The Social Work Drug Team

Developing new services

for drug users and their families

Coinneach Shanks
From the archives: 1999 approx
INTRODUCTION ............................................................................................................... 2
C Shanks .......................................................................................................................... 2
Section 1: The Evaluation Project ....................................................................................... 3
1.0 Introduction...................................................................................................... 3
1.1 Approach.......................................................................................................... 3
1.2 Problems and limitations ................................................................................. 4
1.3 Outcomes and opportunities. ........................................................................... 6
2.0 Principles and objectives ................................................................................. 7
2.1 Origins of the Drugs Team .............................................................................. 7
2.2 Drug team structure and staffing...................................................................... 9
2.3 Operational practice: throughput. .................................................................. 11
2.4 Operational experience .................................................................................. 12
2.5 Overview........................................................................................................ 14
Section 3: Agencies in the Drug Team community network ...................................... 16
3.1 Introduction.................................................................................................... 16
3.3 Relationship with agencies ............................................................................ 17
3.4 Referrals......................................................................................................... 18
3.4 Overview of community role ......................................................................... 19
Section 4: Casework .................................................................................................. 21
4.1 The approach.................................................................................................. 21
4.2 Casework and the opiate user. ....................................................................... 21
4.3 Ethics ............................................................................................................. 24
Section 5: Beyond casework ....................................................................................... 26
1.0 The clients’ view of social workers: social policemen or family friends?..... 26
5.2 The family view of drug team social workers. Love, guilt and reparation. ... 29
5.3 The comparative position............................................................................... 32
5.4 The pleasure principle: treats, fun and living life. ......................................... 32
Section 6: Finance, resources and the role of the Drugs Task Force .......................... 36
6.0 Introduction.................................................................................................... 36
6.1 Role of the Drugs Task Force ........................................................................ 37
Section 7: Options for development .......................................................................... 39
7.0 Introduction - making a difference in casework ............................................ 39
7.1 Areas for development................................................................................... 40
7.2 Child Care ...................................................................................................... 41
7.3 New team and co-ordination structure........................................................... 43

1
INTRODUCTION

The Social Work Drug Team was established as an innovative approach to working
in the community with families affected by addiction. It did not strictly fall within the
normal social work rubric. Designed as a support mechanism, it was an alternative to
taking children into care. Designated social workers gave extra support to affected
families in a way that went beyond the traditional social work role.

In investigating the project I found that it reminded me of the buddy system

introduced for those suffering from AIDS. The buddy was a trained volunteer who
was there for the person living with AIDS and who – despite having full time work
of their own – found time to be with that person and to support them through life’s
problems. In the case under study, social workers went beyond the call of duty to
assist families living with addiction problems.

The purpose of the study was to ascertain whether this kind of resource could prevent
things getting worse for the families, to protect the children and to improve their
lives in a manner that would benefit the community as a whole. It was expected that
there would be reductions in illness and crime, and that it would alleviate undue
stress for members of extended families (such as parents or grandparents) who were
trying to support those affected.

This report with recommendations was submitted to the funders, but to my

knowledge, was never published. The author is also uncertain of what became of the
Drug Team. Given this lack of knowledge, the identifying features of the areas,
personnel and agencies have been removed from the document so that it can be
published here. I have edited the original text for clarity only. I also acknowledge that
the edited document is based on the surviving available text. Much time and
computer changes have meant that some of the document has been lost. Intending
readers should “dip into” the report since early sections are primarily devoted to
“setting the scene”

Belated thanks to all those who helped with the original project, especially social
workers, clients and clients’ families. It is my fervent wish that the clients involved
made a good recovery.

The author wishes to state that he feels the document should be placed in the public
domain in the interests of transparency. The author’s intellectual rights are asserted
herein. The author takes responsibility for any errors involved in the transcription of
the archived material.

C. Shanks

2
SECTION 1: THE EVALUATION PROJECT

1.0 Introduction
The Drugs Team is one of a number of recent initiatives funded under the local Drugs Task
Force. In terms of current funding mechanisms, this project is unusual. Within the range of
current social welfare provision, a purchaser-provider relationship involves the central or
local state as a funder. The funder (perhaps a social services department) “buys” an allied
or ancillary service. In this way the state widens and adds value to its statutory functions,
whilst at the same time developing partnerships at community and voluntary level. In the
case of the Drug Team however, the relationship is reversed. Here, the Drugs Task Force -
a body working at community level in a partnership that incorporates a wide range of
bodies - contracts the statutory body to generate a project not hitherto in operation. That is,
the project represents work that would not generally be carried out1 in the normal course of
statutory duties.

This review seeks to explore the nature of this innovative project from a number of
different perspectives in a multi-dimensional way. Implicit within this is a consumer
approach that includes the notion of consumer satisfaction. Whilst it could be held that
recovering opiate users are not always able to judge benefits, the Drug Team and indeed
this research study accepts and stresses the rights of opiate users in so far as they are
citizens. The examination therefore privileges the views and experiences of the clients and
significant others.

It also seeks to establish and indeed ensure that the clients themselves, their families and
the relevant pre-existing agencies in the community:

• understand the nature of the service - its purpose and objectives

• understand the general philosophy of the (social work) approach
• are aware of ethical issues involved
• are satisfied that the project and approach proves beneficial in their lives or work

1.1 Approach.
The evaluation adopted a traditional, multi-dimensional approach, examining information
from the perspective of

• funders
• related drugs, family and children agency workers
• clients
• clients families

Within this approach, it was envisaged that triangulation of results would reduce the effect
of one-sided or biased views. Emphasis was also placed on the networks created by Drug
Team social workers in the Drug Team. This constituted a wide structure and included
statutory services such as doctors and police as well as traditional community agencies and
organisations. The approach additionally examined social work cases as case studies in
1
That is not to say that no social work support service is provided for drug users, but to accept that no team
provided an extended and specialised level of service for drug users.
3
their own right. Within this approach, an attempt was made to transcend consumer
satisfaction by locating the clients in the broader terms of families, housing and recovery
progress. The case study approach whilst not strictly replicable is here regarded as
revealing “typicalities”2. Here issues and responses can be seen as likely responses at the
general level.

As a supplemental activity, the project would be evaluated as a consumer-orientated

initiative based on the model developed by Deaken et al (EFILWC, Dublin). This model
subjects initiatives to analysis based on four criteria:

• choice
• voice
• access
• accountability

In this way, the access by the citizen (in this case, the person living with addiction
problems) is regarded as a sovereign consumer possessing various human rights. The
attention of the reader is drawn to the discussion of philosophy and principles in section 2.
The approach to the report itself is determined by several factors that include the following:

• the innovation inherent in the service

• the wider readership outside social work and casework practice
• the need to protect the confidentiality of those who contributed information

This report is more discursive than would generally be typical of an evaluation. The
consultant feels that in a review of casework, there is a need to accept that even seemingly
insignificant phenomena may be important – that is, what might initially appear to be
epiphenomenona. Where innovation is present, there is a requirement that levels of
comparison need to rest on some kind of benchmark. But the benchmarks of social work
are necessarily flexible. In addition, clients living with addiction are likely to have an idea
of social work that may be based on poor information, mistaken assumptions or subcultural
values. The client may additionally regard social work structures as unified or
homogeneous whereas they have complex responsibilities, requiring complex management.

Additionally, confidentiality presents an enormous restriction in the case of opiate users,

because they are demonised3 within their own neighbourhoods. The numbers in their
category aren’t so many that description of a case would not identify them. I have therefore
tried to use the case studies flexibly, lest a full picture might identify an individual or
family. So the case studies present a kind of patchwork or mosaic that is designed to bring
the reader a little closer to the thoughts and opinions of the clients.

1.2 Problems and limitations

Before the evaluation commenced, it was envisaged that clients' interviews might prove
problematic for the following reasons:

2
Yin, R.K. (1981), The case study as a serious research strategy. Knowledge, 3, 97-114
3
The opiate user is regarded as a “junkie”. It is assumed there is a one to one relationship between criminality
and drug use. “I was mugged by a couple of junkies”. The drug problem is a “scourge”.
4
• Present state of clients: The client’s recovery was likely to be uneven. The research
anticipated that clients might suffer from problems of medication, drug use, and
psychological disposition. It was foreseen that this would affect research data.
• The client’s ability to keep appointments: It was foreseen that there would be occasions
when clients broke appointments with the interviewer.
• Confidentiality regarding clients: strict rules regarding data transfer - particularly
background data - precluded the researcher having access to some data regarding
clients and cases. Data recording was thought likely to prove problematic in that the
information was sensitive. It was decided that recordings and/or notes would be made
only where appropriate - depending on the clients’ disposition.
• Necessity for (some) supervised interviews: It was felt likely that some clients would
be have anxiety regarding interviews. This is a common problem in social welfare
research. The client is apt to feel that something crucial (like continuation of a valued
service) rests on the outcome of the interview and gives a positive but biased response.
Clients do not always acknowledge the neutrality of the research approach, especially
where the sponsoring body may be regarded as partial.
• The client-social worker relationship might be disturbed by the interview. Particularly
where opiate users are in recovery, relationships are gradually constructed and can be
fragile. It was imperative that the interviews did not damage any gains made by
workers. In contradistinction, the client is sometimes likely to try to protect the social
worker from adverse criticism. Here, he or she regards the interview as an inspection of
the worker, rather than the social work service.

In practice, only a few problems arose during the course of client interviews as follows:

1. There was one “no-show” through family confusion about arrangements. The
interview was successfully mounted at a later date.
2. A client, whose speech was slurred because of his medication, was difficult to
understand. Since the meeting was with a young couple, this minimised the
problem somewhat.
3. The accessibility of clients who were in work was limited in some cases. This
meant that the interview schedule was slightly delayed.
4. Some clients showed an understandable reluctance to be recorded. In this case the
conversation was recalled and notes written up immediately after interview. This
technique was also used where the interviewer took the decision that a recording
would produce poor results or adversely affect the client.

In terms of outcome, the material produced was detailed and qualitatively rich, despite
variations in data gathering. The willingness of clients to disclose personal information is a
tribute to the relationship created by the drug team social workers and can be regarded as
one indicator of the project’s success.

There were limitations implicit to the consumer-oriented approach. The ability of the client
to exercise choice, to articulate a specific voice, to have the ability to gain access to
services or to participate in democratic assessment of the service in question were all
limited by the nature of the problem itself. It was accepted that for this area of work, the

5
physical and mental affects of opiate addiction might curtail optimum functioning in even a
“perfect” system.

