drug Intervention Programme teams within Wales. The negative impact of parental substance misuse on children has been well documented and has been acknowledged in two key UK government publications (Advisory Council on the Misuse of Drugs, 2003; Prime Minister s Strategy Unit, 2003). In response to concerns around the impact of parental substance misuse, the Advisory Council on the Misuse of Drugs (ACMD) Hidden Harm report outlined a series of 48 recommendations. From the inquiry, six key messages emerged:- 1. We estimate there are between 250,000 and 350,000 children of problem drug users in the UK about one for every problem drug user. 2. Parental problem drug use can and does cause serious harm to children at every age from conception to adulthood. 3. Reducing the harm to children from parental problem drug use should become a major objective of policy and practice. 4. Effective treatment for the parent can have major benefits for the child. 5. By working together, services can take many practical steps to protect and improve the health and well-being of affected children. 6. The number of affected children is only likely to decrease when the number of problem drug users decreases. (ACMD, 2003) Hidden Harm (2003) found that there were adverse and cumulative consequences for children of substance misusing parents according to their stage of development. Children may be at high risk of maltreatment, emotional or physical neglect or abuse, family conflict, and inappropriate parental behaviour (Barlow, 1996). They are more likely to display behavioural problems (Wilens et al, 1995), experience social isolation and stigma (Kumpfer and De Marsh, 1986), and may misuse substances themselves when older (Hoffman and Su, 1998; McKeganey 1998). Children whose parents misuse substances may also be exposed to, and be involved in, drug related activities and associated crimes (Hogan, 1998). Despite this evidence, help for families affected by substance misuse is woefully inadequate. All services (including services specifically for adults) have a duty of care towards children as part of the Children s Act However, children are often neglected in both policy discussion and service provision and there is a propensity for policy and practice to focus on the individual with the drug problem and ignore consideration of the severe and enduring impacts of problem drug use on the family. Hogan, Higgins et al (2001) support this view and found that drug treatment services were perceived as focusing on drug users as individuals rather than family members with responsibilities and relationships. 1

4 As a result of the launch of Hidden Harm in 2003, an officer from the substance misuse policy development team of the Welsh Assembly Government was seconded to Barnardo s Cymru to build links between children s services, substance misuse services and the criminal justice system with respect to Hidden Harm, as well as to develop protocols and policies for joint working between children s and adult services on this issue. The remit of the secondment included: n Running ten-week accredited parenting courses in Swansea prison for substance misusing offenders who are fathers. Discussion is under way about rolling this out across the other prisons in Wales and providing a similar course in community settings for partners of male prisoners, via contact with the Probation Service. n Developing the family support element of the Drug Intervention Programme (DIP) in Wales, including the possibility of providing parenting courses and one to one work for those on Drug Rehabilitation Requirements (DRRs). In order to progress the second part of the work with the DIP, further funding from the Welsh Assembly Government was sought. Executive Summary Our key findings are: n Many DIP workers perceive their role clearly in terms of direct work with adults. Although they recognize that child protection issues may arise through this work, they do not identify themselves as having safeguarding responsibilities towards children and young people. n The majority of DIP workers who participated in the study had limited awareness of agencies providing interventions for the children of substance misusing parents. n There was limited awareness among DIP workers in relation to referral routes for vulnerable children. Where there were concerns about risk to a child or young person, these concerns were routinely passed on to a line manager. n The majority of DIP workers will not make a referral to agencies other than Social Services without the parents consent, which can often prove difficult. n DIP workers unanimously acknowledged that far more had to be done for children both at the child in need stage and before this point was reached. They were unsure of how this should be implemented.

