The Family Drug and Alcohol Court Sophie Kershaw Service Manager Copyright presentation: FDAC Team Tavistock 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 support & compulsion

The H Family’s Journey through FDAC The Local Authority initiated care proceedings an altercation with another couple where Ms H head-butted the other woman who was holding a baby. The Local Authority initiated care proceedings an altercation with another couple where Ms H head-butted the other woman who was holding a baby. In the background was a 14 year history of neglect and violence in the context of parental substance abuse In the background was a 14 year history of neglect and violence in the context of parental substance abuse The Local Authority removed the children and asked the Father to move out of the family home The Local Authority removed the children and asked the Father to move out of the family home

Engagement & Assessment The FDAC team (parent mentors and multidisciplinary professional team) met the family in court on the first day of proceedings and invited them to join the project The FDAC team (parent mentors and multidisciplinary professional team) met the family in court on the first day of proceedings and invited them to join the project In the same week the family were visited at home and spent the day at the FDAC team base at Coram Fields In the same week the family were visited at home and spent the day at the FDAC team base at Coram Fields

History: parents Father is a 40 year old man with a 20+ year history of poly-substance misuse and alcohol dependence. He also has a history of violent crimes against members of his family, the public and police. Father is a 40 year old man with a 20+ year history of poly-substance misuse and alcohol dependence. He also has a history of violent crimes against members of his family, the public and police. Mother is in her late 30s she has had problems with depression, amphetamine misuse and hazardous non- dependent drinking. Abstained during pregnancy and first 2 years of life for youngest son (c) Mother is in her late 30s she has had problems with depression, amphetamine misuse and hazardous non- dependent drinking. Abstained during pregnancy and first 2 years of life for youngest son (c)

History: children 16-year-old daughter (A) was sexually abused by a babysitter aged 4. Oppositional behaviour emerged in teens, promiscuous, substance misuse and under-achieving academically 16-year-old daughter (A) was sexually abused by a babysitter aged 4. Oppositional behaviour emerged in teens, promiscuous, substance misuse and under-achieving academically 14-year-old son (B) has ADHD, head injury (with personality change), persistent aggression and school failure 14-year-old son (B) has ADHD, head injury (with personality change), persistent aggression and school failure 3 1/2-year-old son (C) apparently doing well 3 1/2-year-old son (C) apparently doing well

Parent’s goals Abstain from drugs and alcohol and overcome their dependence on substances Abstain from drugs and alcohol and overcome their dependence on substances Address their problems with violence Address their problems with violence For the couple to be reunited and for the youngest child (C) to be returned For the couple to be reunited and for the youngest child (C) to be returned

Initial prognosis Substance misuse: poor Substance misuse: poor Violence: poor Violence: poor Meet their children’s needs: poor Meet their children’s needs: poor

Intervention Algorithm Supported rehabilitation for the family Timely permanency elsewhere for the child Y N

Intervention 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 OrOr

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 OrOr Intervention Algorithm

Initial plan Detoxification under medical supervision for Father Detoxification under medical supervision for Father Stabilise Mother in the community Stabilise Mother in the community Testing Testing Assessment of the children’s needs Assessment of the children’s needs Parenting skills course Mo and Child C Parenting skills course Mo and Child C

Progress Mother stopped drinking and amphetamines, regularly attended contact, teenage children said she was ‘more herself’ Mother stopped drinking and amphetamines, regularly attended contact, teenage children said she was ‘more herself’ Father had difficulty making any progress in the first 3 months and so went into residential detoxification and rehabilitation Father had difficulty making any progress in the first 3 months and so went into residential detoxification and rehabilitation Couple celebrated Father getting into detoxification by having a drink Couple celebrated Father getting into detoxification by having a drink Agreed with parents unable to meet A & B’s needs but might manage C (who then returned) Agreed with parents unable to meet A & B’s needs but might manage C (who then returned)

Prognosis now Substance misuse: Mother fair, Father still poor Substance misuse: Mother fair, Father still poor Violence: Uncertain Violence: Uncertain Meeting C’s needs: Mother fair, father poor Meeting C’s needs: Mother fair, father poor

Next step Father returns home to Mother and child C Father returns home to Mother and child C Domestic violence group Domestic violence group Mother knows she may have to go it alone Mother knows she may have to go it alone

What’s different about the FDAC? Therapeutic relationships with the FDAC team including the Judge Therapeutic relationships with the FDAC team including the Judge We have met relatively few families who don’t want to overcome their problems and stay together, however they need guidance on how to achieve their goals We have met relatively few families who don’t want to overcome their problems and stay together, however they need guidance on how to achieve their goals Assessment, prognosis, referrals and drug/alcohol testing via the FDAC Specialist Team within 2/3 weeks of first hearing Assessment, prognosis, referrals and drug/alcohol testing via the FDAC Specialist Team within 2/3 weeks of first hearing FDAC team promotes the family’s problem solving capacities, parents are part of the planning, collaborative working FDAC team promotes the family’s problem solving capacities, parents are part of the planning, collaborative working FDAC team continue to support the family and coordinate, review and amend the interventions for up to a year FDAC team continue to support the family and coordinate, review and amend the interventions for up to a year Transparency Transparency Testing and rapid intervention Testing and rapid intervention Parent Mentors provide credible role models of resilience and change Parent Mentors provide credible role models of resilience and change Network of Collaborators Network of Collaborators FDAC sits at the centre of a vast network of court, social care, health, housing, etc services FDAC sits at the centre of a vast network of court, social care, health, housing, etc services FDAC broker, co-ordinate and monitor the best possible intervention package with efficiency and within tight timescales FDAC broker, co-ordinate and monitor the best possible intervention package with efficiency and within tight timescales Less adversarial court process which parents find fair, motivating and supportive Less adversarial court process which parents find fair, motivating and supportive

Other 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: To contact the FDAC team –

What the parents say? Show DVD