1.3 Outcomes and opportunities.

It was felt that the research investigation would produce expected outcomes and reveal
certain opportunities:

Outcomes
• the state of client satisfaction would be determined
• the mode of social work operation would be described and assessed
• the relationship of social workers with the community operations would be
established
• gaps or lacks in service would be revealed

Opportunities
• Assessment of the model as one of good practice
• Operational problems would be described and assessed
• Opportunities for changes in structure would be determined
• Opportunities for operational extension would be determined

The report itself offers opportunities for circulation at the policy level, in that this method
(or modified method) of service delivery deserves attention in the formal policy making
arena.

6
SECTION 2: HISTORY AND DEVELOPMENT OF THE PROJECT

2.0 Principles and objectives

Underlying the stated objectives of the drug team is a framework of principles that are
based on fundamental human rights. The emerging idea and approach are central
organising principles of the work carried out by social workers. I have compiled a list of
points that emerged from discussions with social workers, clients and families and from
observation of relationships.

• that opiate users, are people rather than “cases”

• that opiate users are entitled to the respect in the same manner as any citizen
• that the opiate users have rights in common with all citizens
• that the opiate user deserves all the consideration granted to anyone with
difficulty
• that the opiate user is entitled to such services as are necessary for rehabilitation

It emerged during the course of the fieldwork that this perspective in not necessarily shared
by those in the communities in which they live. At the political level (central and local
state, politicians, police officers) the opposite can be the case. Where both levels appear
seized by moral panic, all ills can be blamed on the opiate user and the results of this
attitude can be devastating for the neighbourhoods concerned4. The opiate user finds that
he or she is labelled for one aspect of his life and all the other aspects that make him an
individual are downgraded. Those interviewed in this project are sons, daughters, mothers,
fathers, football players, car enthusiasts, and artists. Drug Team social workers can see
these aspects of their clients' lives and use them to promote recovery and integration. Thus
where there is respect, the recovering addict finds himself in a supportive rather than a
hostile environment; finds himself or herself regarded as psychologically rounded - a whole
person (albeit with problems) rather than an irksome freak. This is also important for the
children and family of opiate users who know the client as a real individual with positive
and negative attributes.

2.1 Origins of the Drugs Team

This review of the process of setting up the Drugs Team will start with a focus on origins
within the Drug Task Force strategy. Given the somewhat innovative funding mechanism,
the expectations of the Drugs Task force is of considerable importance. The review then
goes on to look at the Eastern Department, the Health Authority Task Force
recommendations and the position of the project within the overall service. Finally this
section will examine the operational beginnings of the project and any social work
expectations that have influence the project itself.

The local Drugs Task Force was set up in 1997 in response to local drug use. Its remit
concentrated on the three areas below . The issues were as follows:

• treatment
• prevention

4
Shanks, K., Education needs in a South Dublin estate, Dolphin House Education Group, Dublin 1999
7
 • rehabilitation

Without existing drug support infrastructure in the area under study, the Task Force
required a project delivery system to evolve a community approach. Using an existing
model from other localities and information from university research departments, it was
recognised that the key "missing" element was that of family support for those living with
drug related problems. The Drug Task Force approach was later extended to encompass
further aspects of preventive work, including family support and crime reduction. The
Drugs Task force invited tenders for projects of differing types and received several from
the community sector, none of which were considered suitable. It was the social work drug
team proposal that fulfilled the additional objectives acknowledged to be important. These
were as follows:

• community based family support

• child protection for children of drug using parents

The social work department had recognised that scarce resources did not allow it the
necessary time for families with drug addiction problems. Its proposal therefore suggested
the establishment of a specialist team with a focus on such families. This team would have
lower case loads, allowing for a more intensive approach to problems. A plan was duly
submitted and accepted. So given that this involved a purchase from a statutory body it is
instructive to acknowledge the nature of purchaser-provider relationships within the social
work department itself. What regulatory constraints did it place upon its own providers?
An interim report of the Task Force examined the question of voluntary and statutory
providers and stated that "all providers should be subject tot he same requirements
concerning service agreements and annual service plans as would apply to voluntary
providers". In consequence the social work department was required to provide a service
plan, featuring common elements as follows:

• quantum of service provided

• effectiveness
• efficiency
• quality
• equity
• access
• appropriateness of care
• responsiveness of care
• responsiveness to the public

It is clear that this displays considerable compatibility with aspects of the consumer model
utilised in this report (access, choice, voice, and accountability). But in social work,
relevant work is constrained by several factors that include recruitment problems,
demanding work, the stress related to child protection work and violence against staff
members. In particular retention of staff presents difficulties, because of the competitive
nature of the labour market.

8
Social work is organised through Care Areas, which are more or less contiguous with
postal districts. Care Area F deals with the catchment under review. - the electoral area
stretching from the river to the county border. This includes the north inner city and several
outlying boroughs. As a whole, Care Area F has a complement of 29 social workers and 3
childcare workers. Four team leaders and one head social worker supervise staff members.
It is generally recognised that there is an under-provision of human resources in all
departments. A significant portion of services in the area is provided in conjunction with
the voluntary sector.

The function of child-care and family support is dealt with in a review of adequacy
published in 19985. Of particular interest is the family support service that aims to "buttress
vulnerable children and their families". Although the Drugs Team constitutes a separate
entity from the family support function, its objectives are pertinent to the overall approach,
as follows:

• empowering and enabling families to sustain the care of their children and the
maximisation of their potential to so do
• reduction of the need to take children into care or to keep them in care
• alleviation of pressures experienced by families
• assistance to families in developing social contacts in their communities

In addition to a range of family problems, this support function includes substance misuse.
It is accepted that drug-related problems generate a range of child difficulties. Hogan’s
qualitative study undertaken by the Children's Centre6 at Trinity College, Dublin explored
the social and psychological needs of children of drug users. The study confirms the link
between parental drug use and social deprivation and finds that at community and family
level, support makes a substantial difference to the ability of parents to cope with child
rearing in the following areas:

• help with short and long-term care of children

• advice and information
• therapeutic benefit of just having someone to talk to

Grandparents and other family members appeared crucial in all the above areas. The Social
Work Drugs Team approach acknowledged these findings and mobilised a programme
where community level support constituted the key method of engagement. Currently the
team catchment covers only two wards. The necessity for extending the model to the
remainder of Area F will be reviewed.

2.2 Drug team structure and staffing

As can be seen from Diagram 1 below, the Drug Team structure comprises three social
reporting to a team leader. There is provision for trainees to be attached to the team. At the

5
Child Care and Family Support: Review of adequacy. 1998
6
Hogan, D.M., The Social and Psychological Needs of the Children of Drug Users, The Children's Centre,
Trinity College, Dublin 1998 ((A subsequent study will use a quantitative approach utilising control groups so
that there will be a comparison between children of drug using and non-drug using parents.)
9
time of evaluation, no trainees were in place, although there was provision at pre and post
evaluation stages.

Chart 1: Drug team structure and staffing

Team Leader

SW 1 SW 1 SW 3

T r a in e e s

The diagram above shows vacant posts in white boxes. Due to staffing difficulties only two
social workers were in post, due a member of staff having moved to a different service.
There was no team leader in post, due to staff changes. This resulted in one social worker
fulfilling some team leader responsibilities. A new trainee joined the team immediately
after the termination of evaluation fieldwork. Research established that staff shortages had
caused resulted in difficulties that include:

• inability to mount full monitoring or ongoing evaluation

• little space for innovation
• stress on existing staff
• inability to fully implement the policy function

This research established that the team was working to the best of its abilities to overcome
these difficulties and suggests that team members should be credited for development
successes. The consultant feels that any constraints in the fulfilment of aims and objectives
were minimised by the team's productivity. and commitment.

It is likely that in a period of social and economic change those government departments
will find it necessary to examine and revise budgets,, structures and career paths. Where
social work resources are limited, staff will necessarily be affected by the following:

• the lack of formal reporting structures induces staff stress

• a restricted labour market exerts a "pull" away from existing posts

It is noted that the department is taking remedial measures, including out of state
recruitment. However, in such circumstances there is a necessity to examine training and
education in social work, such that career possibilities may be expanded for new entrants.
10
The staff shortage affected the team in other ways. Due to the lack of policy direction and
distance from operational management, the team members were faced with carrying out
development work whilst incurring an increased caseload. As a result, some flexibility in
family support was lost. Since the priority in all casework is the child, child protection
matters tend to dominate the work, leaving a restricted space for family development – say
in encouraging physical and mental well being through leisure activities. Leisure
development, to be examined later in this report, is held to be important to the success of
support work at community level.

2.3 Operational practice: throughput.

The following figures reflect the quantity of cases seen by the Drug Team Social workers.
It musty be recognised that this does not represent caseload intensity. Since inception in
November 1998, the team has worked with a total of 115 cases, involving 115 children.
The current caseload (at time of evaluation) is 40, reflecting the average caseload. The
caseload latitude lies within the range of 30 and 50. To date, 27 cases have been closed -
that is, resolved or referred elsewhere. During the period of team operation, 14 cases have
been referred to therapy or counselling, 28 to methadone clinics and 11 to General
Practitioners (GPs). The current condition of clients on the drug team caseload is as
follows.

Display 1: Condition of clients within scope of drug team.

Condition of clients % of caseload

Stable (no heroin) 40%

Nearly stable (intermittent) 20%

Heroin in urine test 40%

This does not fully reflect the level of community support generated by the team. During
the course of casework, the team has also dealt with the following departments or agencies
in its support of clients, clients' families or clients' children.

• therapy and counselling organisations

• resource centres
• methadone (rehabs) clinics
• general practitioners
• off-area specialist resources (rehab)
• housing advice agencies and charities
• hostels, bed and breakfast accommodation
• housing department
• money advice services
• employment schemes
11
 • insurance companies

It is clear that many of these contacts would be present in general (non-specialist) social
casework. The method of application and the degree of work in depth, renders the Drug
team approach different.

2.4 Operational experience

Although interviews with staff members reveal some differences in outlook within the
team, it must be borne in mind that the function remains at an early stage of development.
Additionally, a key social worker team member previously worked as a social worker
within the catchment, retaining a contact network. At the same time, social workers may be
relatively new to the service and are more familiar with a directed work environment. In
the initial period where there can be as many approaches as there are individual workers, a
period of adjustment is necessary before a new approach is fully developed. The initial lack
of a well-defined developmental staff position caused some difficulty.