5 n There are inconsistencies in the way DIP workers request, record and subsequently action information from clients about children. However DIP workers routinely ask questions about children as part of initial assessment processes and as part of ongoing care planning. There is greater awareness of the need to record information about children in the family but a lack of confidence in relation to what to do with this information. n All DIP services stated they had child protection policies which were followed, particularly when a child was thought to be at risk of serious or significant harm. n DIP services are less clear as to what action should be taken if any, when a client discloses that they have children living with them but no other information is available in terms of the wellbeing of those children. Methodology A questionnaire schedule was drawn up in consultation with a Senior Research and Policy Officer at Barnardo s, piloted with a small group of professionals and appropriate amendments made. The questionnaire also formed the basis for an interview schedule and the focus for a discussion group. Semi-structured interviews were held with 32 key professionals across Wales and questionnaires were filled in by eight key professionals. Interviews with four DIP managers and 28 DIP workers were conducted between December 2008 and February 2009 and lasted between 30 minutes and one hour. The interviews were recorded by hand; these were then analysed using content analysis and data was organised by questions and the key issues reported. n Practitioners in this field have continuing training needs in relation to the impact of parental substance misuse on children and in terms of best practice in child protection. n Further research is needed with substance misusing parents and their children to identify the support they are most likely to respond positively to, in terms of engagement. n The Drug Intervention Programme teams are motivated to implement change. This is reflected in their willingness to participate in the research, their recognition of service deficits, their commitment to service improvement, and their interest in what is working well in other areas in the UK. 3

6 Findings Summary of interviews with Drug Intervention Programme workers Q1a. Is family support currently offered as part of the wrap around service for service users? There were varying views across Wales as to whether family support was offered as part of the wrap around service. n Four DIP workers in North Wales stated that family support is offered as part of the wrap around service and is provided both internally and externally. n Twelve DIP workers in South West Wales (Bridgend, Neath, Swansea) felt that family support is not offered as part of the wrap around service. n Four workers in South East Wales (Cardiff, Vale of Glamorgan, Merthyr/RCT) stated that family support is offered as part of the wrap around service with referrals being made to external agencies; two workers stated family support is not offered, with one stating there is a lack of services or awareness of services in the area. n There were mixed responses amongst DIP workers in Dyfed Powys. Two DIP workers stated that family support is provided internally by PDAC, four DIP workers did not feel family support was offered and an agency respondent felt that family support is offered. n Eight DIP workers in Gwent stated that family support is offered through external means. The majority of DIP workers felt that family support was only activated if Social Services are involved. However, if there was no social services involvement children were effectively ignored. Q1b. What have been the main challenges/barriers to providing family support? n A number of DIP workers mentioned the service user s resistance when discussing their family, with one worker disclosing service users liked to keep this side of their lives separate. Many were fearful of alienating the client and would often tread carefully as they feared the client may disengage from treatment. n Over half of the DIP workers interviewed mentioned a lack of funding. n A large proportion of workers felt that the Drug Intervention Programme was a short intervention and this was a challenge to providing family support. One worker commented we have such a short amount of time with the service user and we are concentrating on getting them stable and less chaotic so tend to focus on their needs and don t discuss their family as much. Concerns about service user disengagement, lack of funding and the short-term nature of DIP intervention were identified as the main challenges to providing family support. Q2. Are issues related to the parenting role of service users a significant factor in attempts to engage with and support service users? n The majority of DIP workers felt the parenting role of service users was a factor in getting them to engage. n They described a number of barriers in relation to the parenting role of substance misusers. These include childcare issues, being stigmatised and labelled, fears about the consequences of disclosure and becoming visible to social services. n A number of DIP workers felt that service users don t like to talk about their children for fear of having their children taken 4

