Mothers in Addiction Services who have had their children removed
Research type
Research Study
Full title
Study to investigate the feasibility of developing a psychological intervention to support mothers within NHS Addiction Services who have had their children removed
IRAS ID
211262
Contact name
Lynda Russell
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde
Duration of Study in the UK
1 years, 11 months, 23 days
Research summary
There is increasing international recognition that the needs of women who have experienced the removal of their children is poorly understood and services struggle to support these women during and after the removal process. Current research suggests that removal of children is associated with a deterioration in mental health, increased risk of self-harm and suicide attempts and relapse of their alcohol and/or substance use. In addition, a subset of this group of mothers will go on to have further children who are at increased risk of being removed from their care.
Female service users who have had children removed from their care and are currently working with the Alcohol and Drug recovery service in North West Glasgow will be invited to undertake a one off interview about their experiences of removal and contact with services. Staff members will also be interviewed about their experiences of working with and supporting this group of women.
10 to 15 women and 10 to 15 members of staff will be interviewed. All interviews will be transcribed and analysed using interpretative phenomenological analysis. The results will hopefully allow us to shape the service we provide to this group of women by developing an intervention for women who have experienced removal of children, training for alcohol and drug recovery service staff and good practice guidelines for other services who have contact with these women such as primary care, maternity services and children and families social work.
Summary of Results
Paper 1 - Mothers
Parental substance use can expose children to harm and risks to their wellbeing, and removal from parents care is sometimes necessary. This can result in feelings of grief and poor mental health in parents, and concerns about a lack of support to prevent child removal or to have their children returned. Previous research has mainly focused on children or foster and adoptive parents experiences rather than birth parents. This study, therefore, aimed to develop an understanding of the experience of child removal and contact with services from the perspectives of mothers with an addiction. Twelve mothers accessing Alcohol and Drug Recovery Services in Scotland and who had children removed from their care were interviewed about their lived experiences. Using Interpretative Phenomenological Analysis (IPA), four themes were identified “safe/unsafe”, “changing identity”, “loss” and “no way to win” with important implications for service development. Services that can develop a sense of safety in their client through continuity in workers, clarity and consistency about boundaries and communication with other services and supporting mothers to feel respected and validated as a person and as a mother, regardless of whether their child/ren are removed, are more likely to engage their clients and achieve better outcomes.
Paper 2 - Staff
Parenting can be impacted by substance misuse, and children can be at risk of maltreatment, leading to their removal from their mothers. Successful treatment of substance abuse relies on these women gaining effective support from services. Previous research has demonstrated the impact working in this field can have on staff, including high staff turnover, vicarious trauma, and burnout. The present study further explores the experience of staff members working in a Drug and Alcohol Recovery Service in Scotland who work with mothers who have had their children removed. Six interviews with nurses and social care workers were analysed using interpretive phenomenological analysis (IPA). Two superordinate themes were developed from the data: (1) complexity and tension within working relationships and (2) emotional experiences and attempts to resolve them. Participants described the complexity of their roles, including the dual role of supporting mothers while also being involved in the child removal process by providing reports and evidence and how they respond and work with mothers after removal and conflicts with the wider system. They also highlighted their attempts to cope with the emotional impact of being part of this process and the empathy they have with mothers, especially when they are parents themselves, and described the complexities of trying to cope and manage when working in this challenging area. Clinical implications, including training needs and requirements, are discussed.
REC name
West of Scotland REC 1
REC reference
17/WS/0255
Date of REC Opinion
20 Dec 2017
REC opinion
Further Information Favourable Opinion