Minimising risks and safety considerations

Your discussions with young parents dealing with substance use should emphasise health and safety for both parents and child.

Focusing on reducing or eliminating substance use isn’t always the best or most useful approach; rather, tailoring your support to each client’s individual needs is essential and for many that will involve forming plans to minimise harm and risk when using substances.

Assessing the risks involved in a client’s substance use must consider both the client and their child. A plan to minimise risk must extend beyond the time of usage and into the ‘coming down’ period, when a client’s ability to parent will likely be compromised.

While clients may feel they’re well informed when it comes to a range of substances, it’s important to discuss the details and effects of each so that clients can best plan for how they’re going to feel, particularly when mixing substances and when coming down. Equipped with the necessary information, clients can prepare for how particular thoughts and feelings might affect their parenting duties with regard to their emotional and mental state.

For clients with mental health issues it’s essential explore with your client how using substances can affect their existing mental health concerns.

Encourage clients to reflect on how they usually feel when coming down – is keeping a close eye on their toddler something they’re capable of or will their recent substance use compromise their ability to focus on and be patient with the child in the days following? Planning a practical timeline for use is also beneficial; that is, hold a discussion that highlights when a client needs to stop using substances in order to be able to meet their obligations the next day, such as driving their child to child care or attending access.

While it’s important to tailor your support to the client’s individual needs (which are often linked with substance use), it’s also important to remind the client of their priorities; namely, their parental duties. And so even though it’s necessary to work on plans that outline ways to safely ‘suspend’ parenting duties while a client uses substances, and how to go about resuming parenting duties afterwards, your discussions should also touch on possible alternatives to substance use and emphasise the importance of parental responsibilities.

For clients involved with Child Protection and who are randomly drug screened regularly, you will need to discuss the potential consequences of their substance use, which in worst-case scenarios could involve removal of their child.

Highlighting this consequence might encourage your client to reassess their choices or to consider alternative options. While you’ll never explicitly tell a client not to use, your guidance should note, with sensitivity, the negative consequences of using, particularly for the client’s child; for example, in addition to risking removal, substance use will usually place additional stress on a tight budget, disrupt routine for both client and child and confuse a client’s sense of priority.

Negotiating fine lines and challenging conversations

You will often need to analyse and negotiate the fine lines and complexities of your relationship with your client and your knowledge of their substance use, calling on your experience, judgement and forward thinking to weigh up the consequences of making or not making certain calls. While putting together harm reduction plans, having a heightened awareness around the questions you’re asking and responses you’re expecting is advisable.

As a worker, conducting challenging conversations is one of your many skills: consider what you will need to do with certain information you might elicit.

Often an indirect approach is best for all parties – simply prepare your client with all the information they might need and canvas the potential consequences of substance use and other high-risk behaviour. Obviously, if you have serious concerns about a child’s welfare, you will follow the process of notification.

The challenge and stress of parenting can leave young parents feeling overwhelmed and exhausted. Brief periods of respite involving alcohol or drug use don’t have to be viewed as inherently negative so long as plans that secure the safety of the client’s child are in place and the client is familiar with their harm reduction plan. For example, a client wished to celebrate her twenty-first birthday by going out and drinking with friends. Her grandparents, who were fit and able, assumed the great-grandchild’s care for the entire weekend, allowing ample time for their granddaughter to celebrate and recover. Although a Child Protection order stipulated the client must remain substance-free, the occasion demonstrated the client’s ability to implement a well-considered safety plan that balanced her need for respite with prioritising the safety of her child.

Education, training, and exploring flexibility with child protection

The need to communicate and establish a relationship with Child Protection workers is imperative.  Some of the relationship building may involve offering training and education on subjects where child protection worker’s understanding of the AOD concerns could be discussed to meet the needs of the court order and the client.

For example, you can work with Child Protection staff to view a positive screening in more shades than simply black and white. A test result may come back positive, however, it may reveal that a client has stopped using ice and reduced their use of cannabis. Shifting perspective like this and encouraging Child Protection workers to acknowledge and understand that substance use has many shades and layers is hugely important.

Steer discussions to safety plans and harm reduction.