7 off them. One DIP worker commented that if parents did not open up and talk about their children then the children s needs cannot be identified and we can t make any referrals. Another DIP worker stated that a number of their clients no longer had custody of their children so no work is undertaken around this. This is concerning as research indicates regaining custody of a child is a motivating factor in abstaining from substance misuse. The fear of child protection proceedings and the lack of trust in confidentiality were identified by Models of Care (2002). In February 2004 Rotherham DAT conducted research into the needs of women drug users. Their findings identified two key barriers to taking up treatment: child protection fears and shame. One DIP worker in South Wales disclosed that a client had expressed an interest in attending parenting classes but when she became aware the classes were delivered by social services she withdrew her interest. Gardner (2003) undertook a national evaluation of family support services provided by the NSPCC in the UK and found that the organisation providing the service was a factor for many parents in accessing services. He comments that parents generally preferred services provided by voluntary organisations to those provided by social services. DIP workers reported that service users have concerns about discussing their parenting role in terms of fear of social service involvement. At the same time accommodating the requirements of service users in terms of their parenting role is often an important element of successful engagement. Q3. Are family support/parenting responsibilities addressed as part of the assessment and review process? n All DIP workers stated that family responsibilities are addressed as part of the assessment process when conducting the Drug Interventions Record (DIR) form 5 and included in the care plan if identified as an area of concern. n Many workers felt the forms paid lip service to family support/parenting responsibilities and had concerns with the limitations of the form with one worker stating I don t think it is gone into in enough depth to be honest. For a fuller picture I ask a lot more questions off my own back but that s because of my experience. What if someone was coming into the job new with no experience they wouldn t know to question the client further they would just follow the form. n A number of workers stated that if child concerns were not brought to their attention at assessment then they were not reviewed. Cardiff and Carmarthen provided additional forms they use alongside the DIR form to address child protection concerns. Although family responsibilities are routinely covered as part of the assessment and care planning process this rarely leads to outcomes in terms of intervention or referral for family support. Q4. Are there policies and procedures in place for referring service users/ their children to appropriate support and joint working? Does this include addressing ante-natal issues/concerns? n DIP workers in South Wales and Dyfed Powys were unaware if there were policies and procedures in place for referring service users/their children to appropriate support and joint working. n Eight DIP workers in the Gwent area stated that there were policies in relation to the above. n The majority of DIP workers stated that once they became aware that a service user was pregnant they would be referred to an appropriate external agency for example WGCADA or CDAT where specialist support was provided.

8 Across Wales there are inconsistencies in awareness of policies and procedures for reporting concerns or issues in relation to the children of service users. Some DIP workers are not aware of policies or procedures in their region. Q5a. (If so) Which agencies/ services do you refer to? DIP workers stated the following agencies they refer to: South Wales Dyfed Powys Gwent North Wales Bridgend: EPPIP (has now stopped taking referrals) Home Start, CDAT Swansea: WGCADA (family support worker), SANDS, CDAT, PSALT Neath: CDAT, YMCA (parenting classes), WGCADA (family support worker) Merthyr/RCT: None identified Cardiff/ Vale of Glamorgan: Social Services, Option 2, CDAT (family support worker) Carmarthen: Choose Life, Carmarthen Council (family support worker) Newtown: Social Services Cyswllt: Social Services, Mental Health Team Brecon: Social Services Pembrokeshire: Social Services Gwent Specialist Substance Misuse Service, Social Services, DAFS and JIGSAW Channel, Families Matter (Barnardo s funded by WAG), Local Authority Childcare teams, CDAS (specialist midwives) Many of the services identified by DIP workers do not provide specific interventions for children. If DIP workers are unaware of the services provided in their area, one can assume that service users may also be unaware of these services. Henricson (2002) supports this theory and states that a major reason for limited engagement by parents is their lack of knowledge of local services and how they could help. There is a lack of knowledge among DIP workers concerning referral routes for vulnerable children. 6

9 Q5b. Is it easy to get a response to a referral you make? In general, DIP workers reported receiving appropriate responses to their referrals. However, a small number reported long waiting lists and limited places. Q5c. Do you think they are fit for purpose/appropriate for the level of need/specific needs of the user group? The majority of DIP workers felt more specific child focused services were needed, with the exception of Gwent who reported that DAFS and JIGSAW provided sufficient provision. Q6. What do you think service users do, or would value, in terms of the kind of support available, eg practical support/emotional support/ childcare? DIP workers listed the following support: creche facilities, advice on practical issues such as budgeting and cooking and Parenting Programmes. Counselling for the children to have someone they could talk to about their feelings regarding the issues of their parent s substance misuse. Everyday experiences were mentioned as being necessary. Activity days and daytrips were suggested so the family could spend time together away from the stresses of the substance misuse. Many DIP workers felt this question should be directly posed to service users. Q7. How would you like to see family support for service users developed and delivered? DIP workers suggested the following interventions: a specific family support worker based within DIP, a creche facility for service user s children (not situated in the same building). Drop-in centres where parents and children can go together for information and advice away from social services where they would not be stigmatised. Parenting skill groups, family therapy, and they felt a counselling group and activity days for children and young people to attend alone. One worker in South Wales stated A directory of services in the area would be a help. For example we know exactly where to go with housing or employment issues something which guides us on provisions for children would be helpful. Q8a. Is there a clear child protection procedure in place? All DIP workers stated that there were clear child protection procedures in place; however some DIP workers were unaware as to where the policies were located. DIP workers commented that if there is a child protection concern then the first course of action would be to talk to their line manager to establish if a referral to social services is needed. 7

