Early FDAC (Families Do Achieve Change)
Emily Rogers
Tuesday, January 17, 2017
Pre-proceedings version of the Family Drug and Alcohol Court, a problem-solving form of care proceedings for the children of substance-misusing parents.
- Pilot "pre-proceedings" version of the successful Family Drug and Alcohol Court (FDAC) aims to help expectant parents who have had at least one child taken into care to break the cycle of recurrent care proceedings
- The two-year intervention sees a specialist team help pregnant women and partners tackle substance misuse or other underlying issues and make the changes needed to safely parent children, months before the authority decides whether to initiate proceedings
- If proceedings are decided on, parents go through the FDAC, regardless of whether they have substance misuse issues
ACTION
The Family Drug and Alcohol Court (FDAC) is a problem-solving form of care proceedings for the children of substance-misusing parents, aimed at helping parents stop using drugs and alcohol and, where possible, keep families together or reunite them.
Launched in 2008 in London, where it is run by Tavistock and Portman NHS Foundation Trust and the charity Coram, it now operates in 21 English authorities. The US-inspired approach involves parents being helped by a team of social workers, substance misuse and domestic abuse specialists, psychiatrists or psychologists, therapists and parenting experts to turn their lives around, alongside fortnightly interactive hearings with a judge.
Early FDAC grew from the London team's conviction that its impact could be increased by working with parents before their baby was born, helping them onto a journey of change months before social workers decide whether care proceedings are needed. "Many parents we work with are still very much holding onto this hope of being able to parent this child or the next," says FDAC National Unit co-director, Sophie Kershaw. "We wanted to take this hope seriously and provide a programme giving them the best opportunity to turn things around."
A £540,000 grant from the Department for Education's Children's Social Care Innovation Programme enabled the London team to work with the FDAC National Unit, Lancaster University and an advisory group of birth parents to design the two-year pilot, which became operational in London and Coventry in autumn 2015 and in Kent and Medway councils in February 2016. It aims to work with 30 families: 14 across the London boroughs of Lambeth, Southwark, Islington and Camden, and eight each in Coventry and Kent.
In London, pregnant mothers who have had one or more child removed are referred to FDAC by social workers, midwives or other professionals, regardless of whether they have substance misuse issues, ideally before 20 weeks of pregnancy. Parents are visited at home by a team member accompanied by a social worker, enabling him or her to have an early conversation with them about the authority's concerns for the unborn child. "Parents don't want to talk about this, but it's in their interests to start thinking about it if they're going to show they've made changes since the last baby and give themselves enough time," explains London FDAC manager Sheena Webb.
Consenting parents embark on an assessment day, covering issues including parenting insight, substance misuse, domestic violence and physical and mental health. Assessment is followed by a multi-agency meeting, attended by the parents and relevant professionals. Attendees draw up an intervention plan combining community services with FDAC interventions, beginning with the treatment of issues such as mental health or substance misuse and assessing the mother's relationship to her unborn baby. After birth, the team focuses on strengthening parent-baby attachment, through methods such as video interactive guidance, and on facilitating practical support to help parents maintain their treatment.
Parents have weekly supportive one-to-ones with a key worker from the team and attend six-weekly intervention planning meetings with the relevant multi-agency professionals, to review progress. The FDAC team reports to social workers at critical points, making a recommendation shortly before birth on whether the child should return home.
If care proceedings start, the case is heard in the FDAC court, regardless of whether there is substance misuse, and support continues for up to 12 months after proceedings close.
"Traumas are put into context, so people can see they've had a broader life than just these bad things that happened to them, seeing themselves on a continuum," explains Webb.
Kershaw says Early FDAC helps parents remain on a journey towards parenting, even when the court decides to remove their child. "If we help a parent keep this child or the next, we may just break this cycle of repeat care applications," she says.
IMPACT
A recent five-year evaluation of FDAC by its research team - a partnership of Brunel and Lancaster universities and consultants RyanTunnardBrown - shows 46 per cent of 133 FDAC mothers ceasing to misuse by the end of proceedings, compared to 30 per cent of 98 mothers from ordinary care proceedings.
Of 140 FDAC families, 37 per cent were reunited or continued to live together at the end of proceedings, compared to 25 per cent of 100 comparison families.
Analysis of Early FDAC is expected in the summer.