The team had to create its own development. Some found that hard. In the team, we
redefined roles. But there was a lack of a wider responsibility and developmental remit.
We need a principal role to network. [social worker]

Immediately following operationalisation, it was acknowledged that remit specifications

were unworkable. It was felt that therapeutic work would take place using groups but
initially limited referrals made this impossible. Neither could the planned developmental
work with school children take place since this would have duplicated another service (also
Task Force funded). The holistic outlook of the team was also compromised by concrete
conditions existing in the (external) sector. Agencies engaged in housing and
accommodation provision were initially reluctant to place those with drug problems,
perhaps due to a failure to recognise the distinction between a user and a dealer7. At
community level the team outlook was perhaps less judgmental attitude than the range of
community groups and leaders. Their failure to acknowledge the drug addict as a citizen
tended to undermine the team's work both in the community and with individuals.

Staff shortages have already been highlighted. But this resulted in the lack of a team leader
who could provide context and a planning perspective, giving rise to the internal view that
"the team does not do anything more special than any other team". Yet the following table
suggests the opposite

7
This appears to be a problem in many agencies. The complexity of drug dealing does not produce a
polarised world of dealer and pusher. The system tends to operate in a retail cascade, where criminal elements
dominate only the apex of the system. In supply distribution, many dealers are merely supporting their own
habit through trading. That is, they are not profit motivated. As in other spheres the dealer is a peer and can
be a family friend rather than a "pusher".
12
Display 2: Perspectives and Outcomes

preconceptions
social workers • working with marginalised
group
• break down prejudice
• break down barriers against
social work dept.
• work at community level
• provide non judgmental
service
• build on strengths not
weaknesses
clients • social workers as there to
take the children away
• social workers are
"interfering"
Drug Task Force • social workers would have
lower, more intensive
caseload
• social workers could make
useful intervention
• social workers might not be
able to "give the extra hours"
that some community
workers do.
community • acknowledge of community
feeling as above
• some perceived difficulties
with "old style" social
workers
outcome
• successful identification of clients
and families
• difficulties due to judgmental
attitude of some community
leaders
• barriers to social workers could
be overcome through work with
individuals
• some problems due to negative
forecasts of other authorities
• feeling that no difference from
"normal" social work
• drug team workers perceived as
supportive/friends
• drug team workers perceived as
"there for the children"
• extent and depth of drug team
approach recognised
• some problems continue
concerning awareness of
statutory child protection role
• lower case load and different
approach acknowledged
• quality intervention recognised
• lack of feedback mechanisms
• feeling that "can't tell social
workers how to do their job"
• perceived lack of feedback but
accepted due to staffing
problems
• satisfaction expressed
concerning co-working with social
workers
• different approach acknowledged
• new referral point appreciated
• recognition of drug team as extra
source of knowledge

It is useful to consider an example of change. During the research period and during a
consultant visit, a social worker received a telephone call from a client. This client's
attitude to the drug team is indicative of the different manner in which these social workers
are perceived.

This is a man who (for good reason) hates social workers. He is a classic "junkie-
looking" person with a horrendous history. He is now squatting in the back of a car and
his family is caring for his children. We have worked hard to build up trust. For this
man, the fact that his father had just died required that he be given sympathy. He is
more than just a drug user. So whereas traditional social work may not be there for
him, he has the right to services. [social worker]

13
Clearly the fact that such a client might voluntarily contact the drug team is a significant
indicator of the success of a non-judgemental approach. As will be detailed in a later
chapter, families also perceive a difference in style to which they can relate.

In addition we must consider the outlook and expectations of the various bodies within the
drug service catchment. In general, as will be explored in the following chapter, the
network expectation and outlook differ considerably from those working within the remit
of the Department. At the same time, may of those in the network have considerably more
experience in community service delivery. Within the community sector, the engagement
with clients can be necessarily partisan.8 That is, it is necessary to identify quite closely
and share with peers in the community. Yet for many within the community sector the
approach of the drug team proved beneficial. In addition to widening the scope of their
services, community workers gained a wider perspective and a new information source -
particularly in terms of knowledge of the statutory requirements under which social
workers operate..

2.5 Overview
It is clear that the drug team was established with a differing approach from mainstream
social work. Operationalising of the service is in contrast to pre-existing services so it is
accepted that some expectations were unlikely to be fulfilled in the initial period.
Evaluation research finds that service outcomes are very positive, particularly in view of
existing staff constraints.

It is clear from the existing figures maintained by the Department, that drug team caseloads
were intended to be smaller than the departmental average. This has been undermined
somewhat by delays in filling vacant posts. In particular, the lack of a team leader has had a
serious negative impact on team building, ongoing monitoring and policy development. It
is unfair to expect social workers to solely maintain monitoring duties. Whereas extensive
"log" records exist, the lack of evidenced overview places the service at a disadvantage.
The team needs to be able to:

• determine the comparative intensity of individual cases

• allocate priority levels
• use indicators which have specified weighting
• have an overview of the total caseload
• have a method of establishing trends in their work

Because of the professional experience within the team, workers currently have a good
grasp of the total system. This functions at the intuitive level, but this can only remain
possible where the overall caseload remains comparatively low. It is therefore
recommended that a caseload monitoring system be introduced which includes:

• state of health of client

• type of substance misuse, drug of choice
• likelihood of recovery, scope of possible outcomes
• record of previous recovery attempts
8
The partisan relationship can be held to be either positive or negative. For community groups however, it is
necessary to maintain a strong participation structure.
14
• record of previous social work intervention
• family structure and arrangements
• arrangements for children
• any children problems
• court or informal orders
• current accommodation needs
• type of assistance given
• stage of recovery reached to date
• number of casework hours allocated to each client/family

For the most part, this kind of information is present in the detailed notes currently made
by social workers. Systemisation is necessary however, in order to have an overall view of
the effectiveness of the process facilitated by members of the drug team.

The work of the Drug Team can be seen to have made considerable positive impact on
clients, families and on the network members offering drug services. Additionally, the
overall approach and style of the Drug Team has substantially challenged the taken-for-
granted views that pertain at community level in the catchment. There are inherent
limitations within this approach, however. A later chapter will deal in depth with changes
in the way social workers are regarded by clients and workers at community level – and
how this is constrained.

15
SECTION 3: AGENCIES IN THE DRUG TEAM COMMUNITY NETWORK

3.1 Introduction
This section seeks to describe and analyse the drug team's relationship with the network of
agencies and organisations that make up the fabric of drug-based services in the catchment
area. In describing this infrastructure of services as a “network” presupposes a relationship
between all or most of the agencies. How does this work? In the minimum position,
organisations are at least aware of the others’ services. This will be described as repertoire
functioning. The maximum position can be described as an inter-related web of services
with a high awareness where agency workers know each other at a professional-personal
level. The network - in part or as a whole - is able to make joint plans for clients and their
families (innovative or proactive functioning).

Within the catchment a range of organisations provide drug or drug-related services.

Although some are well established (clinics, counselling services, police), small innovative
projects are more recent. The history and development of the Drug Team must be noted at
this point. The drug team’s introduction takes place within an existing network. And a key
member of the team has already worked in the area and has relationships with most of the
agencies. There is no necessity for time consuming "cold contact" procedures since the
social worker has already forged informal links in the network. There are some obvious
questions to ask at this stage:

• What kind of effects does the introduction of the drug team have on the network?
• What is added to or subtracted from the network system?
• Does the drug team increase or decrease the workload?
• Does professional drug related work become easier or more difficult?
• What are the benefits for the client?
• What are the benefits for the “client'' children or families.?

3.2 Agencies
It was clear from interviews with major agencies and providers that the presence of the
drug team had enhanced their work. The most major impact appears to be that of a central
agency with specialist experience, not merely in the realm of drug related problems, but in
complex negotiations between providers, awareness and abilities in relation to statutory
requirements and enforcement. Overall, it appeared that the introduction of the drug team
helped to consolidate the overall service. The drug team appeared to most agencies as
welcome addition to the structure of drug services. It could best be described as "the piece
that competed a jigsaw". The introduction of the new service appeared to have interwoven
within the existing community fabric a finer mesh - through which it was more difficult for
those at risk to fall. The consultant was present in the drug team office when agencies
phoned for specialist advice, to discuss a shared problem or in emergencies and can
confirm this vital role. In general, the work of the team is held in high esteem and all
agencies appreciated the effort of the drug team workers to keep in touch, to stimulate their
involvement at a confidential level. They also appreciated the respect shown by the drug
team in acknowledging existing specialist and community-based agencies.

16
CHART 2: DRUG TEAM NETWORK AND LINKS

DRUGS TASK FORCE: Funding; Resources; Strategy; Co-ordination

Garda
Methadone Community
Locally
Doctor Liaison
Based Home
Clinics School
Liaison

Links to out of area bodies

EHB
Clinic

Resource
Therapautic Centre
Work
Projects Counselling
services

Off-area resources 1 TRINITY

EHB
structure
Off-area resources 2 REHAB COMMUNITIES
services
resources
knowledge
Off area resources 3 CHILDREN RESOURCES

3.3 Relationship with agencies

Interviews with key agency staff showed that whilst staff were aware of the role and
functions of other agencies in the network and often met other workers, this was taking
place on a relatively unstructured basis. Regular formal meetings were taking place but
were only indirectly connected with the day-to-day operations of agencies. Additionally,
the community catchment would not necessarily match the drug team catchment. In
particular, there were unavoidable discontinuities between networks despite their
proximity. In consequence, members of the drug team were the only drug related agency

17
professionals who visited all other agencies. What therefore was the function of the drug
team in this respect?

It appeared that the drug team exerted a binding influence upon the existing structure.
Agencies could remain relatively autonomous in that they both possess resources and a
guaranteed flow of clients. For example, some projects could, with referrals, sustain their
own activities. But the addition of drug team social workers, to some extent, sutures the
system together. With their own referrals already in place, the social workers utilise the
network to provide appropriate services for their clients. In the course of this work, the
team therefore:

• is in direct and day to day contact with all agencies

• performs duties in the service of its clients who are now "shared"
• obtains current information which it carries back to the centre
• acts as a dissemination vehicle for other projects
• brings an appreciation of movement and trends in client group, treatment and
resources

Research established that for many agency workers, up-to-date knowledge of other
agencies often came as a result of contact with drug team social workers. Even at this early
stage in the team's development, there is a sense of increased awareness in the system as a
whole. Naturally, this is not to suggest that the social workers are alone responsible for
increasing awareness. Yet the drug team appears to have exerted a catalytic affect, through
perceived differences in tone, style and approach. Establishing good practice has also
healed wounds in some parts of local sector. So what aspects of practice have contributed
to this overall improvement?

