Yesterday’s post presented the most important elements of Bapp’s family. Our service is a home-based drug and alcohol counselling service providing one-on-one counselling for parents who have identified goals related to their drinking or drug use. Bapp and the family presented with many complex issues. Some of the support/work provided to the family is summarised below. I hope it provides a little insight to the work drug and alcohol outreach counsellors are involved in each day in and around our communities.
The family’s Aboriginality
As there were no Aboriginal workers at the service Bapp was offered a forward referral to another service. He declined stating that within his community of culture ‘everyone knows everyone’s business and they all talk’. However, some months later he was willing to be referred to an Aboriginal Family Support Service to provide opportunity for his children to be assisted with cultural and language learning as well as addressing the behaviour issues within the family.
Alcohol and Cannabis Use
Providing information, alcohol and cannabis diaries and workbooks appropriate to Bapps capacity to understand and hold information was difficult due to illiteracy issues. Videos, culturally appropriate flip boards, You Tube clips were used to introduce difficult concepts of substance dependence. These sessions were kept short and information was repeated over a number of weeks until Bapp was confident he understood the information and was able to reframe his new-found knowledge. Six weeks after the commencement of counselling he achieved abstinence from both cannabis and alcohol use and remained abstinent for the duration of his engagement with the service. Once Bapp was no longer using alcohol or cannabis the sessions were spent discussing the high risk situations, people and places that may trigger a lapse, or relapse (relapse prevention work). With his dual diagnosis (substance dependence and depression) he was at risk of re/lapse on both these levels and we worked on identifying things that may set him off in the opposite direction to where he wanted to be heading.
CPS (child protection services) had been involved with the family for some time and had recently closed the case as he had linked in with our service that would provide him with counselling as well as some parenting support. The Aboriginal Family Support Service provided information to increase Bapp’s awareness of ‘adequate and appropriate care’ of his children. The children were referred to cultural activities once a week where they learned art, dance, drama and language. Daycare was arranged through our service for the youngest child. In collaboration with the school an Aboriginal Education Liaison Officer became involved to assist the children with assessment to ensure milestones were being achieved and to refer on for problems with ear, speech, learning, immunisations and behaviour difficulties.
There were indications that the oldest child having stepped into the parent role. She was getting the children up in the morning, attempting to get them dressed for school and daycare as well as providing breakfast and preparing their lunches. She was anxious and later diagnosed as experiencing anxiety and depression. Parentification is a form of child abuse but common in circumstances similar to those of Bapp’s family, where parenting capabilities are limited, or absent. The long term effects of parentification are as dramatic as other forms of child abuse. CPS were notified by the counselling service.
Bapp’s literacy issues
He enrolled in a literacy course through the local college and attended for three weeks. He reported being unable to maintain the routine which involved getting the children up and ready for school, delivered to school and daycare and then across town in time for the course start at 9.30.
He engaged well with his GP (doctor) and attended regular heart check ups and took his medications daily. Blister packs were arranged with the local pharmacy to ensure medications were taken correctly and a locked cabinet placed into the home to ensure the children did not have access.
Anyone accessing social housing needs to have a “T” number. Because of the debt owed to the department of housing Bapp’s “T” number had been suspended. Once regular repayments were in place he was reinstated and placed on the priority listing for Aboriginal housing which, could take up to two years. In the meantime, he became eligible for housing through our service as he had been abstinent for a six month period and was attending regular counselling. The service’s housing scheme is social housing for parents with drug/alcohol issues, who have children in their care, but who have a poor rent record. The tenancy provides the client an opportunity to start again and provide evidence of being able to sustain significant change. Bapp’s application was successful with the caveat that Abena not be permitted to either visit or reside in the house. After the first three or visits Bapp was reluctant for home visits and requested that visits again be office-based. One of the tenancy requirements is that he attend random urinalysis screens (drug testing).
After twelve months Bapp vacated the premises to take up a tenancy with the department of housing. This tenancy would provide long term secure accommodation for the family and all services were able to continue to support Bapp and the family.
The counselling service house had been left in a state of disrepair that required significant structural work to be undertaken; rent was in arrears; unwanted clothing, toys, personal items, furniture, broken washing machines and dryers were left on the front lawn.
Termination of Service
Under normal circumstances Bapp would have completed an exit interview during which his goals – achieved and not yet achieved – would have been summarised, and appropriate forward referrals made. However, once settled into his new home with the department he ceased to engage with the counselling service and was no longer contactable. After eighty counselling sessions and two years of support and advocacy the service closed Bapp’s file.
Three months on …
CPS contacted the counselling service to find out what our involvement had been with the family and whether or not we were still engaged with Bapp. They advised that Bapp had moved his ‘best mate’ into the new house and resumed drinking. CPS had been called a number of times as the children were no longer attending school and appeared to be suffering neglect. Parental supervision was absent and the oldest child (eight years old) was endeavouring to keep the family going. Subsequently the children were taken into care; Bapp was evicted from the house as his rent was in arrears and he became homeless.
The last we heard of Bapp, he had admitted himself to a rehabilitation programme.
“I have absolutely no pleasure in the stimulants in which I sometimes so madly indulge. It has not been in the pursuit of pleasure that I have periled life and reputation and reason. It has been the desperate attempt to escape from torturing memories, from a sense of insupportable loneliness and a dread of some strange impending doom.”
Edgar Allan Poe