# Presentation: 067398

## Meth and Safety Management

-  Theresa Costello, MA
- National Resource Center for Child Protective Services
- A Service of the Children’s Bureau

**Notes:**
The objectives for this workshop are:
 To consider the question of whether to leave kids in their homes or place them when meth use is involved in the broader context of safety decision making
To review critical safety concepts that apply
To provide a method for analyzing meth related family situations to determine what is needed to protect kids
To provide a practical experience of judging what sort of safety management is indicated in a meth-related case

## Meth and Safety Management

-  In-Home or Out of Home?

**Notes:**
The objectives for this workshop are:
 To consider the question of whether to leave kids in their homes or place them when meth use is involved in the broader context of safety decision making
To review critical safety concepts that apply
To provide a method for analyzing meth related family situations to determine what is needed to protect kids
To provide a practical experience of judging what sort of safety management is indicated in a meth-related case

## Covering the Basics	

- Concepts & Analysis

**Notes:**
It seems that people approach the question of safety management in meth cases as if this is such an unusual family situation that a special approach to safety decision making is required.

It’s important to always consider safety decision making and therefore safety management within the context of governing concepts.

The idea is to use concepts as the foundation and to employ them in an analytical process to judge how to manage safety in meth-related cases.

## A Child is Unsafe...

- Unsafe
- Present danger
- Impending danger

**Notes:**
The handout provides definitions, some explanation; and examples.

Review these.

Fundamentally the challenge in determining the right approach to safety management (in home or out of home) is to correctly identify and understand the meth-related safety threats and to evaluate the capacity of caregivers to protect.

Present danger (at initial contact) involving meth issues likely will always require separation of the child from the situation – at least until more information is collected and more can be understood about the nature and extent of meth use and it effects on parenting; protectiveness; and family life.

Impending danger – the state of danger existing because of meth use and related safety threats – is the real challenge for safety management. 

Sufficient information to understand meth use and what is going on is the most important part of the safety decision making and safety management process.

## Universal Safety Threats

- Nobody to supervise
- Violence
- Lack of impulses
- No motivation
- Insufficient knowledge or skill
- Distorted view of a child
- Deprivation of essential resources
- Serious threats
- Intention to seriously harm

- Hiding child; refusing access
- Unmet exceptional needs
- Dangerous environments
- Serious injuries
- Provocative or self destructive child behavior
- Fear as an expression of  threats or terror
- Unexplained injuries

**Notes:**
The universal safety threats (impending danger) is available to participants on the handout.
Review.

“Universal” means that these safety threats are contained in virtually all safety models in one form or another; they represent what is generally accepted as criteria for judging the presence of impending danger.

Safety assessment involves 1) identifying & understanding meth-related behavior and family circumstances so that you can 2) identify safety threats that corresponds to meth-related behavior and family circumstances.

Why is the process so crucial to eventually deciding how to manage safety?  It is one or more of these safety threats that safety management must be sufficient to manage or control. How will you control a meth-related safety threat?

## Meth Related Functioning & Family Situations

- Physically debilitating
- Tremors, weakness, weight loss, headaches
- Psychologically debilitating
- Confusion;  Irritability; Poor concentration;   Paranoia; Hallucinations; Panic reactions;  Fatigue; Depression; Memory loss; Anger;  Insomnia; Psychosis
- Cognitively debilitating
- Recognition; Information processing; Communication; Inability to learn from experience; Attention; Memory; poor judgment
- Parenting & Family Situation
- Inconsistent or avoiding parenting
- Chaotic home life; high-dangerous traffic
- Lack of resources/provisions
- Access to drugs/paraphernalia
- Deteriorating relationships

**Notes:**
These are examples of functioning and family situations that are compromised by meth use. 

These are examples of what one sees in a case that represent the basis for, association with or cause of threats to safety.

This leads to the matching process – family conditions to safety threats.

## Mapping Meth Related Family Conditions to Safety Threats

-  A Handout

**Notes:**
The handout provides a visual for participants to see how this process of information collection; understanding; identification of meth related issues, problems and affected family circumstances reduces down what is happening to the identification of safety threats that must be controlled as the function of safety management.

Walk through.

## Safety Intervention Analysis

-    Definition & Handout

**Notes:**
This is the method for answering the question in meth cases – can we protect the kids in the home or should we remove?

The next slide should be reviewed – the definition – before going onto the handout.  

## Safety Intervention Analysis

- Analyze *meth-related *safety threats; caregiver protective capacity and family information to determine the degree of intrusiveness and the level of effort necessary for assuring that a safety plan will be  effective in protecting a child
- The method to determine in-home or out-of-home safety management in meth cases

**Notes:**
Comment and elaborate.  
Questions?

It may be useful to point out that this is best done when sufficient information is available to fully understand the meth use and its affect on caregivers, children and the family.

Here is a case for why the official full blown safety assessment and official fully blown safety plan needs to be considered at the conclusion of the initial assessment.

## Safety Intervention Analysis

- What Must Be Controlled: How Are Threats Occurring?
- Can & Will a Caregiver Protect?
- How to Judge In-Home/Out-of-Home?
- What Level of Effort is Required for In-home Safety Management?

**Notes:**
This slide provides an overview of the safety intervention analysis questions.

Walk through the handout.

Comment and elaborate.
Discussion and questions.

## The Russell Case

-  Video – Handout - Case Application

**Notes:**
The purpose of this exercise is to bring everything together.
This is a meth case involving a woman who began using meth within the last three months. The effects are already evident and likely will get worse. This is a challenging case in terms of the question of in home or out of home safety management because the meth use has not progressed to the point of fully debilitating the woman or misdirecting her total capacity. However, judgment and responsiveness to her parenting duties are apparent.

## Application

- Review the Russell Intake
- Observe the Interviews
- Read the Russell Initial Assessment Findings
- Identify *Meth-Related *Safety Threats
- Walk Through the Safety Analysis
- Identify In-home or Out-of-home Safety Management

**Notes:**
This slide shows the process to be used to complete the application.

After participants read the intake see if they have any questions.

The video involves three short interviews: with the child; with the non custodial father who is also the reporter; and with the mom. The interviews are excerpts of the initial assessment focused on maltreatment. The initial assessment would naturally involve a lot more information collection that is reflected in the Angela Russell Initial Assessment Findings.  After the video is completed participants may have questions or comments before proceeding.

Following the video participants should read the narrative to gain additional understanding of the Russell family before analyzing for safety management.

Before analyzing the Russell case ask participants to refer to the universal safety threats.  Attempt to reach some consensus about which threats are apparent in the Russell case.

Use the Safety Intervention Analysis handout to walk participants through the process of determining the approach to safety management. 

## Summary: Safety Management in Meth Cases

- How important is fully understanding individual and family functioning as influenced by meth use?
- How important is analyzing/breaking down *meth-related *safety threats?
- Can analysis be used to rule in or rule out in-home safety management arriving at the out of home option?

**Notes:**
These questions frame and summarize the workshop.

## Thank You!

-  _[www.nrccps.com](http://www.nrccps.com/)__ _