The Conceptual Practices of Children and Family Social Work: Protection, Risk and Partnership

In this thesis I examine the contemporary social work gaze and social work knowledge as a practice of government. The data for this thesis is derived from qualitative analysis of interviews with children and social workers from two local authority social services departments in which they described their practices. In addition I have carried out analyses of social work guidance and regulation. The professionalisation of social work, and legislation to mandate its activities coincided with, and was intimately linked with a post-war politics of consensus. It was part of a more general governmental strategy of alleviating problems, which were understood as social in character by supporting the family through a blend of welfarist measures and a therapeutics of the family. Analysis of policy and legislation over the last five decades reveals that the conceptual currency of social work, the focus and subject of its gaze have been transformed. It is the priority of protection, which dominates contemporary social work practices. Contemporary social work and its problematisation of intervention into the private space of the family has become characterised by, on one hand, a concern to render visible the `at risk' population through multi-disciplinary strategies of risk management and surveillance, and on the other hand, by discourses of `partnership', in which parents are enjoined to work with social workers in the interests of the welfare of their children. I argue that partnership represents a new imagining of the social worker in terms of a reflexivity vis a vis his/her power and a tentativeness vis a vis the legitimacy of her intervention in the family. Attempts to scientise and systematise the social work gaze do not recognise the extent to which social workers' techniques of knowing both make possible at the same time as they limit the subject of social work practices

"You can never work with addictions in isolation":Addressing intimate partner violence perpetration by men in substance misuse treatment

AbstractBackgroundStudies have shown rates of IPV-perpetration among men in substance misuse treatment at rates far higher than the general population. There is poor evidence for the effectiveness of IPV perpetrator programmes.MethodsAn analysis of drugs and alcohol policy documents 1998–2015 was conducted using discourse analysis to examine how English drug and alcohol policy has addressed IPV among substance misusers. Transcripts of interviews with 20 stake holders were analysed thematically.ResultsHow policy ‘frames’ IPV-perpetration among drug and alcohol misusers has implications for service provision. IPV has increasingly been framed in terms of its implications for child safeguarding, and has been ‘folded in’ to policies targeting Troubled Families. With increasing ‘localism’ in English drug and alcohol policy there has been little specification of services for substance misusing IPV-perpetrators. Policy and literature produced by IPV perpetrator and victim organisations has framed IPV-perpetration as an individual choice with intoxication as a post hoc excuse for violence with limited implications for effective service development. Interviews with stake holders indicate a range of understandings/explanations for IPV among substance misusing men. Stake holders suggest that not all staff have the confidence or skills to ask men about their relationships and that there are few referral routes for substance misusing men who seek help for their IPV perpetration.ConclusionThere are gaps and contradictions in the extent to which English drug and alcohol policy has sought to address IPV-perpetration among substance misusers. Recent National Institute for Health and Care Excellence guidance provide an opportunity to include domestic abuse training for all front line social care staff including in the substance misuse sector. There is a need for further research into effective services for substance misusing perpetrators and the development of training for front-line staff

Parents and substance use. Editorial Essay, special themed collection

First paragraph: Parents who use substances are the focus of governmental concern and moral opprobrium internationally, and their children are specifically targeted for social services intervention. Policies that inform practice for parents who use substances are complex and contradictory. There is widespread concern regarding the impact of parental substance use on the welfare of children, but little scientific/clinical consensus regarding what aspects of substance use represent risk or harm to children. This is despite an increasing emphasis on evidence-based policy and practice. Similarly, there is wide variability in how far poverty, poor housing or domestic violence are understood to mediate in child welfare outcomes in families with multiple and complex needs.Output Type: Editoria

A qualitative study of the practices and experiences of staff in multidisciplinary child sexual exploitation partnerships in three English coastal towns

This article presents findings from a qualitative study of the practices and experiences of people working in multi-disciplinary child sexual exploitation (CSE) partnerships in three coastal towns in England. The study is based on focus groups conducted with 36 practitioners from a range of professional groups, including police, social work, substance misuse, education, specialist youth workers, sexual health, and statutory and non-statutory children's services. The article begins with an overview of the three towns and the structure of their responses to CSE. It goes on to explore a range of factors, which contribute to the local issues around CSE and which affect and direct multiagency working. These include practitioner perspectives on CSE vulnerabil-ity, the discrepancy between young peoples' and practi-tioners' views about “exploitation”, a discussion of how CSE perpetrators initiate and develop contact with young people and the role of incentives—including drugs and alcohol—as part of CSE exploitation. We finish by drawing out some general conclusions

The Challenges of Conducting Qualitative Research on "couples" in Abusive Intimate Partner Relationships Involving Substance Use

