Drug workers

The approach taken by practitioners in dealing with parental drug problems as they impact on child welfare and child protection forms Chapter 9. The nine focus groups convened were each made up of three or four practitioners (n=35). The focus groups were split evenly between health visitors, drug workers and social workers (three groups of each discipline). 

This drug worker identified a volatile cocktail of emotions guilt, expectation, obligation, pre-existing relational difficulties, each of which could potentially derail any effort on the part of the practitioner to use the resources of one sibling to help the other. 

Another reason why practitioners did not include the extended family in the treatment and care of their problem drug-using clients was on account of the client s stated reluctance to involve them. The following drug worker said that as an agency they took their lead from this, although clearly with some reservations ... 

Drug workers and health visitors alike saw the advantages of not being seen in the same light as social workers by their client groups ... 

Reticence to lose the purchase afforded by a good relationship with the parent was also voiced by the following drug worker, who like other workers was apparently referring to the situational character of much decision-making in recognizing and responding to problems ... 

The search for mitigating reasons that would allow the practitioner to view the adult s incapacity as a temporary problem to be resolved, and therefore not necessarily a decision about child safety, was also a feature of the drug workers response to the situation ... 

The adoption of a wait and see approach to avoid formalizing the problem means the immediate problem of the mother s incapacity has to be dealt with informally and within the resources of the staff present. In a busy clinic such resources might be thinly stretched which, as the following drug worker acknowledged, could mean it was not addressed ... 

The social workers in the focus groups confirmed this expectation that practitioners should monitor and report concerns to them, because of their statutory responsibilities to protect children. They acknowledged their limited access to families and reliance upon other practitioners, particularly health visitors, to keep a watching brief With regard to services offered by drug workers they could see the merits of a division of labour in working with parents and children ... 

They (drug workers) probably get the best or the most out of the client that they re working with, because we certainly don t, we get a lot of the superficial stuff and a lot of the stuff that goes with the myths - you know that the first time that they slip up we are just going to snatch those children away from them. 

A recurrently raised problem for the referring workers (whether drug workers or health visitors) was that in transferring the case to social work, there was the possibility of a different interpretation of how best to respond to the case. Most commonly for drug workers was uneasiness over a narrow focus on a child protection agenda. There was the expressed anxiety that the response might be overly coercive ... 

Children and family social work services in the UK are chronically understaffed the remaining staff are often demotivated and stressed by the volume of work, and the strain of working with difficult, frequently highly conflictual and chronic child protection cases. Many of the drug workers and health visitors expressed their sense of social work as a service in crisis, with extremely limited capacity to respond to anything other than the worst child protection cases, triggered usually by incidents rather than the chronic accumulation of problems ... 

Information on the withdrawal process is provided, along with schedules for the detoxification medications, and the treatment is also explained to anyone else who will be involved. Importantly, the detoxification takes place when the worker can fit in home visits through the period, preferably every day, and so it is not usually suitable to start a detoxification at a weekend. Given a well-organized service with competent drug workers. 

Kerry was regularly seen by her drug worker during treatment with naltrexone. She checked whether she could use cannabis and alcohol while on the medication, and did continue to use these intermittently. On one occasion only, she tested out the naltrexone by using heroin, but reported that she had no effect from the drug. She also said that... 

---