DOMESTIC VIOLENCE, CHEMICAL DEPENDENCY,

AND MENTAL HEALTH

PROBLEMS IN CHILD WELFARE

Learning Objectives Identifying C/D, MH & DV concerns in the

families we work with

Teasing out the relationship between these issues and child safety within each individual family

Some specifics regarding C/D, MH, and DV, that are particularly important to child welfare work

Understanding our relationship with community experts - how they help us (and the family) and how we help them (and the family).

A two parent family had their three children removed because they were chronically failing to supervise them. Both parents used drugs and alcohol. One parent has been engaging in treatment for 6 months and has clean UA’s since the start of treatment. The other parent has engaged less frequently in treatment and provided few UA’s.

Are the children safe to return home?Scenario 1

An intake is called in by a school, after a 9 year old disclosed to his teacher that last night his parents were fighting and his father hurt his mother by punching and kicking her. The child was very upset and said that he would not let his mother get hurt again. He has two siblings, who are 6 and 4.

Is this child safe in the home? Are the younger kids safe?

Scenario 2

An adolescent was removed from his father after he was physically attacked by him. His father has suffered from bi-polar disorder and PTSD for 20 years and the youth has at many times resided with others when his dad was “totally crazy.” At the FTDM the father reports that he disassociated during the assault and doesn’t remember it. He has an appointment to have medication re-evaluated and to resume counseling next week, and wants his son to come home.

What would need to happen for this child to return to the home?

Scenario 3

An intake identifies concerns about the care of two school aged children, who appear to be unsupervised and marginally cared for a good portion of the time. Upon visiting the home, the worker finds that the parents are both taking prescription medications for injuries, and have prescriptions for medical marijuana. Pill bottles are in a variety of places within the home and drug paraphernalia is laying on the coffee table, along with lighters and several full ashtrays.

Are these children in present danger? Is the parents use of these substances making

their children unsafe? Scenario 4

After being involved with a family for several months, the FVS worker meets with a single mother to discuss closing her case. She has maintained her home in an adequately sanitary fashion and engaged in outpatient treatment for alcohol abuse. The mother discloses that she’s pregnant, and is very afraid of her boyfriend. She states that he has threatened her and her child, and that she doesn’t know what to do.

Should the case be kept open? How can the child, and the parent, be protected?

Scenario 5

Victim Advocacy Programs

Batterer Intervention Programs

Legal DefinitionLegal SystemOther Systems

Why it’s confusing

People who are

SURVIVING

People who

HITa family or HH member

People who

GOT HITby a family or

HH member

People who are

BATTERING

People who need help & resources,

but are not being battered

Classic Perpetrator

Victim Defendant

System Manipulator

Classic Victim

DV is a complex problem with no single solution. Everyone has a role to play in ending abuse AND

in helping people learn healthy relationship skills.

By Mette Earlywine/WSCADV

with thanks to the NW Network

They all need help and resources

tailored to their situation and

circumstances

SURVIVING

HIT GOT

HIT

BATTERINGClassic Perpetrator

Victim Defendant

System Manipulator

Classic Victim

and for the people

involved in the

relationship, and for their friends and families…

GOT HIT

SURVIVING

HIT

BATTERING

It feels like this

??

SCREENING AND IDENTIFICATION

Activity: The Nuts and Bolts of Screening

How Do We…

How might we figure out that DV is occurring, beyond talking to the caregivers or others about the family?

How do we approach these interviews so that the safety of everyone is protected?

What if there is a disclosure of intent to harm?

Accurately identifying the victim

Who is afraid? Who is controlled? Who experiences repeated negative

consequences? Who acts to protect the children when

incidents happen?

Page 30

Specialized DV Assessment

Guides what information to gather (not a form or tool in FamLink)

Informs conclusions about the impact of DV on the family

Critical in determining if DV makes a child unsafe

Documented in a case note specifically presenting information and conclusions

Summarized on p. 34Section 4, p. 33 - 53

Screening for MH and CD

GAIN-SS

Other approaches

Chemical Dependency Assessments

Making a referral

Providing necessary information

Understanding the report

UA’s

WHAT THEY TELL US

WHAT THEY CAN’T

A particular drug or class of drugs was used

General time frame this happened

Exactly when a drug was used

How much of the drug was used

Legal drugs

How does our assessment change if a client is using or abusing a legal

drug?

AlcoholMedical Marijuana

Recreational MarijuanaPrescription drugs

Prescription Drug Abuse

Managing chronic problems

Stabilizing or improving functioning

Creating care team

Connecting to substance abuse treatment

Opiate Replacement Therapy

Typically Methadone Addresses physical impacts of

addiction Lowers risks associated with

illegal use Highly monitored – program

compliance required

Particularly common for pregnant mothers

Substance Exposed Newborns

Creating a plan of safe care

MENTAL HEALTHAssessment and Treatment

Intake/Assessment by community Mental Health

provider vs.

Psychological Evaluation

Depression

PTSD

An array of treatment approaches

Psychotropic Medications

CO-OCURING DISORDERS

Effectively serving this large population

What works with this population?

Employ a recovery perspective Adopt a multi-problem viewpoint Develop a phased approach to treatment Address Specific Real-Life Problems early

in Treatment Plan for the client’s cognitive and

functional impairments Use support systems to maintain and

extend treatment effectiveness

SAMSA publication TIP #42 – Substance Abuse Treatment for Persons with Co-Occurring disorders

The intersection ofChemical Dependency,

Mental Health, and

Trauma