Toolkit for social workers

Social workers in adult teams

Alcohol misuse is a significant factor in up to 60% of social work case loads but the role alcohol misuse plays in a plethora of difficulties can be overlooked – its role in depression for example, as well as more practical issues such as family breakdown, homelessness and financial problems. Does the person drink because of these problems or is alcohol the cause? Although the question itself is not irrelevant the fact is that alcohol misuse will need to be tackled if a person is to successfully find a way forward. Basic questions about consumption need to be included in all assessment – how much does a person drink, how often and whether they have experienced difficulties. The chart below gives a pointer to levels of consumption that need to be of concern. If alcohol consumption looks problematic full assessment is required. The toolkit provides full guidance on this along with an explanation of treatment options. Often however a first step is to link in with the local alcohol advisory service - which can help with an assessment and may be willing to work with people who perhaps need intensive help but are not yet at a stage of being able to accept this.

The toolkit whilst focusing on the effects on children affected by problem drinking parents can also be used to help social workers in adult teams in identifying immediate risky behavior which should alert them to contact children and families, assessing protective factors against long term harm and working with adults on alcohol related issues from brief interventions through to full assessment and referral to specialist services.

Frequently asked questions.

1) What levels of drinking indicate a problem with alcohol that we should take as a serious risk to children?
Alcohol effects different people differently – for example men can safely drink a third more without risking health even if they are the same weight and height as a woman! Also much depends on the pattern of drinking and the family circumstances. As explained earlier there are many factors that help avoid long term harm. So it is not possible to give a simple answer. The toolkits concern detailed advice on assessing a potential problem drinking which will be of use to adult social workers in particular. The following chart summarised from the toolkit gives a rough guide to levels of consumption and likelihood of problems – but it needs to be used along side the guidance on assessment.

No alcohol problem indicated	Those who drink less than the recommended levels (3-4 units a day for men and 2-3 units a day for women), and do not regularly become intoxicated, and whose presenting problems have no association with alcohol misuse.
No alcohol problem indicated but at risk of damage to health – brief interventions recommended	Those who either regularly drink significantly more than the recommended levels, or who become intoxicated sometimes, but not frequently, but whose presenting problem has no strong association with alcohol misuse.
Alcohol problem indicated – intervention needs to aim towards reducing consumption and controlled drinking.	Those who regularly drink significantly more than the recommended levels and up to 35 units per week for men and 21 units per week for women, and those who become regularly intoxicated, with this contributing to the presenting problem (family troubles, loss of work and financial difficulties, problems in taking action to alleviate other difficulties) do have an alcohol problem requiring intervention.
Serious alcohol problem indicated requiring specialist help and detoxification prior to referral to a day programme or residential centre.	Those who regularly drink at or above the dangerous levels (50 units per week for men and 35 units per week for women), or whose health is affected by their alcohol consumption, or who are alcohol dependent irrespective of the nature of the presenting problem. This group can be expected to have a serious alcohol problem and may require detoxification.

2) How might a specialist alcohol agency help with my client?
For children and family social workers:

Advice on the parental problem - access to expert opinion if required
Support and counseling for the non drinking parent which has been shown to be effective in reducing risk to children
Some services do provide specific therapeutic services for children (details in the toolkit)
The agency might be willing to have a worker supporting generic therapeutic interventions for the family or just the children or parenting support/training offered to parents
Can work with the parent if they are willing.

For adult teams:

Provide advice and information on assessment and treatment options
Take on case work
Some agencies are starting to work with clients in their parenting role
Access to other support services related to alcohol