10 Q8b. Have staff received training in child protection? n DIP workers in South West Wales have not received Child Protection training. These areas include Bridgend, Neath and Swansea. n A number of DIP workers in Cardiff and the Vale of Glamorgan have received internal Child Protection training and one worker in Merthyr had received external safeguarding children training. n All North Wales DIP workers have received external CP training provided by the Local Authority. n A proportion of DIP workers in Dyfed Powys have received CP training in the Cyswllt and Newtown area, workers in Carmarthen and Pembrokeshire have not received CP training. All of the DIP workers interviewed expressed an interest in receiving Child Protection training and universally acknowledged that far more has to be done for children both at the child in need stage and before this point is reached. They were unsure of how this should be implemented. Q8c. When a child protection concern is reported to statutory services is the response a useful one? n The majority of DIP workers reported a useful response from Social Services. n Five DIP workers reported receiving no feedback when a referral had been made. n One DIP worker in South Wales stated that the response is a mixed bag and it depends on the Social Worker dealing with the case. Some Social Workers do not let you know what is going on with the case and this can be frustrating. The majority of DIP workers reported a useful response from Social Services but there were some exceptions to this. Q9. Have staff received training/ awareness raising in relation to the impact of parental substance misuse/ offending behaviour on children? n Eight workers in Gwent and one worker in Dyfed Powys (Newtown) had received specific training/awareness raising in relation to the impact of parental substance misuse/offending behaviour on children. Most DIP workers across Wales have not received specific training/awareness raising in relation to the impact of parental substance misuse/offending behaviour on children throughout Wales. Gwent was an exception to this. Q10. Please can you provide me with a copy of your policies and procedures in relation to family support, joint working and child protection? n The majority of DIP workers were unaware where these policies were kept with the exception of Cardiff, Merthyr, Carmarthen and Newtown. Most DIP workers stated they would seek the advice of their manager on issues relating to child protection. n Child protection policies were provided by the following areas: South East Wales (Cardiff, Merthyr/RCT, Vale of Glamorgan), Gwent, Dyfed Powys with the exception of Cyswllt whose procedures are in draft form and are works in progress. n Joint working policies: Specific policies were not provided by any area with regards to Joint Working. Joint Working is mentioned in the Wales-wide drug intervention programme information sharing protocol provided by Dyfed Powys DIP and Pembrokeshire have a joint working protocol with the Local Authority. n Family support policies: There were no policies provided around family support. 8

11 The following subjects were also discussed with a number of DIP workers during interview: n Hidden Harm Only a handful of workers throughout Wales had heard of the Hidden Harm report. n The role of the DIP worker There were mixed views amongst DIP workers in regards to what their role entails. Many feel that children s needs are not part of their role as they work with adults, with many stating other agencies would deal with children s issues if there were any. One DIP worker in North Wales, however, commented that she had a moral responsibility to think about the effects of parental substance misuse on children and not solely about their clients needs in order to effect change for the future. Many DIP workers described feeling ill equipped to deal with the needs of children; and feel they do not have the skills to work with children and the family in order to reduce risk factors or increase protective factors for children. n Home Visits Home visits are not routinely undertaken in South Wales, Dyfed-Powys and Gwent, and a number of DIP workers disclosed they had never made a home visit. This is of great concern as home visits allow the worker to make an assessment of the environment a child is living in. Home visits are routinely carried out in North Wales. n Recording information DIP workers recognise the need to record information about children in the family; however, there is a lack of confidence about what to do with that information. 9