Undertaking qualitative dyad or couple interviews involving intimate partner abuse and substance use presents considerable ethical, safeguarding, and theoretical challenges throughout the research process from recruitment to conducting interviews and analysis. These challenges and how they were managed are outlined using the experience from a qualitative study of 14 heterosexual “couples” that explored the complex interplay between intimate partner abuse and substance use. Managing these challenges for participants, their families, and researchers included the use of safeguarding protocols and procedures to manage risk and the provision of clinical support for experienced researchers. Researchers often felt drawn into the conflicts and complex dynamics of opposing accounts from the male and females’ relationship which could be emotionally and methodologically taxing. Researchers discussing their analysis and felt experiences with each other provided a reflexive space to manage emotions and stay close to the theoretical underpinnings

Substance use and Intimate Partner Abuse (IPA):A descriptive model of the pathways between substance use and IPA perpetration for men

Intimate partner abuse (IPA) is a pervasive public health and human rights issue disproportionately affecting women. There is a complex link between IPA and substance use; substance use can increase both the frequency and severity of IPA. Pathway models have been applied to explore heterogeneous trajectories into other behaviours and to identify areas for intervention. This approach has not previously been applied in the area of substance use and IPA. Inductive thematic analysis of 37 interviews with heterosexual men aged 28-52 who had reported previous IPA perpetration was conducted. Men were recruited from alcohol and drug services across two areas of England. Three groupings of pathways into substance use-related IPA were generated: 1) Rule Breaking Pathway (n = 11); 2) Entrenched Substance Use Pathway (n = 13); and 3) Relationship Insecurity Pathway (n = 13). Across the three groupings of pathways, the men's childhood and early experiences led to different journeys into SU-related IPA (abuse that was associated with intoxication, withdrawal, acquisition and substance use lifestyle). Each pathway presented differently with varying core features, for example core features of generalised violence, mental health or jealousy, and different predisposing background factors, including types and timing of childhood abuse and trauma. Adopting a pathways approach drawing on principles of equifinality and multifinality can improve understanding of heterogeneity in men who perpetrate IPA and use substances and propose treatment/intervention targets

Are drug treatment services only for 'thieving junkie scumbags'? Drug users and the management of stigmatised identities.

This article uses qualitative interviews with 53 problematic drug users who had dropped out of treatment in England, UK to explore how they describe the stigmatisation of drug users and drug services. It discusses the construction of the category of the junkie through its association with un-controlled heroin use and criminality. It shows how some drug users carefully manage information about their discreditable identities by excluding themselves from this category, while acknowledging its validity for other drug users. The junkie identity was generally seen as shameful and therefore to be avoided, although it holds attractions for some drug users. For many of the interviewees, entry to treatment risked exposing their own activities as shaming, as they saw treatment as being a place that was populated by junkies and where it becomes more difficult to manage discreditable information. The treatment regime, e.g. the routine of supervised consumption of methadone,was itself seen by some as stigmatising and was also seen as hindering progress to the desired ‘normal’ life of conventional employment. Participation in the community of users of both drugs and drug services was perceived as potentially damaging to the prospects of recovery. This emphasises the importance of social capital, including links to people and opportunities outside the drug market. It also highlights the danger that using the criminal justice system to concentrate prolific offenders in treatment may have the perverse effects of excluding other people who have drug problems and of prolonging the performance of the junkie identity within treatment services. It is concluded that treatment agencies should address these issues, including through the provision of more drug services in mainstream settings, in order to ensure that drug services are not seen to be suitable only for one particularly stigmatised category of drug user

Substance Use and Intimate Partner Abuse (IPA): A Descriptive Model of the Pathways Between Substance Use and IPA Perpetration for Men

Intimate partner abuse (IPA) is a pervasive public health and human rights issue disproportionately affecting women. There is a complex link between IPA and substance use; substance use can increase both the frequency and severity of IPA. Pathway models have been applied to explore heterogeneous trajectories into other behaviours and to identify areas for intervention. This approach has not previously been applied in the area of substance use and IPA. Inductive thematic analysis of 37 interviews with heterosexual men aged 28-52 who had reported previous IPA perpetration was conducted. Men were recruited from alcohol and drug services across two areas of England. Three groupings of pathways into substance use-related IPA were generated: 1) Rule Breaking Pathway (n = 11); 2) Entrenched Substance Use Pathway (n = 13); and 3) Relationship Insecurity Pathway (n = 13). Across the three groupings of pathways, the men's childhood and early experiences led to different journeys into SU-related IPA (abuse that was associated with intoxication, withdrawal, acquisition and substance use lifestyle). Each pathway presented differently with varying core features, for example core features of generalised violence, mental health or jealousy, and different predisposing background factors, including types and timing of childhood abuse and trauma. Adopting a pathways approach drawing on principles of equifinality and multifinality can improve understanding of heterogeneity in men who perpetrate IPA and use substances and propose treatment/intervention targets