• Honesty and transparency in approach

• Willingness to share information in the best interests of the clients
• Respect and acknowledgement for the work of other agencies
• Respect in relation to the clients
• Knowledge and practical know-how on the drugs issue
• Knowledge and practical know-how of statutory implications

3.4 Referrals
For referrals, the current situation was less interactive than could be achieved. The drug
team has not been in existence long enough for an interactive dynamic to develop. Thus the
drug team largely used the network as a resource for clients rather than as a referral point -
although it appears that this relationship is likely to develop in time. Perhaps the most
important aspect to merge was that of the drug team as leading change in approach style
and professional-client relationships. Where many available drug resources are community
based, workers can display the same kind of views as social work clients. That is, they are
as also likely to regard social workers as "policemen" who have behind them the power and
authority of the state. This may be because community organisations are more physically
grounded in the neighbourhoods where clients live. But the outcome is a restriction on
likely social work referrals and a general reluctance to engage with the Department. There
appear to be some grounds for this attitude, although there is a general acknowledgement
that the approach of statutory social work is currently subject to positive change.
18
 Other social workers I have seen, they pretend you are not there. They are very formal.
They come in and tell you that you are doing things wrong and that they should be
done some other way. But this team is more informal - they are like friends really. I
have never seen social workers invited into people's homes apart from them! But
people are still afraid - so it is down to educating rather than dictating to people
[Community Worker].

Naturally, the desired change entails a broader shift in attitudes than lies within the gift of
the Task Force initiative. Yet the work carried out is a significant contribution to this
positive shift.

3.4 Overview of community role

Interviews with network members cannot be consolidated without considerable resources
being devoted to contact at community level. Logically therefore, the work of the team
must be spit between direct client-centred work and the maintaining of a direct community
development role. To date this has depended on the proactivity of the social workers
themselves. At the same time it requires constant maintenance to ensure that the process
continues despite social work and local network staff changes.

Display 3: Options for development of community role

Option Implications

Appointment of a social worker with
community development experience. The
social worker retains a limited caseload whilst
the bulk of time is specifically devoted to:
• community contact
• outreach work
• referral work
Appointment of full time community
development worker as part of a multi function
team. The workers takes total responsibility for
maintaining
• the contact system
• improvement of links
• consolidation of relationships
• improvement of referral system
Appointment of a team leader with community
development experience. The leader devotes a
third of this time to maintaining the network,
using existing community sector staff to improve
referrals
Pro: No split between social work and
community development. Full understanding of
the two roles.
Con: possible difficulty in finding suitable
appointment
Con: possible degradation of existing social
worker-community relationship
Pro: Constant community presence
Pro: Scope for concentrated focused community
development work
Con: worker may be subject to conflict of
position of roles. Community sector may feel
worker is "theirs")
Con: Social work -community development split.
Con: Possible loss of social work contact with
network in favour of exclusively client -centred
work
Pro: good structure for understanding of the two
roles.
Pro: No caseload gives time for development
Con: Possible difficulty in finding suitable
applicant.
Con: Community sector staff tend to meet only
the "boss" of the team

The team needs to consider what portion of the work should be devoted to maintaining an
efficient, sustainable community interface. It is recommended that the team review
19
work with the community sector in order to accurately determine what resources are
required. During the research period social workers acknowledged that work involves a
significant community development role. The possibility of appointing a community
development worker was raised during discussions. What options are therefore available?

The consultant feels that the appointment of a social worker with community development
experience may not be possible given the limited pool of professional staff. Additionally,
that whilst the creation of a full time community development position is worthy of
consideration, this may create some degree of social work/community separation. That is, it
is important in the current period for social workers to retain the maximum community
contact without compromising the development of client relationships. It is perhaps option
3 that presents a viable compromise. A team leader with a community development
outlook and commitment could devote a specific portion of work to the community
development function whilst integrating this into policy development.

The consultant recommends a working party examines the team leader role and
function, with a view to creating a sustainable social work - community sector link at
the operational and policy levels. This has the added advantage of continuity during a
period where social workers are subject to labour market scarcity.

Possible job descriptions will be examined in the concluding chapter, as part of a structural
options for the team as a whole.

20
SECTION 4: CASEWORK

4.1 The approach

It is necessary in this report to examine the nature of the casework approach within the
contact of the drug team’s work. The approach of the social work team members is that the
casework approach is the cornerstone of the work. That is, the work is essentially different
from community work. However, I do not wish to make a case for a monolithic and
homogeneous social work approach.. Social work has changed considerably in the past
century and has been influenced by a number of factors such a political orientation,
political and economic expediency, social engineering, radical interpretations and stances,
etc. Some would argue that the Poor Laws9 that lie upstream from the modern welfare state
continue to hold sway. What has remained constant for some time however is the
concentration of social work on individuals and family as pathologically dysfunctional -
deviant in an otherwise functioning whole. This stance was modified in the 1970s by a
radical movement, which considerably influenced professional certification and social
work style.

A positive outcome was that this substantially diverged from the view of the client as
"feckless" and unable to make changes for his or herself. Problems were acknowledged to
be societally structured and the clients became positioned as somewhat blameless, the
unwitting subject of political processes beyond control of the individual. On the other
hand, a negative outcome of the changing political nature of the social worker was that the
therapeutic concentration on the individual diminished. In the current period however,
these two positions are being reassessed. It is useful to regard the Drug Team approach as a
synthesis which offers the client facilitative support whilst acknowledging the community
structure within which the client lives. It is interesting that the Drug Team initially aimed
to provide a more therapeutic environment for those living with drug problems. The team
planned to provide group sessions for individuals but the number of referrals did not allow
for these to take place. In retrospect, this may be a service, which can, in any case, be
arranged or contracted out through the existing community network10. As referrals
increase, this may be a viable option and it is recommended that a group support system for
clients be implemented as soon as the "operation scale" increases.

4.2 Casework and the opiate user.

I want to examine closely and in a concrete manner what drug addiction casework entails.
The kernel of the casework approach in this instance is clearly the child protection role. At
present, this matter is of considerable concern. We are currently in a period where the state
has been forced to acknowledge the level of domestic and institutional abuse against
children and to take firm steps to eliminate the problem. Where parents are problem drug
users, the matter has some clarity. We have already cited the work of Diane Hogan but it is
useful to concretise this. In the case of the opiate user, neglect is the most serious
consideration. That is, whilst deliberate child harm can be a problem, there appears to be
more likelihood of physical and emotional neglect. In the experience of the consultant,

9
Corrigan, D.
10
It may well be appropriate for the Drug Task Force when developing funding strategies, to consider what
other facilities need to be in place such that the Drug Team functions more effectively on behalf of its clients.
That is, there is need for an integrated approach.
21
physical neglect is somewhat minimised by the parent's projection onto the child. The child
is often sacrosanct and can even provide a raison d'être for existing. In extreme cases, the
child stands between the client and suicide. Additionally, the child is a focus of attention in
terms of appearance and possessions. The child is likely to be very well-clothed, to be
given many toys, to have first call on the food budget and to have things that the parents do
not have. All this despite the financial imperative of obtaining opiates11. The child appears
to suffer more from emotional neglect. Because the parent(s) are unable to provide help
with homework or provide physical attention such as play and reading activities. Further,
the parent is not in a position to maintain the home-school relationship, which is
fundamental to the child's education.

Deliberate harm appears to be accidental. Cigarette burns can be the result of carelessness
induced by being heavily stoned either on heroin or official medication. In one case
observed by the consultant, the parents were very loving and caring towards the child. But
they appeared to be fairly "stoned" from prescribed medication and there was every
potential for an accident to take place through scalding, contact with hot surfaces and so
on. The social worker in this kind of case must assess the danger and make a judgement
about the likelihood of an accident. Ultimately she must determine whether the danger
outweighs the positive aspects of the child remaining with loving parents and if necessary
take action on behalf of the child. The need for continuous monitoring in theses cases is
paramount. For example, in another case the child had been removed from the family after
a burn incident. The parents insistence that the child had not been deliberately harmed
could very probably be the case12. It is however likely that the child was injured due to
carelessness on the part of the parents. The tendency for the opiate user to spend lengthy
period asleep appears to lead directly to the emotional neglect of the child. The parent is,
quite literally, not there for the child. Just as in the case of parents under heavy medication
such as tranquillisers, there is no savage or evil intent.

Additionally, the opiate user is likely to recognise the effect of the behaviour on the child.
In the following case, which is quite typical, the client knows that her behaviour is
affecting those around her.

You are going shop lifting with your kids. Then they see the police stopping you and
you're being brought into the station and they ask "Mummy, what does the policeman
want with you? " Well my kid is only six and he can remember these things happening
when he was three. [client]

It is not that the opiate addict is stupid or unconscious of what is happening around her.
The addict knows what is occurring but by this time is in the grip of the substance. In the
"bad" times they cannot control their behaviour. And although something tells them they
are suffering from paranoia for example, this does not diminish the paranoia itself. During
more lucid periods they can easily recognise the problems and acknowledge responsibility.
In one case examined in this research, a client's mother explained in some detail her
daughter’s irrational behaviour and the disastrous effects on the family. During her own
interview, the daughter was able to present in a most knowledgeable, intelligent and aware
manner. The Drug Team social worker must negotiate these two positions, acknowledging

11
That is not to say that the parent will necessarily avoid theft on behalf of the child.
12
I am speculating a little at this point. Because of social work confidentiality, I am working solely with the
client's view.
22
the possibility of failure and accepting failure when it occurs. At the same time, the
recovering addict may have to make several attempts to rehabilitate and the social worker
must adapt to episodic failure. Those recovering on methadone also have to acknowledge
their reliance on this medication and be aware of the constraints imposed by the new drug.
"It helps to keep us ticking over" and "I may have to be on methadone forever" are
common responses to enquiries concerning their state of health.

If child protection work is at the cornerstone of this kind of casework it is useful to

examine the position of others in the social work case system. A team member commented
that since everything was led by child protection, then there was little difference between
Drug Team and more traditional approaches. In the view of the consultant however, the
relationship is more complex than would normally be the case. I have attempted to lay this
out in the diagram below.

