Stephanie Taplin

The nature and extent of child protection involvement among heroin-using mothers in treatment: high rates of reports, removals at birth and children in care.

INTRODUCTION AND AIMS A substantial proportion of women in treatment for substance use problems are mothers of dependent children, but only a small number of studies have explored the nature and extent of their child protection involvement with substance-using mothers themselves. DESIGN AND METHODS A large sample of mothers on the opioid treatment program (OTP) in Sydney, Australia, were interviewed. This paper describes their characteristics, the extent and nature of their involvement with the child protection system, the parenting-related interventions provided and their views of their own parenting. RESULTS The 171 mothers were disadvantaged and marginalised and had 302 children under the age of 16 years, 99 of whom were in out-of-home care. Nearly half the children in care (n = 42) had been removed at the time of their birth, and half (n = 49) had been removed from a mother who was on an OTP at the time. Among the younger children (age 1-2 years), higher proportions had been removed at birth than among the older children. None of the 32 mothers who had a child removed at birth and then gave birth subsequently retained care of their new baby. Women often chose to enter treatment (63.6%) for child-related reasons (35%) and attempted to shield their children from their substance use. Few health services were provided to them outside the availability of OTP. DISCUSSION AND CONCLUSIONS Entering treatment presents an opportunity for improving outcomes for these women and their children and to reduce future involvement with the child protection system.

Mothers in methadone treatment and their involvement with the child protection system: a replication and extension study

OBJECTIVES Although a high level of involvement with the child protection system has been identified in families where parental substance use is a feature, not all such parents abuse or neglect their children or have contact with the child protection system. Identifying parents with substance-use histories who are able to care for their children without intervention by the child protection system, and being able to target interventions to the families who need them the most is important. This study interviewed a relatively large sample of mothers about their histories, their children and their involvement with the child protection system. We hypothesized that mothers in opioid pharmacological treatment who are involved with child protection services are different in characteristics to those mothers who are not involved. METHODS One hundred and seventy-one women, with at least one child aged under 16 years, were interviewed at nine treatment clinics providing pharmacological treatment for opioid dependence across Sydney, Australia. RESULTS Just over one-third of the women were involved with child protection services at the time of interview, mostly with children in out-of-home care. Logistic regression analyses revealed that factors which significantly increased the likelihood of the mother being involved with the child protection system were: (1) having a greater number of children, (2) being on psychiatric medication, and (3) having less than daily contact with her own parents. CONCLUSIONS This study replicates and extends the work of Grella, Hser, and Huang (2006) and the limited literature published to date examining the factors which contribute to some substance-using mothers becoming involved with the child protection system while others do not. The finding that mental health problems and parental supports (along with the number of children) were significantly associated with child protection system involvement in this study, indicates a need for improved interventions and the provision of treatment and support services if we are to reduce the involvement of the child protection system with these families.

Prescription opioid analgesics for pain management in Australia: 20 years of dispensing

Opioid prescribing/dispensing data can inform policy surrounding regulation by informing trends and types of opioid prescribed and geographic variations. In Australia so far only partial data on dispensing have been published, and data for states/territories remain unknown.

Sensitive topics in social research involving children

Abstract While there is broad consensus that involving children in research is critically important for understanding their lives, there is considerable caution around their participation in social research on ‘sensitive’ issues. Such caution is further amplified by a lack of agreement about what constitutes a ‘sensitive topic’. This article draws on data from interviews with a range of Australian stakeholders, including children, parents, researchers, ethics committee members, government and non-government organisation representatives, and other decision-makers, specifically related to the question of ‘what is a sensitive topic?’. While participants identified a range of sensitive topics, findings point to sensitivities being closely linked with the contexts of children’s lives and experiences. This requires researchers to approach research in ways that reflect more nuanced understandings of these sensitivities, help address potential concerns and facilitate the development of research relationships that promote ethical conduct of research with children.

Psychometric Investigation of the Brief Child Abuse Potential Inventory in Mothers on Opioid Substitution Therapy

The identification of potential child maltreatment using reliable and valid screening instruments is of particular importance in high risk populations. The current study investigates the psychometric properties of the Brief Child Abuse Potential (BCAP) Inventory in mothers enrolled in opioid substitution therapy. The BCAP Risk Abuse scale had strong internal reliability. Comparisons between valid and invalid protocols (≥ 4 on the Lie scale, > 1 Random Responding) failed to find systematic differences across most variables although those with a faking good profile had significantly lower scores on psychological well being. A six-factor solution was obtained and was conceptually strong. Subsequent analyses suggested Rigidity may be an independent subscale that needs further investigation. These results add further evidence for the potential utility of the BCAP as a measure of child abuse potential. Replication studies are needed to ascertain whether the subscales derived have convergent and predictive utility.

KContact, an enhanced intervention for contact between children in out-of-home care and their parents: protocol for a cluster randomised controlled trial

BackgroundWhen children are unable to safely live at home with their parents, contact between these children and their parents is considered, in most cases, important for maintaining children’s sense of identity and relationships with their parents. However, the research evidence on contact is weak and provides little guidance on how to manage contact and when it is beneficial or potentially harmful. The evidence in relation to contact interventions with parents and their children who are to remain in long-term care is the most limited. A small number of studies have been identified where interventions which were therapeutic, child-focused and with clear goals, particularly aimed at preparing and supporting parents, showed some promising results. This trial aims to build on the existing evidence by trialling an enhanced model of contact in multiple sites in Australia.Methods/DesignThis study is a cluster randomised controlled trial of an enhanced contact intervention with children in long-term care who are having supervised contact with their parents. Intervention sites will implement the kContact intervention that increases the preparation and support provided to parents in relation to contact. Baseline and follow-up interviews are being conducted with parents, carers and agency workers at intervention and control sites. Follow-ups interviews will assess whether there has been an increase in children’s emotional safety and a reduction in distress in response to contact visits with their parents (the primary outcome variable as measured using the Strength and Difficulties Questionnaire), improved relationships between children and their parents, improved parental ability to support contact, and fewer contact visits cancelled.DiscussionBy increasing the evidence base in this area, the study aims to better guide the management and supervision of contact visits in the out-of-home care context and improve outcomes for the children and their families.Trial RegistrationTrial registered on 7 April 2015 with the Australian New Zealand Clinical Trials Registry ACTRN12615000313538