12 Conclusions and Recommendations The gaps highlighted above raise some important issues and suggest that the Drug Intervention Programme requires further support in order to rise to the challenge of working in an integrated way, which recognises the parenting role of clients and meets the responsibilities of the Children Act 2004 in safeguarding and promoting the welfare of children and young people. There is no one simple or single solution. The Drug Intervention Programme needs to ensure that the needs of children and families with parental substance misuse are prioritised in policy documents and that there is an organisational commitment to the provision of family-focused services. Until recently the impact of parental substance misuse on children has not been a focus for the Drug Intervention Programme. However, this research included many dedicated practitioners who recognise the problems in current practice and who would welcome additional support and guidance. Recommendations 1. Ensure that child protection policies, joint working protocols, and family support procedures are developed and are in place and visible to all staff members. Guidance should be designed to address the wider principles of safeguarding children as well as child protection. 3. DIP workers across all DIP areas should receive training on child protection and the impact of parental substance misuse on children to include a specific focus on how to assess and meet the needs of clients as parents and their children, as recommended in Hidden Harm. 4. The Drug Intervention Programme should appoint a lead person (ie a worker with a designated brief within their normal duties) who takes the lead on safeguarding for the agency. This person would ideally have undergone Common Assessment Framework (CAF) training and will act as the single point of contact between the agency itself and Children and Family services. 5. Tackling service users negative perceptions of social workers, which represent one of the most significant barriers to disclosure, and engagement should be a priority. 6. Any future research, evaluation and service development should include, where possible and appropriate, the views and needs of children, both to record their experiences and to establish what their particular service and support needs are. 2. Create an all Wales directory of family intervention services available to respond to DIP service users and their children who have been affected by parental substance misuse or offending behaviour. 10

13 Appendix 1 Examples of good practice Whilst preparing this report, a review of good practice examples from elsewhere in the UK has been undertaken. Examples of good practice were found in Brighton and Birmingham. Both projects were visited in February 2009 and the findings are detailed below. Brighton Oasis Project The Brighton Oasis Project seeks to prevent and reduce drug related harm to women and their families by providing services which offer a continuum of support from harm minimisation through to total abstinence. These services are complemented by specialist services for children, young people and women working in the sex industry. They state their focus is specifically on women, as this enables them to hone their skills and services to provide the best possible support. Oasis Women s Project offers a range of services and activities for women with a current or former drug problem. The project delivers a 16 week structured programme of groups, keywork and complementary therapies in a non-judgmental and supportive environment. They have recently introduced a new intensive programme called POCAR (Parents Of Children At Risk) for women whose children are at risk of going into the care of the local authority. Both programmes are built around women s needs. The POCAR programme aims to: n assist substance misusing parents/carers to bring their drug use under control and by so doing reduce the risk to their children n develop a more effective response to their families who need help, to ensure that their children are safe and have good prospects n divert children from the Child Protection Register and the corporate care existence n achieve sustainable family life plans in which children remain in the family 11 n create new and sustainable ways of working between voluntary and statutory services and child and adult services n contribute to a national evidence base of good practice. The current programme consists of four weeks of a generic Parenting Programme, where the challenges of being a parent are explored, four weeks of specialised groupwork where minimising the effects of parental substance misuse on children is explored and eight weeks of the Positive Parenting Programme (Triple P) which equips parents with strategies to cope with challenging and problem behaviour. Brighton Oasis Project offers a creche facility. The creche is open to support parent/ carer access to the service. Children between the ages of 0-5 years (term time) and 0-11 years (school holidays) attend the creche which is staffed by a full time co-ordinator who is a qualified teacher, alongside experienced supervisors, creche staff and volunteers. The creche is Ofsted regulated and a maximum of 12 children are allowed at one time, with no more than four children under the age of two at any given time. The average number of children attending is 3-6 per session. Since April 2008, the project has looked after 67 children from 46 families. The project has a specific young person service which supports children affected by their parents substance misuse. The Young Oasis Service aims to find creative and innovative ways to reach and support young people. The project has developed specific resources and a programme of activities to explore with the young person the effects of being a child in a family where there is problematic substance misuse. One to one counselling is provided to encourage young people to express their feelings. Young people can access individual art, drama and play therapy sessions. School holiday sessions are also offered which include fun and creative activities, as well as peer support groups. Between April 2007 and March 2008, 24 children and young people accessed the service, with an average age of 11 years.

