Project Leads: Deb Rutman, Carol Hubberstey & Marilyn Van Bibber - - PowerPoint PPT Presentation

Funded by: FASD National Strategic Projects Fund Public Health Agency of Canada

Project Leads:

Deb Rutman, Carol Hubberstey & Marilyn Van Bibber (Nota Bene Consulting Group) Nancy Poole (Centre of Excellence for Women’s Health)

Timeframe: 45 months

February 2017 – October 2020

Project goals:

² To bring together many of Canada’s holistic FASD prevention programs to share promising approaches and practices; ² To undertake a prospective, multi-site evaluation on the effectiveness of FASD prevention programming serving women with substance use and complex issues; and ² To identify characteristics that make these programs successful.

National Evaluation of Multi-service Programs Reaching Pregnant Women at Risk

Co-Creating Evidence

Program Sites

Women accessing Level 3 FASD Prevention programs

Key Issues for Women at intake

(of Level 3 & 4 multi-service programs)

Unsafe and/or inadequate housing

Food insecurity

Poverty;

underemployment

Lack of access to /

disconnection from health and social care Transportation issues

Isolation

Intimate partner violence

Experience of violence

• r trauma, including:
• Systemic &
• Inter-generational trauma
• Lateral violence

Experience

• f foster

care Impacts of residential school and colonization

Poor physical health & dental

health

Mental Wellness

Substance use / substance- affected

Self-esteem / Self- confidence

Parenting challenges Maternal-Child separations

Theory of Change (Summer 2017)

Women-centred –

women set their

• wn goals for service

Harm reduction –

focus on minimizing harm and promoting safety

Trauma informed -

appreciating that many women have experienced serious trauma

Culturally grounded –

employing cultural programming and approaches & appreciating the multi-generational impacts of colonization

Inter-disciplinary; developmental lens –

addressing women’s and children’s needs holistically

Kindness; compassion –

using de-stigmatizing language, minimizing shame and guilt

Relational –

focus on safe, respectful, non-judgemental relationships

By employing these approaches…

Practical & material support aimed at

addressing basic needs

e.g. transportation, clothes, infant supplies, income/ employment, community resources

Prenatal & post- natal health services

and/or helping women to access these services

Cultural programming Facilitating peer connections for

women and children

group-based support; drop-in; child care

Women’s health

services / referrals

Substance use counselling,

education, support & referrals

Advocacy, accompaniment,

• utreach re: child

welfare /safety

…and by undertaking these activities:

Food- and nutrition-

related

Housing- related

Parenting

programming

to support mother- child connection

Trauma-related

education / support

Children’s health

services /referrals

and/or assessments, early intervention

Practical & material support aimed at

addressing basic needs

e.g. transportation, clothes, infant supplies, income/ employment, community resources

Prenatal & post- natal health services and/or helping

women to access these services

Cultural programming Facilitating peer connections for

women and children

group-based support; drop-in; child care

Women’s health

services / referrals

Substance use counselling,

education, support & referrals

Advocacy, accompaniment,

• utreach re: child

welfare /safety

…and by undertaking these activities:

Food- and nutrition-

related

Housing- related

Parenting

programming

to support mother- child connection

Trauma-related

education / support

Children’s health

services /referrals

and/or assessments, early intervention

…these

• utcomes will
• ccur:

Mother – Child Connection

(no matter where child is)

Safe Housing

Reduced partner violence

Women keep/ regain their children in their care

Knowledge about parenting & child development

Healthy pregnancy & baby/child

Improved nutrition

Reduced problematic substance use

Basic needs support & connection to community resources

Improved Wellness

Self-esteem/ Self-confidence

Self-compassion/ self-determination

Increased support

Systemic Change

…these

• utcomes

will occur: Mother – Child Connection

(no matter where child is)

Safe Housing

Reduced partner violence

Women keep/ regain their children in their care

Knowledge about parenting & child development

Healthy pregnancy & baby/child

Improved nutrition

Reduced problematic substance use

Basic needs support & connection to community resources

Improved Wellness

Self-esteem/ Self-confidence

Self-compassion/ self-determination

Increased support

Systemic Change

To Date

v Interviews with 125 women at 8 programs v Interviews with program staff & partners at all programs v Quarterly program stats

National Evaluation of Multi-service Programs Reaching Pregnant Women at Risk

Co-Creating Evidence

v HR as defined by staff :

• Working with women where they’re at
• Supporting women to reduce harms in their life
• Working with women to develop safety plans

for their child/ren and themselves if they relapse

v HR…in the context of a holistic programs serving pregnant/parenting women & children

• No substances on site
• No coming to the program high

Preliminary reflections on Harm reduction

v Programs’ diversity

v Complexity related to programs’ location/co-location v Complexity related to women’s substance use

Preliminary reflections: Harm Reduction Issues & challenges

What does harm reduction look like in practice here? We struggle. We’re not always on the same page.

Program staff

It’s a real struggle, balancing women’s and children’s safety and evicting women. - Program staff I love the groups and the format of the groups, but sometimes I have differences with the women who come here who aren’t in recovery. It’s

• ff-putting when there are women

who are smoking weed outside or if they’re high when they come in here.

– Program participant

I don’t like the Harm Reduction part. It’s hard to mix people trying to stay clean and people still using. – Program participant Sometimes it is hard to live with addicts – they are always talking about drugs. I guess it’s normal but sometimes it is a trigger.

– Program participant

I have lived an “ugly style of life” and wanted to get away from that. Seems like HR makes it okay to be an addict. The harm reduction approach is not a good fit for women who are wanting to stay clean. I don’t like them coming in high on drugs. The mandate is to keep us mothering – and that doesn’t go with drugs and alcohol. – Program participant

Harm Reduction - Issues & challenges Reflections from staff & program participants

v Women don’t feel judged or stigmatized v Women feel that staff understand their experiences and struggles v Feeling safe promotes & sustains trusting relationships with staff v Women connect with health and social services, cultural programming, and each other

Preliminary reflections: Harm Reduction Strengths

It’s a safe place to be and they treat me like a mom first and an addict

• second. There’s no judgement.

It’s really helpful. I never feel judged. I’m not scared if I relapse. It’s an opportunity and a blessing. It’s an amazing place for women and

• children. You take the first step. It is safe

and there’s security. You’re not judged if triggered. They understand. Other programs, when you say you’re on drugs, they judge you. Here they understand; most of the workers understand what you’re going through. The environment made me feel very comfortable and relaxed. It wasn’t institutional, which I had experienced

• previously. I didn’t feel ashamed or
• judged. They took me from addiction

to recovery to parenting.

Re: Harm Reduction – the benefits Reflections from women

Deb Rutman, Carol Hubberstey or Marilyn Van Bibber:

notabenegroup@shaw.ca

Nancy Poole: wavelength@telus.net

For more information: