Addressing child protection

The problem

Children who have to cope with a parent’s drinking problem, and who find this difficult, are often treated very differently to the way that other children, who are dealing with other parental problems, are treated by us as generic professionals.

Numbers involved

Between 780,000 and 1.3 million children are affected by parental alcohol problems (Alcohol Harm Reduction Strategy for England, Cabinet Office, March 2004)
There are eight million adult problem drinkers in England and many of these are likely to be parents (Department of Health, 2005)
Parental alcohol problems often co-exist with other parental difficulties that we as generic professionals are likely to recognise and deal with in our daily work with children, for example parental illness, bereavement, marital break-up/divorce, unemployment.

Effects on children
Children are often negatively affected when a parent has an alcohol problem. They may be rather quiet, and may seem preoccupied. They may ‘act out’ and seem to seek attention. They may not seem to concentrate on their schoolwork, or not produce homework or produce work of a poor quality. They may lose interest in social activities. Of course children act out in these ways for many reasons. They may just be going through adolescence, or their behaviour may be due to other problems. But the point here is that these things may occur because of parental problem drinking, and it is our responsibility to interpret the signals to find out why this child is behaving in these ways, and then to respond supportively.

Often, these children are not identified as children of problem drinkers, and they are dealt with symptomatically.

If they are quiet they may be ignored, if they ‘act out’ they may be disciplined, they may be exhorted to work harder or to produce better homework.

We often do not feel (as generic professionals) that it is legitimate for us to ask more searching question (which might even feel like prying). But, as is outlined below, we do feel we can ask questions about other types of problem, and we do not feel that this is prying in the same way.

But even if the underlying issue (them having to cope with parental problem drinking) is identified, we often ‘freeze’ and feel that dealing with such a parental problem is outside our competence. In these cases, we either ignore the issue, or we may refer the child on - frequently to child protection services as a child protection risk, or possibly to a helping service such as a school counsellor, or even to the Child and Adolescent Mental Health Service [CAMHS].

There are two points here that are important.

First, such immediate referral to child protection services is usually not in the child’s best interests.

The reason why children are referred so quickly is often related to our assumptions as generic professionals about what a parental alcohol problem might mean in terms of risk to the child: parental violence, aggression, sexual abuse, etc. It is important to recognise that although such issues may be present, in most cases they are not, so referral to child protection services should happen (if at all) only after we have ascertained whether these risk factors are there or not.

Unfortunately, a referral to child protection services will often mean that the child and the family are entered onto a merry-go-round of assessment and referral, with no help being provided to the family. We need to avoid this.

Social services are required to investigate almost any referral and will have to talk to parents; this is not always in the best interests of the child, especially if they have revealed something ‘in confidence’ to us which they would not wish their parents to know they had talked about.

An assessment of a child being ‘in need’ theoretically leads to access to family support services. However, in reality, because social services are very over-stretched, if they decide that the child is ‘in need’ but not ‘at risk’, they are likely not to offer any help or assistance to that child.

This therefore means that, unless there are very specific child protection dangers (violence, sexual abuse), a referral to child protection services may be a wasted referral and could do more harm than good to the child and to the child’s relationship with his or her parents.

Second, this approach (either referring on immediately, or just ignoring the problem) is a very different one to that which we as professionals take when we find out that the underlying issue is a different sort of parental problem.

So, for example, we (say, a teacher) might be concerned about a child.

We might take the child to one side (after a lesson, or in a break) and chat to them about what was wrong.

It might emerge that the child’s parents are arguing and possibly divorcing.

In such a case, if we as a generic professional found that a child was upset because their parents were thinking about a divorce, it is unlikely that we would refer that child on immediately, either to social services or for counselling.

Instead, we would be quite likely to continue to try to help the child, by continuing to focus on the distress experienced by the child, and by offering support as appropriate. In an extreme case, we might be sufficiently concerned about the safety and welfare of the child to contact social services and ask for a child protection assessment to be made, but this would only be considered in extreme cases where there is obvious evidence that maltreatment is occurring.

This is a very different course of action to that taken when parental alcohol misuse is thought to be a key factor.

Bibliography

Bendtsen, P. and Åkerlind, I. (1999) Changes in attitudes and practices in primary health care with regard to early intervention for problem drinkers, Alcohol and Alcoholism, no. 34(5), pp795-800.

Happell, B. and Taylor, C. (2001) Negative attitudes towards clients with drug and alcohol related problems: finding the elusive solution, Australia & New Zealand Journal of Mental Health Nursing, no. 10(2), pp87-96.

Drummond, C. (2005) The alcohol needs assessment research project (ANARP): The 2004 national alcohol needs assessment for England, London, Department of Health.

Prime Minister’s Strategy Unit (2004) Alcohol Harm Reduction Strategy for England, London, Cabinet Office.

Ruth, C. (1982) Medical, nursing and pharmacy students’ attitudes towards alcoholism in Queensland, Australia, Alcoholism: Clinical and Experimental Research, no. 6(2).

Shaw, S., Cartwright, A., Spratley, T. and Harwin, J. (1978) Responding to drinking problems, London, Croom Helm.

Taylor, A. and Kroll, B. (2004) Working with parental substance misuse: Dilemmas for practice, British Journal of Social Work, no. 34(8), pp1115-1132.