14 In May 2006 the Brighton Oasis Project was awarded best drugs team in the South East region by the Home Office Tackling Drugs, Changing Lives Awards. The project works with and receives funding from a wide range of statutory and voluntary organisations including the Local Authority, Primary Care Trust, the Probation service, drugs agencies, women s organisations, children s organisations, homeless and housing organisations, charitable funders and the private sector. The breakdown of funding for this project can be found in appendix 2. Staffordshire SMART Project Barnardo s SMART (Substance Misuse Assisting Resilience Together) Project in Staffordshire aims to provide a cluster of family support services designed to meet the needs of children, young people and families faced with issues of substance misuse by either parents or a young person. The services work from a viewpoint of early intervention and developing resilience using a range of individual, group and family interventions. SMART children s work operates in the Tamworth area and provides a range of support for children concerned with their parents or other family members drug and/or alcohol misuse. The Project works closely with schools and other community groups to offer either individual programmes of assistance to children, or group work with a selection of family members ie brothers, sisters, grandparents etc. The project provides a number of initiatives which focus on leisure, learning and play (a weekly SMARTIZ group, RAP - relax and play, tots library time, Art house, the Sure Start transitional programme and SMART family learning summer programme). Each of these groups and services provide opportunities for families to work together, enable children and parents to mix with their peers, provide fun learning for children and adults and provide an opportunity for families to stay involved with the support programmes offered following more intensive one to one interventions. The SMARTIZ group has provided support to 31 children directly affected by adults substance misuse and 12 in turn supported a further 12 adults with parenting support and safeguarding children. SMART family support service works across Staffordshire in partnership with Staffordshire DAAT and CRI (Crime Reduction Initiatives) to support parents/ carers and family members who are concerned about a young person s drug/ alcohol misuse. Again using a variety of interventions, the project can work with parents/carers individually, as a whole family group and supports families to access a range of longer term support networks, including parent led support groups local to their area. Both services work flexibly to suit each individual s needs and can deliver services from a range of community venues including service user s homes, local schools, connexions or community centres, or any venue where the service user feels comfortable. SMART is key in bringing together agencies locally to network and influence around the key issues of family substance misuse. Steering groups take place six times a year and not only provide opportunities for financial and monitoring information channels but also information sharing, education and influencing time. The steering group pulls together professionals from the following agencies/ organisations: Staffordshire DAAT, Staffordshire County Council Children and Lifelong Learning, Social Service, Burton, Lichfield and Tamworth PCT, School Nursing representation, Education Specialist drug/alcohol providers CRI/T3, Tamworth Borough Council Community Safety Partnership, Staffordshire Police Community Safety Partnership, Sure Start Children s Centre Tamworth, Home Start Tamworth, Community and Learning Partnership Co-coordinators.

15 Appendix 2 Funding breakdown for Brighton Oasis Project Incoming resources from charitable activities Unrestricted Brighton and Hove Primary Care Trust 139,389 Brighton and Hove City council 20,000 Other grants 5, ,738 Restricted Brighton and Hove City Council 34,600 Communities Against Drugs 25,638 Brighton and Hove Primary Care Trust 105,153 Sussex Probation Service 4,480 Sure Start 14,600 Lloyds TSB Foundation 20,000 The Monument Trust 25,000 Crime Reduction Initiative 40,667 The Body Shop Foundation 2,000 Children and Young People s Trust 2,667 Sussex Community Foundation 5,000 Community of Blessed Virgin Mary 5,000 Capital Works Income 54, ,305 Total 504,043 Expenditure 2007/08 Staff Cost 315,199 Depreciation 11,400 Project expenses 4,897 Rent 35,075 Utilities 26,377 Staff travel and expenses 2,467 Supervision 1,783 Audit and Accountancy 11,300 IT costs 2,495 Other small costs 10,334 Individual Project costs 6,041 Total 426,828 13