Chart 3: Casework structure

Child Childre
Protection n

Rehab &
Clients
support
Mobilise
Direct Client's Family Support
Support
Mobilise
support
Community Network

Social work statutory responsibilities

Drug Task Force remit

Traditional social work function

Non-traditional or "extended" social work function

The diagram shows that the base of the system provides for the substantive social work role
accompanied by the core funding of the Drugs Task Force. Through this combination
workers are able to mobilise support for the client family and children. In "normal"
circumstances, social workers may well secure childcare through parents or family. Yet the
mobilisation of support is different in that the extended family receives an in-depth service
with the objective of underpinning the rehabilitation of the client. Social workers help the
family to help the client.

23
Casework entails substantial visiting and monitoring especially where the safety of the
child is of paramount importance. But we have to acknowledge that the world of the opiate
addict can be chaotic. In practical terms, this means that the clients may not be present at
home even when they themselves have arranged an appointment. It is appreciated that this
is a more extreme problem for those living with opiate addiction, than one might find with
other social work cases. In consequence, social workers require greater patience and
understanding than would normally be the case. During visits, the client requires extra
effort from the social worker. Information and client requirements must be specified in an
ultra-clear manner. This demands extra patience and is time consuming , necessitates a
lower caseload. Observation reveals that becoming a family friend or "buddy" places extra
demands on the skill of the social worker. At this point, an individual’s personality can
make a great deal of difference to the therapeutic effect.

Working with addicts, the social worker has to walk a fine line between friend and
watcher-caretaker. Banter and chat is more amplified than one might expect. Information
must be carefully articulated using concrete examples. Additionally, the social worker as
role model suffers intense scrutiny as the client searches for anomalies, discontinuities and
half-truths in the social worker's script. When things go well, the social worker is regarded
as an angel but where things "go bad" she can quickly transform into devil incarnate. The
client, especially the opiate user, will detect any masks or smokescreens thrown up by a
worker. The worker must sustain a consistent approach at all costs. As a result, work is
likely to be more effective where the worker can present a natural, self aware and
principled persona. This renders staffing policy vitally important and leads us, almost
organically, to the question of ethical stances in social work

4.3 Ethics
This, of all issues, is probably one of the most debated in the social work profession. In the
specialism of work with addicts, it presents extra questions sine the supply, purchase and
possession of heroin is illegal. Social workers do not have immunity from the law in the
same manner as a lawyer or priest Particularly where the issue of child welfare is of
paramount importance, the social worker must again walk a fine line where disclosure is
concerned. The approach of the team partially extends the CCETSW position of 1991
which was:

• respect for client's dignity an strengths

• non discrimination and anti oppression
• commitment to the value of individuals
• counteracting stigma
• Protection of vulnerable people
• Privacy and confidentiality within contextual limits
• Promotion of choice

I draw attention to Bill Jordan's question "is the client a fellow citizen?" Given the
increasing focus on citizen's rights, the answer is a now a little clearer at the formal or
legalistic level. Yet in everyday practice, this is more difficult to assess. Drug--related
phenomena such as vigilantism (concerned members of the community march on the
residence of the drug dealer and/or user) imply that the drug user is not accorded the rights

24
of a citizen in the everyday world. Interviews with social workers suggest that working
with committees at community level can be more hindrance than help, due to the moralistic
and judgmental tactics mobilised by political forces. Many workers at community level
suggest that a rational approach may be quickly subverted by political expediency. This
certainly increases difficulties for social workers attempting to deal with the opiate user as
a citizen with the same rights as others. The Drug Team social workers not only take a non-
judgemental approach but also actively encourage the client to participate in decision-
making. That is, it is not acceptable to make decisions about a client without the presence
of the client. Drug team social workers seek to involve the clients in case conferences -
especially inter agency gatherings. This participative approach has extended to other
services such as the Housing Department. Naturally, decisions may have to be taken that
are unpleasant for the clients but their voice is heard. This approach is particularly valuable
since clients have the opportunity to:

• explore choices
• to hear what is said
• to have a say and participate in the proceedings
• to disagree with a particular course of action
• to explain any circumstances which have not been taken into account
• to voice an opinion about the way in which the decision is being made

This increases the level of accountability to the client and renders the overall system more
transparent. Whilst the social worker remains accountable to the Department in the
performance of his or her duties, all possible efforts are made to secure the participation of
the client. The consultant considers this approach to be a fundamental element in
community-based drug work. Formerly, certain attitudes prevailed which prejudged the
opiate user as incapable of participation. The activities of the drug team suggest that this
attitude is based on erroneous preconceptions.

It is recommended that this element of drug-related social work be retained and

developed through organising support groups within the opiate using population and
with the possibility of the involvement of those who have successfully recovered. This
would assist in increasing accountability and provide an arena to discuss
improvements in user-friendly services.

25
SECTION 5: BEYOND CASEWORK

1.0 The clients’ view of social workers: social policemen or family friends?
For the social work client, it is often difficult to reconcile oneself to the continuing
presence of a social worker. For many types of client the mere fact of having a social
worker signifies an inability to cope. The client occupies a deviant position, whether it is
due to addiction, mental disability or merely being elderly. Further, the social stigma
attached to having a social worker can encourage paranoia and hostility. In the current anti-
drugs climate, where an addict is typed as criminal, the stigma is much worse. The person
(social worker) who regularly parks the car outside and calls to the door is seen as alerting
the neighbourhood to the individual’s problem. The client fears not only social exclusion
and hostility but also the possibility of violence against herself, her children or her
extended family. Furthermore, the stigmatising label of “junkie” can extend from the
neighbourhood to the school and affect the life of the client’s child.

The Drug Team social worker has to transcend this difficulty, yet at the same time maintain
her statutory duties and responsibilities. She may aim to develop a relationship based on
friendship and trust, but if she judges that the child is in danger she does have the power to
act with the power and backing of the state. This is a fine line but research indicates most
clients appreciate that this line exists. On the occasions where the line is crossed,
difficulties emerge and the client reviews the position. For the social worker, there is a fear
that by acting to protect the child, the relationship of trust that is vital to the effective
functioning of support services wilt be destroyed. The objective is to maintain the child in
the family and it likely that the child will be returned at some stage. How does the social
worker act in the best interests of the child, the client and the family? In two of the cases
examined, social workers were forced to cross that line. At the same time, they maintained
or at least limited any damage to the relationship.

CASE STUDY. Non-accidental injury: In the case of two heroin uses living together in a
stable relationship, there was suspicion that the child had been deliberately injured. Social
workers took the decision to remove the child to the care of a relative. This took place
close to Christmas a period that appeared to intensify the strong emotions generated (“It
was to be our first Christmas all together”). The addict couple continued to trust the social
worker that strove to explain the precise reasons for the action. It appeared however that
their focus was primarily on the absent child. The child’s bedroom was arranged in a
shrine-like manner, toys left ostentatiously by the door. The apartment was scrupulously
tidy. Everything was geared to getting the child back and it appeared that, to the clients, its
return would rectify all ills. Whilst very understandable, this manifested as a demonstration
- the outward and visible sign of “being able to manage” were meticulously maintained. It
is the social workers task to go beyond appearance and get to the essence of things. There
was enough doubt in this case for the child to be kept outwith the parental home. The
social worker managed to safeguard the relationship, although it appeared to have suffered
some distortion. From the point of view of the client, there were clear positives and
negatives.

26
 Pros
• The team know more about drug problems (than other social workers)
• They put a lot of time and effort into their jobs
• They have the child’s best interests at heart
• They help with benefits/they help us if they can
• They have contacts/got me into a (methadone) programme early

Cons
• It is frightening because if you do anything wrong at all, the social worker is there
(to take the kid back). They just go by the book
• It was just a big rush for the social workers to finish before Christmas
• They never give us straight answers. Makes us sweat.
• It’s not always the same social worker.
• They shouldn’t tell the police anything if it is intimate
• They must be sick of us by now, having to be on our backs all the time

The comments appear to indicate inconsistency or ambivalence on the part of the clients.
There is a chance that they may have picked up upon the ambivalence of the social
worker’s role. The worker has to forge the relationship and assist and yet be willing to take
action on behalf of the child. On the other hand the ambivalence may be their own,
projected onto the social worker. Despite honest, comprehensive and comprehensible
explanations from the social worker, it is clear that the many apparent contradictory
opinions of the clients stem from a failure to fully appreciate the role of the social worker
and her statutory duties. They were able to detect that support went beyond what they
regarded as “normal”, but could not reconcile this with the worker’s child protection remit.

The following table attempts to describe how the system appears from the parents’ point of
view (POV) where the parents are subject to or have been subject to child protection action
where the child is removed. As the chart shows, access is determined through the social
worker who is exercising her roles of support, observation and judgement. From the
position of the client-parents the rest of the system looks remote. They cannot rely directly
on the parents and so they appear quite distant - possibly on the "side" of the key
authorities on the right hand side of the display. Their link to the child has become tenuous
and depends on impressing or convincing the social worker that they have the capacity and
stability necessary to have the child back in the parental family home. The social work link
to the child has become the all-important connection. In this system, although some
elements of support (buddy/friend) are acknowledged, they appear conditional. They insist
that the social worker should believe their side of the story. They feel that the social worker
should not give the police any information regarded as "intimate", by which we can
suppose the parents understand as "confidential".

27
Chart 4: POV Parents in child protection case

S upport observation judgem ent

PAR EN T (S) Access S.W . PR O FESSION ALS Liaison

Keep child in hom e Protect child from harm

H appy fam ily life Ensure well being of child
R ecovery from addiction Support parents with services
"N orm ality" Ensure "recovery space" for parents
P rotection

C H ILD
Medical

Security G arda Enforcem ent

Stability
Be with parents Extended fam ily

O ther

This point of view does not exhibit any concrete grasp of the centrality of involvement,
which through discussion and explanation, the social worker has attempted to ensure.. In
this case the worker has explained the existing limitations to confidentiality at all necessary
junctures. That is, she has explained, in lay person's language, the duties and
responsibilities inherent in her role and she has attempted to involve client-parents in
decision-making regarding the child. Whereas the social worker has successfully striven to
set up a partnership, it is likely to work effectively only in so far as no extreme crisis
develops. But in the case of suspected non-accidental injury no chances can be taken. In the
case as described above, the clients deny responsibility for the injury and are annoyed with
the medical staff who are perceived as defining the parents as junkies "stoned" on
methadone. References to their perceived inability to cope whilst on methadone diminish
their status as parents and they detect that medical staff have failed to appreciate the
necessary use of methadone in their recovery. So whereas the social worker's has success in
remaining non-judgemental in regard to drug addiction and recovery, chance remarks at the
hospital exert an undermining influence.

