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

Project Leads: Deb Rutman, Carol Hubberstey & Marilyn Van Bibber (Nota Bene Consulting Group) Nancy Poole (Centre of Excellence for Women’s Health) Funded by: FASD National Strategic Projects Fund Public Health Agency of Canada

Co-Creating National Evaluation of Multi-service Programs Reaching Pregnant Evidence Women at Risk 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 Timeframe: 45 months programs successful. February 2017 – October 2020

Program Sites

Key Issues for Women at intake (of Level 3 & 4 multi-service programs) Theory of Change (Summer 2017) Experience of violence Unsafe and/or or trauma , including: Intimate inadequate partner Systemic & • Poverty; housing violence • Inter-generational trauma Lateral violence • underemployment Impacts of Food residential school insecurity and colonization Experience Women accessing Transportation of foster issues Level 3 FASD care Prevention Substance use / Isolation programs substance- affected Parenting Self-esteem / Mental challenges Self- Maternal-Child Wellness confidence separations Poor physical Lack of access to / health & dental disconnection from health health and social care

By employing these approaches… Women-centred – women set their own goals for service Harm reduction – Relational – focus on minimizing focus on safe, respectful, harm and promoting non-judgemental safety relationships Trauma informed - Kindness; appreciating that compassion – many women have using de-stigmatizing experienced serious language, minimizing trauma shame and guilt Culturally grounded – Inter-disciplinary; employing cultural developmental lens – programming and addressing women’s and approaches & appreciating children’s needs the multi-generational holistically impacts of colonization

…and by Food- and Practical & material undertaking nutrition- Advocacy, support aimed at these activities: related accompaniment, addressing basic needs outreach re: child e.g. transportation, clothes, infant supplies, income/ Housing- welfare /safety employment, community related Parenting resources programming to support mother- Prenatal & post- child connection natal health services Substance use and/or helping women to access these services counselling, education, support & referrals Women’s health Trauma-related services / referrals education / support Children’s health Facilitating peer Cultural services /referrals connections for and/or assessments, programming women and children early intervention group-based support; drop-in; child care

…and by Food- and undertaking Practical & material Advocacy, nutrition- support aimed at these accompaniment, related addressing basic needs activities: outreach re: child e.g. transportation, clothes, welfare /safety infant supplies, income/ Housing- employment, community related Parenting resources programming to support mother- Prenatal & post- child connection natal health services and/or helping Substance use women to access these counselling, services education, support & referrals Women’s health Trauma-related services / referrals education / support Children’s health Facilitating peer services /referrals Cultural connections for and/or assessments, programming women and children early intervention group-based support; drop-in; child care

…these outcomes will occur: Increased support Safe Reduced Basic needs Housing support & partner Self-esteem/ connection to violence community resources Women keep/ Mother – Self-confidence self-determination Self-compassion/ Reduced regain their Child problematic children in their Connection substance use care (no matter where child is) Knowledge Healthy Improved about parenting pregnancy & & child nutrition development baby/child Improved Wellness Systemic Change

…these outcomes will occur: Increased support Safe Reduced Basic needs Housing support & partner Self-esteem/ connection to violence community resources Women keep/ Mother – Self-confidence self-determination Self-compassion/ Reduced regain their Child problematic children in their Connection substance use care (no matter where child is) Knowledge Healthy Improved about parenting pregnancy & & child nutrition development baby/child Improved Wellness Systemic Change

Co-Creating National Evaluation of Multi-service Programs Reaching Pregnant Evidence Women at Risk To Date v Interviews with 125 women at 8 programs v Interviews with program staff & partners at all programs v Quarterly program stats

Preliminary reflections on Harm reduction 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: Harm Reduction Issues & challenges v Programs’ diversity v Complexity related to programs’ location/co-location v Complexity related to women’s substance use

Harm Reduction - Issues & challenges Reflections from staff & program participants I love the groups and the format of What does harm reduction look like the groups, but sometimes I have in practice here? We struggle. We’re differences with the women who not always on the same page. come here who aren’t in recovery. It’s Program staff off-putting when there are women who are smoking weed outside or if It’s a real struggle, balancing they’re high when they come in here. women’s and children’s safety and – Program participant evicting women. - Program staff I don’t like the Harm Reduction part. It’s hard to mix people trying to stay I have lived an “ugly style of life” and clean and people still using. wanted to get away from that. Seems – Program participant like HR makes it okay to be an addict. The harm reduction approach is not a good fit for women who are wanting to Sometimes it is hard to live with stay clean. I don’t like them coming in addicts – they are always talking high on drugs. The mandate is to keep about drugs. I guess it’s normal but us mothering – and that doesn’t go with sometimes it is a trigger. drugs and alcohol . – Program participant – Program participant

Preliminary reflections: Harm Reduction Strengths 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

Re: Harm Reduction – the benefits Reflections from women It’s a safe place to be and they treat It’s an opportunity and a blessing. It’s me like a mom first and an addict an amazing place for women and second. There’s no judgement. children. You take the first step. It is safe and there’s security. You’re not judged if It’s really helpful. I never feel judged. triggered . I’m not scared if I relapse. The environment made me feel very They understand. Other programs, comfortable and relaxed. It wasn’t when you say you’re on drugs, they institutional, which I had experienced judge you. Here they understand; previously. I didn’t feel ashamed or most of the workers understand what judged. They took me from addiction you’re going through. to recovery to parenting.

For more information: Deb Rutman, Carol Hubberstey or Marilyn Van Bibber: notabenegroup@shaw.ca Nancy Poole: wavelength@telus.net