It will also be worth touching on the significance of safety planning. A safety plan should demonstrate to Child Protection workers that a client has given appropriate consideration to the effects of their behaviour and prioritised the child’s safety by leaving them with a trustworthy and capable carer for a reasonable amount of time. Where a good working relationship exists between you and the client’s Child Protection worker, you will hopefully be able to assist the worker to view the client’s actions positively; that is, as a demonstration of forward-thinking and actively responsible behaviour.

Safety Hand

Preparing a solid list of ‘safe people’ who are well known to the client and child will help to safeguard against situations where the child is left last-minute with a new acquaintance or unsuitable carer. Ideally, a young parent will have at least five people on their list, also known as a safety hand.

Young children should also have a safety hand of people with whom they feels safe and familiar.

The often chaotic lifestyle of young person with a new child (particularly a young parent who is also dealing with substance use) might see them fall in and out of contact with the people around them. It’s important to make sure that those featured on a client’s safety hand are people with whom the client has regular communication. This will ensure that calling on that person for assistance in moments of crisis (whether it be asking them to mind the child at short notice or to pick the child up from childcare in an emergency etc.) will cause less stress and concern for the child and young parent.

In addition, if the child is given regular contact with those on their parents’ safety hand, it’s less likely they will experience discomfort or distress when left unexpectedly with that person.

Relatives, grandparents and great-grandparents might be available to watch your client’s child/children regularly; however, willingness and availability doesn’t necessarily mean that person is a suitable choice. Encourage your client to consider their options from as many angles as possible; for example, is your client’s 80-year-old grandmother clear-headed and mobile enough to monitor a toddler’s movements for an entire afternoon? Is the client’s aunt’s house baby-proofed enough to ensure dangerous liquids are completely out of a child’s reach? Is it sensible to leave the children with their father against whom your client has an active intervention order even though their personal issues have been resolved? Such questions and what if-based discussions will help your client to develop a keener sense wariness and sharper common sense when exploring temporary care options.

Often a client’s chaotic lifestyle will mean that friends and acquaintances come and go from the client’s address regularly; however, this isn’t ideal for a child’s safety. Discuss with your client who should and shouldn’t know the client’s address, taking care to emphasise that the home should be a child’s safe space and that safety can be compromised when too many people in the client’s circle have access to that space.

See also ‘Safety around other people’ (Parenting).

Modelling

Children absorb information at a rapid rate and learn to imitate all sorts of behaviours. It’s important to discuss this with your client and prompt them to reflect on the kind of behaviour they model for their child. 

While never using substances in front of a child is an obvious place to start, modelling should extend beyond this to encompass things such as how clients conduct conversations with other adults in front of the child, how conflict is handled, being hyper-conscious of who comes and goes from the house and at what time, and ensuring the child is never exposed to deals or dealers.

When discussing substance-use related subjects with your client, ensure children are not present regardless of whether or not they’re old enough to understand.

Steer your client to practise new behaviours as early as possible in their child’s life; for example, never smoke cannabis in the house, even if the child cannot see or won’t understand the behaviour, and instead always go outside; or, when the urge to smoke strikes, consider taking the child for a walk as a way of training the mind to think of other things.

As a worker, you will never rely on scare tactics to motivate behavioural change; however, it’s important that you highlight potential negative consequences of risky behaviour, particularly in situations where Child Protection is involved. Rather than creating fear, your intention is to encourage clients to think more deeply about their lifestyle and its effects on their child, and to assess whether or not the client is coping with their parental responsibilities. If a client acknowledges they want to make a lifestyle change, your support will entail discussing a range of support services relevant to the client’s needs and goals (such as counselling, respite, detox etc.) and the process of connecting the client with these services.

Early Intervention 

If elements of a client’s behaviour give you consistent cause for concern, consider what actions you can take in the form of early intervention. With concerns raised early, the client is given an opportunity to address them before the situation escalates; for example, before Child Protection becomes involved.

An example of early intervention: a worker, client and the client’s parents sit down to discuss the client’s substance use, its effects on her behaviour, mental state and on her child. An arrangement is made with the client’s parents to care for the child for two weeks while the client attends detox and tends to her mental health. Such an arrangement demonstrates that clients are able to make significant lifestyle changes without a statutory body’s intervention; however, such an arrangement usually relies heavily on a worker’s foresight, advocacy, mediation, support and ability to connect the client with a range of community connections.