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Domestic violence, chemical dependency, and Mental health problems in child welfare

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

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Domestic violence, chemical dependency, and Mental health problems in child welfare

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  1. Domestic violence, chemical dependency, and Mental health problems in child welfare

  2. 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).

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. Victim Advocacy Programs Batterer Intervention Programs Why it’s confusing Victim Defendant People who are SURVIVING Classic Victim People who need help & resources, but are not being battered Legal Definition Legal System Other Systems • People who • HIT • a family or • HH member People who GOT HIT by a family or HH member People who are BATTERING Classic Perpetrator System Manipulator

  9. 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. They all need help and resources tailored to their situation and circumstances Victim Defendant SURVIVING Classic Victim SURVIVING It feels like this and for the people involved in the relationship, and for their friends and families… • HIT • HIT GOT HIT GOT HIT BATTERING ?? BATTERING Classic Perpetrator System Manipulator By Mette Earlywine/WSCADV with thanks to the NW Network

  10. Screening and Identification Activity: The Nuts and Bolts of Screening

  11. 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?

  12. 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

  13. 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. 34 Section 4, p. 33 - 53

  14. Screening for MH and CD • GAIN-SS • Other approaches

  15. Chemical Dependency Assessments • Making a referral • Providing necessary information • Understanding the report

  16. 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

  17. Legal drugs How does our assessment change if a client is using or abusing a legal drug? Alcohol Medical Marijuana Recreational Marijuana Prescription drugs

  18. Prescription Drug Abuse • Managing chronic problems • Stabilizing or improving functioning • Creating care team • Connecting to substance abuse treatment

  19. 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

  20. Substance Exposed Newborns • Creating a plan of safe care

  21. Mental health Assessment and Treatment

  22. Intake/Assessment by community Mental Health provider vs.Psychological Evaluation

  23. Depression

  24. PTSD

  25. An array of treatment approaches

  26. Psychotropic Medications

  27. Co-ocuring disorders Effectively serving this large population

  28. 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

  29. The intersection ofChemical Dependency, Mental Health, andTrauma

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