Acknowledging the hidden harm of drug use in families

At Family Matters we can often be working with children whose lives are disrupted by the chaotic lifestyle of their parents, which often goes unacknowledged by other services. In many families where there is a history of substance misuse, there are children who have taken on the role of carer to their parent. Many of these children, as well as experiencing neglect, miss opportunities to engage in education and training and are disadvantaged for future participation in the wider community. Over a period of twelve months we have been meeting with a mother and daughter who were both unhappy with their life together. The mother had a long history of heroin use and the daughter had always looked after her, taking time off school and keeping a distance from other young people in case they learned her 'secret'. Having stopped using drugs, the mother was unable to take back the role of parent and enable her daughter to feel less responsible for her. We spent time exploring both the roles and over time have seen the mother gain confidence in her role as a parent and the daughter learn that she can begin to trust her mother to look after her. She is now able to talk about her own aspirations and take steps to realise them. She has returned to education and is engaging with other young people to undertake the Duke of Edinburgh Award Scheme.

Liaising with other services to promote the re-engagement of families

When we meet with a family at Family Matters we are always aware of their potential need to engage with other services. We recognise that the greatest contribution to health and wellbeing of all family members requires a multi agency approach. We have recently been meeting with a family where the mother has been largely confined to her home, marginalised due to a disability and obesity. She has been unable to engage with schools and health services in the best interests of her children. The youngest child in the family also experiences health problems due to being seriously overweight. Our initial intervention has been to work with the mother and build her confidence enough that she could respond to input from her Health Visitor. Through a building of this relationship the mother was able to attend a 'Mini Mend' programme, promoting healthy eating and lifestyle for families with children under five. Now that the mother has experienced a sense of herself as a successful parent and met with other parents from her own community, she is more able to support the needs of her children. We are continuing to support her growing confidence, while exploring some difficult issues around domestic abuse from her past.

Prioritising a speedy response and ongoing support for families

One of the strengths of Family Matters is that families wait a relatively short time from referral to the first appointment – usually around four weeks, although initial contact is made as soon as possible. This has a positive effect on families who feel they are being supported at a time when life at home is at its most difficult. We regularly close files when families tell us they have no further need of our service, but ensure families know they can contact us direct if they would like to return. We recently met with a family who have used our service in three episodes over a three year period. Each time they were able to connect back in with the same therapists, so they had a sense of continuity and an experience of being understood. Their thirteen year old daughter had been disruptive at home, which was contributing to family breakdown and considerable distress for the younger children. The contact we had had with the family over time enabled us to see a pattern in the daughter's behaviour, which led us to contacting the school to discuss the girl's learning ability. This resulted in recognition of a previously unnoticed learning need that was addressed by the school through intensive learning support. On the last occasion we saw the family things had settled down for them all, they were enjoying family time together and the daughter had become calm and content, engaging in both school and home life at a level that was comfortable for her.

Exploring the effects of domestic abuse on families

When we meet with families at Family Matters one of our primary concerns is the safety of all family members. We openly enquire about domestic abuse and child protection issues and would consider carefully the appropriateness of commencing meeting with a family where there are current serious risks to safety. However, for many families using our service there has been a history of domestic abuse in the past that has a far reaching and significant effect on the whole family. A family we are currently working with has a mother who experienced long term regular violence from the father of her two sons. She is now unable to express affection to her oldest son as he bears a strong resemblance to his father and this brings up painful memories for her. The boy is eleven years old, at a time of transition in his life, as he approaches the move from primary to secondary school. He experiences frequent outbursts of anger, which he expresses by shouting, swearing, kicking over furniture and punching walls. Both mother and son are concerned about the situation at home and want the relationship between them to change. They have been coming along together and using the time to talk about some of their difficult shared experiences in a safe and neutral setting. The effect of witnessing parental violence on children is widely known and so our work will progress carefully and with sensitivity to the vulnerability of both mother and son. The early intervention Family Matters offers can contribute to a reducing of the risk of the boy engaging in increasingly violent behaviour, and preventing it spilling over into other areas of his life, including school or the local community.

Supporting the couple relationship and strengthening the parental role

Referrals to Family Matters are made when people have become concerned about the behaviour of children in the family. It often becomes apparent when we meet the family that there is a strong connection between the child’s behaviour and a breakdown or difficulty in the parental relationship. We will then focus our attention on the couple, meeting them without the children, as we know a significant factor in children becoming vulnerable is an ongoing disruption in the capacity of the adults in their lives to focus on the parenting role. For many families this is made more difficult by trying to negotiate the complexities of step-parenting. We have been meeting with a family who are concerned about the behaviour of the eleven year old son, who has been defiant, unresponsive and staying out in the city centre until late at night. He lives with his mother and her husband of two years. The mother feels alone with the problem and guilty that her son is creating family upset. She believes she has exhausted all options in how to manage the boy's behaviour and is becoming increasingly pessimistic about the potential for the situation to improve. This leads to her withdrawing from parenting altogether. The stepfather has a strong view on parenting, believing that children benefit from an authoritative approach. He says he feels unable to voice his opinion as he is not the boy's father, however there are regular arguments between the couple, during which the mother feels undermined and criticised. We are working with the couple to build their confidence in each other as parents and for the stepfather to have a place to voice his views calmly and plan with his wife for a 'united front'. So far the couple have been able to find some areas of compromise and have started to become closer as a couple. This has led to a more settled atmosphere at home, which is having a positive effect on the boy's behaviour.