16 Acknowledgements We would like to thank the Drug Intervention Programme for funding this report and the Drug Intervention Programme managers and workers for giving their time to be interviewed for the report and their commitment to this work. We would also like to thank the Brighton Oasis Project and Barnardo s Staffordshire SMART project. References Adams, P (1999) Towards a Family Support Approach with Drug-Using Parents: The Importance of Social Worker Attitudes and Knowledge. Child Abuse Review Vol. 8: Advisory Council for the Misuse of Drugs (2003) Hidden Harm Responding to the needs of children of problem drug users. The report of an inquiry by the Advisory Council on the Misuse of Drugs. Aktan, GB, Kumpfer, K and Turner, CW (1996) Effectiveness of a Family Skills Training Program for Substance Use Prevention with Inner City African-American Families. Substance Use and Misuse, 31 (2) Barlow, J (2000) Survey of the Needs of Families Affected by Substance Misuse. Report for Lanarkshire Drug Action Team, April Barnard, M (1999) Forbidden Questions: Drug Dependent Parents and the Welfare of Their Children. Addictions 94; 8; Barnard, M (2001) Intervening with drug dependent parents and their children: what is the problem and what is being done to help? Centre for Drug Misuse Research, University of Glasgow. Brighton and Hove City Council (2004) Children, Families and Schools Child Protection Guidance for Schools/ Colleges/ Educational Services. Brighton and Hove: Brighton and Hove City Council. Canning, U, Millward, L, Raj, T and Warm, D (2004), Drug Use Prevention Among Young People: a Review of Reviews. Health Development Agency. Catalano, RF, Gainey, RR, Fleming, CB, Haggerty, KP and Johnson, NO (1999) An Experimental intervention with families of substance abusers: one-year follow-up of the focus on families project. Addiction, 94 (2) Cleaver H, Unell I and Aldgate J (1999) Children s Needs Parenting Capacity. London HMSO Green Paper (2003) Every Child Matters 14

17 Dawe, S, Harnett, PH, Staiger, P and Dadds, MR (2000) Parent Training Skills and Methadone Maintenance: Clinical Opportunities and Challenges. Drug and Alcohol Dependence DfES (2004) Every Child Matters: Change for Children DfES (2005) UK Government Response to Hidden Harm Elliott, E and Watson, A (1998) Fit to be a Parent. The needs of drug using parents in Salford and Trafford. Research Report 8. Public Health Research and Resource Centre (PHRRC), University of Salford. Forrester, D (2000) Parental Substance Misuse and Child Protection in a British Sample. Child Abuse Review, 9, Foxcroft, DR, Ireland, D, Lister-Sharp, DJ, Lowe, G and Breen, R. Primary Prevention for alcohol misuse in young people (Cochrane Review). In: The Cochrane Library, Issue 2, Chichester, UK: John Wiley & Sons, Ltd. Gorin, S (2004) Understanding What Children Say. Children s experiences of domestic violence, parental substance misuse and parental health problems. London: NCB for the Joseph Rowntree Foundation. Hogan, D and Higgins, L (2001) When Parents Use Drugs Key Findings from a Study of Children in the Care of Drug-using Parents. The Children s Research Centre, Trinity College, Dublin. Joseph Rowntree Foundation (2002) A national survey of problem behaviour and associated risk and protective factors among young people. Joseph Rowntree Foundation (2004) The effect of parental substance abuse on young children. London: Joseph Rowntree Foundation. Kearney, J and Taylor, N (2001) The Highs and Lows of Family Life. Report of a two-year research project. Bolton Home-Start/Institute for Public Health Research and Policy (IPHRP), University of Salford. Kroll, B And Taylor, A (2003) Parental Substance Misuse and Child Welfare London: Jessica Kingsley Kroll, B (2004) Living with an elephant: growing up with parental substance misuse. Child and Family Social Work, 9, Mahoney, C and MacKechnie, S (2001) In a Different World. Parental drug and alcohol use: a consultation into its effects on children and families in Liverpool. Liverpool Health Authority. 15

18 McKeganey, N, Barnard, M and McIntosh, J (2002) Paying the Price for their Parents Drug Use: The Impact of Parental Drug Use on Children. Drug Education, Prevention and Policy, 3, National Children s Bureau (2006) Assessing the Impact of Parental Drug Use: a toolkit for practitioners NSPCC (2006) Adult Problems Children s Needs: assessing the impact of parental drug use; a toolkit for practitioners and multi-agency training pack Powis, B, Gossop, M, Bury, C, Payne, K and Griffiths, P (2000) Drug-using mothers: social, psychological and substance use problems of women opiate users with children. Drug and Alcohol Review, 19, Barnardo s Registered Charity Nos and SC /CD/08 16