The feasibility of delivering the ADVANCE digital intervention to reduce intimate partner abuse by men receiving substance use treatment:protocol for a non-randomised multi-centre feasibility study and embedded process evaluation

BACKGROUND: Compared to men in the general population, men in substance use treatment are more likely to perpetrate intimate partner abuse (IPA). The ADVANCE group intervention for men in substance use treatment is tailored to address substance use and IPA in an integrated way. In a feasibility trial pre-COVID, men who received the ADVANCE intervention via face-to-face group delivery showed reductions in IPA perpetration. Due to COVID-19, ADVANCE was adapted for remote digital delivery. METHODS/DESIGN: This mixed-methods non-randomised feasibility study, with a nested process evaluation, will explore the feasibility and acceptability of delivering the ADVANCE digital intervention to men in substance use treatment who have perpetrated IPA towards a female partner in the past year. Sixty men will be recruited from seven substance use treatment services in Great Britain. The ADVANCE digital intervention comprises a preparatory one-to-one session with a facilitator to set goals, develop a personal safety plan, and increase motivation and a preparatory online group to prepare men for taking part in the intervention. The core intervention comprises six fortnightly online group sessions and 12 weekly self-directed website sessions to recap and practise skills learned in the online group sessions. Each website session is followed by a one-to-one video/phone coaching session with a facilitator. Men will also receive their usual substance use treatment. Men’s female (ex) partners will be invited to provide outcome data and offered support from integrated safety services (ISS). Outcome measures for men and women will be sought post intervention (approximately 4 months post male baseline interview). Feasibility parameters to be estimated include eligibility, suitability, consent, recruitment, attendance, retention and follow-up rates. In-depth interviews or focus groups will explore the intervention’s acceptability to participants, facilitators and ISS workers. A secondary focus of the study will estimate pre-post-differences in outcome measures covering substance use, IPA, mental health, self-management, health and social care service use, criminal justice contacts and quality of life. DISCUSSION: Findings will inform the design of a multicentre randomised controlled trial evaluating the efficacy and cost-effectiveness of the ADVANCE digital intervention for reducing IPA. TRIAL REGISTRATION: The feasibility study was prospectively registered: ISRCTN66619273

Adapting the ADVANCE group program for digitally-supported delivery to reduce intimate partner violence by men in substance use treatment: a feasibility study

IntroductionCOVID-19 restrictions created barriers to “business as usual” in healthcare but also opened the door to innovation driven by necessity. This manuscript (1) describes how ADVANCE, an in-person group perpetrator program to reduce intimate partner violence (IPV) against female (ex)partners by men in substance use treatment, was adapted for digitally-supported delivery (ADVANCE-D), and (2) explores the feasibility and acceptability of delivering ADVANCE-D to men receiving substance use treatment.MethodsFirstly, the person-based approach and mHealth development framework were used to iteratively adapt ADVANCE for digitally-supported delivery including conceptualization, formative research, and pre-testing. Then, a non-randomized feasibility study was conducted to assess male participants’ eligibility, recruitment, and attendance rates and uptake of support offered to their (ex)partners. Exploratory analyses on reductions in IPV perpetration (assessed using the Abusive Behavior Inventory; ABI) and victimization (using the revised ABI; ABI-R) at the end of the program were performed. Longitudinal qualitative interviews with participants, their (ex)partners, and staff provided an understanding of the program’s implementation, acceptability, and outcomes.ResultsThe adapted ADVANCE-D program includes one goal-setting session, seven online groups, 12 self-directed website sessions, and 12 coaching calls. ADVANCE-D includes enhanced risk management and support for (ex)partners. Forty-five participants who had perpetrated IPV in the past 12 months were recruited, forty of whom were offered ADVANCE-D, attending 11.4 (SD 9.1) sessions on average. Twenty-one (ex)partners were recruited, 13 of whom accepted specialist support. Reductions in some IPV perpetration and victimization outcome measures were reported by the 25 participants and 11 (ex)partners interviewed pre and post-program, respectively. Twenty-two participants, 11 (ex)partners, 12 facilitators, and 7 integrated support service workers were interviewed at least once about their experiences of participation. Overall, the program content was well-received. Some participants and facilitators believed digital sessions offered increased accessibility.ConclusionThe digitally-supported delivery of ADVANCE-D was feasible and acceptable. Remote delivery has applicability post-pandemic, providing greater flexibility and access. Given the small sample size and study design, we do not know if reductions in IPV were due to ADVANCE-D, time, participant factors, or chance. More research is needed before conclusions can be made about the efficacy of ADVANCE-D