In contradistinction to the above case, another client couple appeared to enormously

welcome the social work visits (one senses it was a key social event to which they looked

28
forward). These parents were relatively unconcerned by the way they appeared. The care
and love with which they treated their child demonstrated the child was in no current
danger. Although they appeared a little sedated, they were assessed to be functioning in an
adequate manner. There was considerable reference to (another) unnamed social worker
deemed to have behaved with a lack of respect and here, the experience of the drug team
social worker was favourably compared with a previous negative experience. And although
the family members were living in conditions that were far worse than those of the case
study above, the social worker was regarded as a friend in whom they placed great
confidence. There was no sign of nervousness or anxiety.

We see here a split in attitudes conditioned by or at least circulating around the child or
children of opiate users. Where there is crisis concerning the child, the social worker is less
likely to be regarded as a friend, supporter or facilitator. But it appears that even where
there is stress concerning the child’s continuing presence in the parental home, dependence
and projection can play a large part in determining attitudes. In the cases examined, the
absence of the social worker was generally condemned. Where social workers have shown
honesty in regard to absences - particularly vacations - the client's attitude takes on a
judgmental tone. The reference to Christmas (above) is not the only instance of
condemnation for going on holiday. Condemnation extended to the length of vacation and
destination. The more the destination is perceived as exotic or out of reach, the more the
condemnation. The client is ever watchful of the social worker. Where the social workers
are acting as “buddies”, their role modelling is vital. At the same time this demands
disclosure. In the process, the client observes and assesses the (mostly external) signs of
clothes, car, leisure activities, vacation. Conversely, where the social worker is exhibiting
signs of stress or appears to have a problem, the clients can be very supportive. In one
instance of a car breakdown, the clients acted as friend to the social worker offering
reassurance and support. At the risk of minimising the genuine warmth shown to the social
worker on that occasion, this could be regarded as either sharing or a reversal of power.
The dynamic of the buddy relationship is therefore one that is liable to fluctuate and should
be closely monitored.

5.2 The family view of drug team social workers. Love, guilt and reparation.
This research indicated that family support for the family member who is experiencing
addiction problems varies considerably with the type of relative, emotional distance from
the addict, geographical distance from the addict. Mothers and children offered the most
support. Siblings also offered support but appeared generally more inclined to exhibit
feelings of frustration, aggression, anger and distrust. This resulted in “giving up” on the
client based on an assessment that the addicted sibling showed no likelihood of recovery.
An addict’s mother talks about the reaction of her other daughter:

They (the siblings) got fed up but they never did anything bad. But there was a
disagreement when M. was high on drugs and her sister and she fell out. It was stupid.
I was at her sister’s when she came down at Xmas wanting the child. Her sister told
me I was going to have to be hard (and refuse to let M. see her child). Then she gave
M. the cold shoulder. But she has mellowed now because she heard that some of her
(M’s) friends hung themselves ....

Although there can be no doubt that siblings are prepared to provide care for the addict’s
children, this (often as time of recovery lengthened or there were relapses) was often
conditional on denial of access. Whereas the children’s grandmothers undertake
29
considerable and unconditional support activities, the altruism of siblings is probably
limited by their own family responsibilities - children of their own, family, husbands,
wives and so on. But the dynamics of family conflict circulate around the erratic behaviour
of the opiate user. Observing the affect on the mother, siblings appear more likely to
exclude the addict sibling to protect the addict’s child, their mother and themselves (in that
order). Although love and care is not absent, the addict carries the totality of blame. The
research indicated that the presence of the drug team social worker curtails many of these
anxieties on the basis that:

• something is “being done”

• there is a “someone” to contact, complain to, make suggestions to
• the involvement of the "authorities" may persuade the client-parent to address
recovery

As a rule of thumb, it can be said to be addicts’ mothers rather than fathers13 who bear the
brunt of care. The care however is marked by anxiety and guilt and it appears typical for
the mother’s coping strategies to be tested to the limit. At a time when the mother should
be settling into a relatively relaxed time in her life, she must recommence the child care
duties which she has already performed for her own children. What implications does this
have for the specialist social worker? At this stage, the support of the social worker as
“buddy” is critical. Since the mother is getting older and could also be working, her extra
care duties with a concomitant demand on time and scheduling are apt to prove extremely
arduous. As a consequence of community fears, she is also likely to have a limited forum
for discussion of the problem. Resulting mental or physical health difficulties could impede
the capacity of the mother to assist in the addict’s recovery, so the opportunity to talk (or
offload) to the social worker is a vital function of the drugs team.

In the case of one of the mothers interviewed as part of this investigation, the presence of a
non-judgmental worker who could provide practical support, information and knowledge
and a sympathetic ear helped her to manage her own life and that of her daughter. This
proved vital in the case of M. Attempting to juggle care for her grandchild and her
(addicted) daughter with the demands of a full time job, she found the practical support of
a social worker from the drug team invaluable. M’s mother said:

If she (social worker) comes in, up her feet will go on the chair. No note book, no
angry look, no “you let the children away with too much!” So I could not have got
through - financially as well - if it weren’t for her. If I come up against anything, then
I can ring the social worker. And I can tell other people about this now whereas I
was afraid before.

In this case, the social worker assisted in maximising financial support of the mother. At
the time of the research, she was helping with an insurance problem created by her
daughter’s actions. A combination of social work style (befriending and non-judgemental
support) and practical know-how facilitated the carer in helping her daughter. It is
interesting to note how the mother’s outlook has changed. Now she can now talk about the
problem without embarrassment. Her employers have proved supportive in offering the
flexibility she needs to pick up her grand children from school and she states that she now

13
The “absent father” appears typical in these cases. In cases here and elsewhere, the father with alcohol
problems is a background figure.
30
has no difficulty in explaining circumstances to work colleagues. Despite her obvious
strength and coping capacity, social work assistance diminished the increasing internal
pressure within the family.

In this case, the mother had reached the stage where she would be able to help others in the
same situation and welcomed the idea of a support group. In some areas, parents of addicts
and those in recovery from addiction have come together to form such groups. The benefits
of this kind of response are clear. Besides the therapeutic effects of talk there can be a
reduction in isolation, diminution in guilt and the sharing of burdens. Active support in
terms of fun outings for (grand) children have been organised by these groups14. However,
the conditions pertaining in the locality may not always permit the formation of self-
sponsored support structures. In the area under investigation, rivalry of location and
perceived differences in social status prevented people getting together. Another mother
interviewed was particularly glad of support from the social worker. And although her
situation was similar, it was apparent that she did not have the necessary confidence to take
up this option. The differences in perceived status of localities appeared to militate against
participation. It was likely that she and others could not participate in the self-disclosure
necessary for the functioning of a support group because guilt and shame seemed (to them)
to present an insurmountable obstacle.

Specialised social work support for families of drug users is providing a range of assistance
that goes beyond traditional casework. The mothers’ of addicted sons and daughters now
regard the social worker as a friend. In common with the clients (addicts), they admitted to
having previously regarded social workers as a threat. The latter views, typical enough in
marginalised communities, demonise the professional worker. “They only want to come in
and nose around your place” is a reported response from one addict’s husband - himself an
addict and ex prisoner. “They’ll take the kids off you” is another15. Yet often the
information that informs these views is second-hand. Where parents have no knowledge of
or contact with social workers, they are apt to be influenced by stereotypes. So the service
they received went far beyond what they expected. Additionally, they appeared rather more
likely to recognise the honesty and involvement of social workers than the addict clients
themselves. The commitment of social workers to transparency of action16 was appreciated
in a mature manner. Even where the threat of a care order was present, parents welcomed
the emphasis on full explanation, no matter how unpalatable.

What are the key social work contributions in this instance? The following appear to be the
most pertinent areas:

• being there: being reachable and available in a crisis

• being non-judgemental: the families, sons and daughters with problems are regarded as
people first and clients second
• being a buddy: the carer can often feel isolated and alone. The friendliness of the social
worker is major consideration in building and maintaining effective relationships

14
The Reachout group in Killinarden is one example.
15
The perceived threat of removal of the child to residential accommodation is ever-present and is usually an
unacceptable option for families.
16
Explanations of reasons and the likely consequences of action taken.
31
• having know-how: the social worker is knowledgeable about services, legislation and
rights and is thus a valuable resource for families
• having contacts: the positioning of the social worker within the welfare system gains
her access to those who have resources. It allows for the circumvention of gatekeepers
and other barriers

5.3 The comparative position

The social worker is forced to juggle two sets of attitudes. She must nurture the family and
ensure that it has the capacity to support the client or clients. At the same time, she must
provide a service to the (addict) client, promoting the welfare of the child by assisting the
client in achieving stability and recovery. Where a family member takes responsibility for
one or more children, that person is more likely to regard the social worker as a friend than
the client who is living with the immediate pressure of addiction and recovery. For the
family, the social worker appears to represent a solid anchor point. The child protection
function is more readily accepted since the child is liable to be placed in the care of a
relative and the formality of procedures offers the carer a firm position from which to
discharge care duties.

In the case of the client who is living with addiction problems, the spectre of the removal
of the child tends in some manner to either distort or dominate the social worker
relationship, depending on the level of crisis involved or the proximity to a crisis situation.
Yet clients understand and pay lip service to the necessity of maintaining social work
contact and there can be no doubt that they appreciate the differences in approach. Even
where there has been no previous social work contact, clients will make comparisons based
on cultural expectations or via word of mouth or hearsay. So during the course of the
research, it was difficult to detect any animosity directed at drug team social workers. Yet
neither were clients overwhelmingly grateful as is sometimes the case in some community
projects17. In the cases where the social worker was regarded as the “key” which opens the
door of services or resources, any falling short of objectives tended to be blamed on the
social worker - particularly where housing was concerned - rather than the state, society or
market conditions. This tends to be couched in terms of "she should really have been able
to manage this or that". Again, clients show some awareness of the social workers ability to
"pull" in contacts on behalf of their client. Yet they appear to exhibit a somewhat
unrealistic view of the capacity, status and power of the social worker as regards other
agencies.

5.4 The pleasure principle: treats, fun and living life.

The Drug Team provides regular outings for the clients’ children. Underlying the provision
of leisure opportunities for child and family lie several objectives for drug team social
workers.

• the child may not normally be involved in such trips due to family low income or the
inability of the parents to provide such trips due to opiate use. As such this is an aspect
of education, socialisation and interaction, which may otherwise be lacking for the
child

17
See Shanks, C., Opiate users and the Child support Function, Killinarden-CARP, Dublin, 2000
32
• the social occasion provides an opportunity to asses the child outside the family
environment
• the social occasion provides an opportunity to observe the relationship between child
and parent
• trips and outings can provide a break for parents and/or families under pressure
• trips and outings are in themselves good fun and hence perform a therapeutic function

Additionally, drug workers from the community network are encouraged to join such trips,
thus giving them an extra perspective on their clients and indeed on innovative social work
practice. This constitutes a non-controversial area in this study! Everyone interviewed felt
that the provision of fun activities for children was most beneficial, finding them both
valuable and instructive. Clients acknowledge that they cannot currently provide the
necessary resources not merely for admission to such venues as zoos museums etc, but that
the ancillary spending on food, drink and fares placed such trips beyond their reach (“If we
went, we wouldn’t be able to afford it. We would have to buy everything and bring them in
for burger and chips and all”).

Display 4: Satisfaction levels concerning children outings

Position or role Qualified satisfaction levels

• Outings integral to approach of drug team

• Observation of children promoted greater knowledge
Drug Team about affects on child
Social Workers • Observation of children with parents informed child
protection
• Funding for trips available but cash/petty cash
availability presents some administrative difficulty
• Those who participated report this as a valuable
experience (“brilliant ..”)
• Widened appreciation of drug team members and their
Network professionals work
• Added perspective on clients, families and workers
• Very appreciative of trips.
• Acknowledgement that activities were currently outside
Clients their own financial resources ("we can't afford them")
• Most indicate they would like more opportunities for
outings
• A variety of sources report that the children exhibit a
Children high level of satisfaction ("he loved the trip to the
butterfly farm")
• Non social-work professionals note that no fear of
social workers is exhibited by children
• Children satisfaction indicated by further demand

33
The trips and outings organised by social workers can be regarded as very successful. In
addition to the inherent therapeutic value, the opportunities for the child’s social
development are extensive. Additionally, there are very few negative aspects apart from
that affecting any specialist work with clients’ children or children at risk. The primary
drawback of such work appears to be in those cases where the child feels singled out for
special treats. This negative and unintended impact increases with the age of the child and
usually manifests at the time when the child asks “can my friend come with us on the trip?”
It is understandable that the child may either fail to understand reasons for exclusivity or
begins to appreciate that he or she is in a kind of “social club” where membership depends
on the negative status of the parent. There appear to be no definite ways in which to avoid
this apart from a) acknowledging the problem and taking measures to limit adverse impact
and b) seizing the opportunity to increase the involvement of older children in supporting
the parents’ rehabilitation18.

The research therefore indicates that this valuable element of the work should continue and
be enlarged. Whilst accepting that parental involvement may be variable, the following
options may be possible:

• To extend the range of trips available

• To use some trips in a didactic manner: that is, to promote drug awareness in a “fun”
way
• To involve clients, parents and siblings in the organisation of such trips
• To “spin off” some activities such that the organisation and administration does not
reduce client contact time

Current developments in homework clubs offer an possibility for development.

Intensifying active links with school liaison officers in order to integrate children into
existing clubs will create an organic opportunity for social workers. The community and
neighbourhood nature of these clubs present a chance to “drop in” in for an informal visit.
Additionally, given the extensive network developed by the drug team social workers, the
opportunity of involving other professionals in leisure provision is worthy of consideration.
As can be seen from information on networks, the level of personal contact and
professional respect that already exists could be mobilised in child leisure provision where
fun and play are creatively combined. Where client intervention is shared, there is common
ground for development. At the same time, many professionals are also community
activists and devote spare time to elements of their professional work. As such, they can
feel that they are “spreading themselves thinly” already. The need for support groups here
appears as a more critical since these groups can themselves provide.

• extended leisure opportunities for children

• develop productive relationships for adults and increase skills
• reduce social work administration time
• provide additional forums for productive social work involvement

18
This appears to be present in many cases. Children are very supportive of their parents and often exhibit a
keen awareness of difficulties (often they appear mature “beyond their years”)
34
The parents and siblings of clients can certainly learn from existing groups. It is therefore
suggested that the team encourage selected parents to visit19 functioning support groups in
the city area and beyond. This should be designed to raise self-esteem, increase status and
provide for a pleasurable experience. Often, such groups are regarded as peripheral but I
wish to recommend they become more centrally integrated. It should be recognised that
developmental training will be required to improve the ability to manage such ventures. As
such this report wishes to recommend that budget should be available for such
development. The budget should also allow for the managerial time involved in
facilitating the setting up of such a group and costs should accommodate training,
supervision and support.

It must be noted however that the child protection function must extend through all
developments at the community level. The responsibility for training does not remain
solely within the Department. The compartmentalisation that exists within the (very
effective) drug network sometimes militates against the development of an holistic support
structure. This is examined in the chapter regarding networks. Helping the parents and
family of client-parents (addicts and recovering addicts) could extend more organically
throughout the sector. It is through this function that the Drug Team can, through creative
use of its central position, stimulate and facilitate strengthened community support
structures.

19
In this way, it may be possible to reduce any conflicts of location and perceived status for parents
35
SECTION 6: FINANCE, RESOURCES AND THE ROLE OF THE DRUGS TASK
FORCE

6.0 Introduction
In developing funding mechanisms for the Drug Team, we need to look at benefits existing
within the system. For example, is this a system that could be supplied independently
through hiring qualified social workers and providing a service at community level? Does
the service have to be located within the Department? Can it be located more effectively
and economically elsewhere? I have attempted to look at positive and negative
consequences of the current arrangement..

The current arrangement operates in the following fashion. The Drugs Task Force funds the
Department to provide a Drug Team and mount social activities for the child support
function. Task Force funding pays for the salaries of 3 full time social workers. I will
ignore the staffing difficulties for the purposes of the exercise below and return to the
question later in this section. I have used nominal figures for the Department cost
equivalent since the team's finance costs are necessarily "hidden" in existing Department
accounts. Thus budget heads do not allow for anything other than estimates. The table
below must therefore be used as a guide only.

Display 5 : Cost comparisons

Partner Budget head Cost or equivalent

• salaries: 3f/t posts
• Drug Task Force • activities £90.000

• premises £12,000
• trainee attachments20 (1) £15,000
• training (ongoing and specialist) £9,000
• reception staff (telephone) £15,000
• telephone and communications £6,000
• Department • power: light, heat £1,500
• capital equipment £10,000
• computer record system (software) £500
inc. in rent
• canteen facilities
£6,000
• car allowance (reimbursement)
£1,500
• consumables

• Department total • all 76, 500

It is clear from the above table that the service could not be mobilised without the
resources currently provided by the Department. As such, it presents as a good value for
money (VFM) exercise for the Drugs Task Force and appears to constitute a more or less
20
Trainee costs should be apportioned, bearing in mind that training requires supervision from full time
professional staff. Some training and supervision costs are included in the establishment budget.
36
equal financial partnership. Naturally, the question remains as to whether the service could
be improved outside the remit of the Department. This would require a cost benefit
exercise where the advantages of an external independent service would have to be
weighed against (roughly double) existing costs to the Drugs Task Force. It is
recommended that the Department undertake such an exercise as a mater of urgency.
When complete, the Department should be able to calculate the cost per client, per
family and per child. It will then be in a position to compare this with the cost of
supervising other cases. At the same time the Drugs Task Force will then be able to make
informed choices regarding VFM and extension of the service.

I am forced to comment on the lack of team leader and the inordinate time involved in
replacing vacant posts. The position of the Department in regard to labour scarcity is
however acknowledged, but it is impossible to ignore the repercussions of this situation.
The team has for the greater part of its existence worked without benefit of a team leader.
As a result, a policy vacuum developed. Social workers by dint of hard work and effective
use of considerable organising skills managed to temporarily overcome this problem at the
operational level. But the consequences appear to be as follows

• a lack of direction for the remainder of the team

• a lack of training implementation
• a lack of essential supervision functions
• a failure to maintain adequate monitoring
• a lack of policy development
• a build up of team frustration
• a lack of team cohesion

It is therefore recommended that the Drugs Task Force launch discussions on the
resolution of this issue. It is recommended that the Task Force fund an extra team
leader post and that the work undertaken by the post holder should be restricted to
the Drug Team.

6.1 Role of the Drugs Task Force

In funding the Department operation, the Task Force needs to ensure that this is work that
would not otherwise be carried out in the normal course of Department business. That is,
its financial contribution should be seen to carry added value for the target community.
Discussions with clients and families suggest that clients do feel they are receiving a
different kind of service and are drawn to make positive comparisons drawn either from
their own previous experience or the experience of peers. The role of the Task Force in this
regard is to maintain a close contact with the Department, ensuring that the Team is not
submerged in general social work.

In order to avoid internal conflict21, it is recommended that social workers play their
part in emergency duties thus maintaining contact with mainstream social work and
personal relationships with work colleagues. It is further recommended that the Task

21
It is to be expected that social work colleagues might feel that a those with a lower caseload are in a
favoured position. It is necessary to convey to all social workers the nature and intensity of the specialist
function.
37
Force set up formal liaison sessions to take place at regular intervals. These meetings
would be designed to ensure the sovereignty of the Drug Team and ensure that target
community's interests are fulfilled. The meetings would take the following shape:

• receive reports on the overall state of work with opiate addicts and families
• discuss trends, compare statistics, implement monitoring
• discuss issues where problems have arisen
• take measures to eliminate problems and refine the service
• ensure continuity of staff and speedy staff appointments
• monitor appointment procedures
• assess efficiency and effectiveness of the work
• ensure the specialist training function is in place
• ensure that client's voice is heard
• discuss plans for support work (outings) and ensure that sufficient funds are available
• ensure that the work of the team dovetails with the remainder of Task Force funded
operations
• plan future developments

It is recommended that these meetings be the responsibility of the team leader. The
team leader should ensure that these meetings take place at regular intervals and that
some level of informal contact with Task Force officers takes place between meetings.

38
SECTION 7: OPTIONS FOR DEVELOPMENT

7.0 Introduction - making a difference in casework

The casework approach adopted by the Drug Team may not appear to be so different from
mainstream work. It is rather a matter of degree, emphasis and balance.

• Degree: The Drug Team approach pushes out the boundaries of the client-professional
relationship to the degree that the social worker is a buddy or friend
• Emphasis: The Drug team emphasises the inherent quality of the person. The client is
regarded as sovereign and remains a citizen with all human rights intact
• Balance: the Drug Team seeks for a balance between supporting the addict in recovery,
mobilising family support and engaging with services at community level.

Fundamentally. the casework approach adopted by the Drug Team is underwritten by a

basic attitude to human rights. Whilst it conforms to traditional social work values, it
emphasises the citizenship of the client in a distinctive manner. Additionally, it extends
these values into the community in which the team works. Thus at one and the same time,
the individual and the community are valued. In the Drug Team approach, support
functions are mobilised on behalf of the client and the client’s children. But the family
members receive social work support although, technically, they are not clients. Social
workers have managed to adopt a "buddy" or befriending role whilst continuing to carry
out professional social work that fulfils statutory requirements. As previously explored,
this is difficult and demanding task, which requires a combination of professional
discipline and the employment of personal interaction skills. Such workers have cultivated
a self-awareness that allows them to develop trust with clients and clients' families in a
manner that is somewhat different from mainstream social workers.

My social worker helps me by talking to me and I trust her. We need more social
workers like her. If you judge people, then you won't be liked. She is like my best friend
and I would tell her anything. [client]

The most striking feature of Drug Team social workers is their openness, frankness and
honesty in relation to clients. I believe that this is the basis for their consistent approach.
Naturally, this appears different to clients who have in some cases been misled or even lied
to in previous encounters with authority figures. Their willingness to respond to the
disclosures of the social worker is an indicator of trust and appreciation. This is not to say
that problems may arise and they may feel angry with the social worker in the same way as
they might with a family member. ("they shouldn't have done that".). At the same time
there is an acknowledgement that the social work system has limitations and that the social
worker has statutory duties to perform. Thus the client's ambivalence described in Section
5 seems at least partially due to her recognition of the state's role in ensuring child
protection.

Criticism and blame tended to be directed at other state institutions, Police, Hospitals,
Housing Department and so on. Clients suggested that their Drug Team social workers
understood their problems - whereas others (in the community) did not. It was also very
evident that clients knew they were regarded as fellow citizens. That is, they were aware of
being treated as people as opposed to cases. This attitude may have encouraged clients to
39
be frank in regard to personal information. In all client interviews, clients were prepared to
take responsibility for their drug use. This is in contradistinction to some members of other
client groups who often erect elaborate blame structures, which project responsibility onto
other individuals, organisations or the state. I must again stress that most clients welcomed
and looked forward to the visits of their social worker. I found this both unusual and
refreshing. At the same time, the social workers managed to avoid being partisan in the
way in which some community agencies work. The constraints of the Department does not
allow for such an independent stance. Nevertheless, clients acknowledged that team
workers would "fight their corner" and were aware that social workers were in a position to
either secure services at community level or to negotiate on their behalf for scarce
resources.

7.1 Areas for development

Housing and accommodation: A few clients expressed criticism of social workers in regard
to what had been achieved on their behalf. In particular, accommodation presented various
difficulties that were not within the gift of the social worker to resolve. Clients affected
found it difficult to acknowledge the structural problems that give rise to the housing crisis
affecting those on low-income. Although social workers can "open doors" where other
professionals are refused entry, social workers are not in a position to resolve this question
and as such are subject to considerable constraints. Yet, the difficulties of living in
cramped and rule-bound hostel accommodation with no cooking facilities probably reduces
the clients’ critical function more than most problems.

People here drink and fall down the stairs. It's not nice for the child to see … the kids
are getting fleas and they pick up needles. The drugs wouldn't bother me if I had my
own place. You see it around you all the time … especially when you have been
addicted, because they do it in your face. [client in hostel]

In these cases the client often jettisons solidarity and turns on other marginalised groups. I
feel that this increasing frustration and hostility diminishes the chances of recovery and
perhaps the Drugs Task Force could usefully examine opportunities for accommodation for
recovering addicts. This would be designed to ensure that clients are not placed in
circumstances that endanger their recovery. One of the most serious matters to be resolved
is that of the unwillingness to relocate recovering addicts to housing estates elsewhere.
Such a move will often reduce the likelihood of slipping back into drug use through peer
contact. It is recommended that the Task Force-Drug Team liaison group (as
recommended) examine this question with a view to launching accommodation
projects for recovering opiate users. The City Council would make a useful partner in
such a venture and perhaps draw housing officers to more rigorously define and distinguish
drug use from drug distribution. Involvement of social workers in such discussions would
help to create a professional and dispassionate examination of such problems and mobilise
the Drug Team role of combating prejudice.

Support Groups: An earlier section drew attention to the creation of support groups. Such
groups are vital in building the confidence of the client group, especially carers in the
extended family. I have drawn attention to the problems of perceived status that arise in
more mature housing developments. Area conflicts may have intensified due to economic
change that has brought with both a change in tenure and attitudes. Older solidaristic

40
patterns break down as "right to buy" arrangements cut across the public rented sector. This
can be seen in some outer-city wards. As a result, residents begin to define themselves in
relation to parts of estates, especially those that border areas that are considered as more
"up-market22". As a result, the types of action that would increase solidarity and reduce
stigma are difficult to mobilise. Drug Team social workers, through engaging with the
community sector, can acknowledge these differences and work with them - although quite
clearly this is a role for community development. The proposed team leader could take the
responsibility for mobilising such groups, using those carers identified in the course of
casework. It might be useful to start with a single area, gradually inviting the involvement
of those from nearby estates. Arrangements can be made for participants to attend drug
awareness courses, which in any case may be sponsored by the Drugs Task Force.
Participation in these courses may well promote liaison with others who would assist them
in group development. If the carers feel they have a contribution and that their voices will
be heard, they will develop at a faster rate. A Drug Team leader might usefully visit
existing city groups and invite participants to engage in informal discussions with selected
carers. It is recommended that the Drug Team commence the process by initiating
informal discussions with interested carers, education providers and existing groups.

The demands and limitations of client support groups have been outlined elsewhere in this
report. Yet whilst it is difficult to get involvement from those living with opiate addiction,
it has proved possible. As the work of the team progresses, those who have achieved
successful rehabilitation may offer the best opportunity for eliciting the voice of the opiate
user. A users advisory group would provide a support mechanism for those in the period
immediately following recovery23 . Furthermore, it offers clients a chance to have a say in
service delivery and an opportunity to discuss emerging problems or dissatisfactions. It
may also offer opportunities for mobilising a buddy or befriending system . This system
would provide extra support for those in recovery. I do not envisage the system utilised by
Alcoholics Anonymous although this might be successful for some clients. The system
should rather look to providing the kind of support that in line with the Drug team ethos,
targets the person rather than the substance.

7.2 Child Care

Interviews with Drug Team social workers revealed a need for a childcare specialist to
work with the team. Children constitute a prime focus for the work of the Drug Team and
clients clearly wanted assistance with children. The fact that social workers were there for
their children had enormous significance. Attention has been drawn to the complex impact
on children of parental opiate use. Careful identification of problems and appropriate
referrals to other agencies require enormous knowledge, care and tact. Such a worker
would require similar sensibilities to those that I have described. He or she would need to
work with both clients and families, ensuring that the needs of the child are met in an
appropriate and effective fashion. Additionally, there would be a large role in the effective
provision of outings and social activities that improve the confidence and outlook of the
child. It is recommended that the Drug Team seek a childcare attachment to work
with the team on a permanent basis.

22
This is common in many European housing developments. See Shanks, K. et al, Social Action and Local
Change, Community Development Foundation, London. 1991
23
We have to acknowledge that some opiate users may stabilise but never recover. This group also offers an
organisational possibility.
41
42
7.3 New team and co-ordination structure
Implications for the structure of the team are outlined in Diagram - below. This charts the
responsibilities of the team leader and the relationship of agencies outside the Department
with team members is omitted. The Team Leader is responsible for the following structural
activities.:

• Co-ordinating the work of the Drug Team

• Liaison with the Drug Task Force
• Liaison with the Community Network
• Liaison with Support Groups
• Liaison with User Group

Chart 5: Proposed structure of Drug Team and related bodies

Community
Network Chid care worker

Social Worker 1
Opiate User
Advisory Group
TEAM LEADER Social Worker 2

Social Worker 3
Carers Support
Group (s)

Drugs Task Trainee

Force

External Agencies or groupings

EHB staff

Client user and support groups

The diagram above shows the links between Department and agencies and groups (blue
lines). Links between the agencies are shown (red lines). This Partnership arrangement
merges state, community and client in a tripartite arrangement and is designed to increase
voice and participation. It should be regarded as something to be aimed for over a number
of years, rather than a structure that can be implemented immediately or "grafted on" to
existing structures. If the structure emerges organically then its sustainability is likely to be
greater. This tripartite relationship is one example of the Partnership arrangements
described under the National Development Plan and related measures under the
Department of Justice, Law and Equality. It is recommended that the Drugs Task Force

43
implement such a structure over a designated number of years, underwritten by a 3-
year development plan. The support mechanisms can then be built in manageable stages.

Display 6: Consumer model

Consumer model summary matrix

• no personal access to • access by telephone • drug team could

social work offices for • fast response by increase referrals
clients workers through
• Some problems with • clients are happy community sector
Access telephone access with telephone • drug team
• cases limited to contact members could
referrals • Social Workers can hold open access
• child protection meet clients at "surgeries" in
priorities apply nearby premises. community
• minimum client facilities
dissatisfaction with • success of team
access arrangement may increase self
referrals

• Drug Team extends • choice in children's

• Limited choice in
localities
Choice • No other (e.g.)
community sector
casework projects
choice in localities activities could be
• project increases extended
choice for client • arrangements for
recovery options eliciting the voice
• project increases of the child could
choices for children be improved

• participants have • clients user group

• participant (clients)
involvement limited by
Voice addiction recovery
process
ability to be involved could increase
but chaotic lifestyle democracy and
limits capacity transparency
• user and support
groups offer a
route for problems
to be raised
• children’s rights
issues should be
taken into account

• accountable through • interaction with • Drug Team could

government community sector invite participation
department produces more by selected clients
Accountability • accountable to Drugs transparency • Participation could
Task Force • accountability could be extended to
• social work ethical be extended recovered clients
standards and codes through user groups
of conduct

44