Summary of the impact

A high proportion of social work clients have alcohol or drug problems, ranging from 5% in some adults services to over 70% in children's services. Workers find this work challenging, and misuse is strongly associated with negative outcomes, including abuse and neglect. The Tilda Goldberg Centre (TGC) leads research on substance misuse in social work, that has had the effect of:

• Identifying often hidden problems, through key studies on, for example, the extent of parental misuse in Children's Services and problem drinking in older people;
• Improving effective practice, such as intensive family interventions and the use of Motivational Interviewing in Children's Services;
• Influencing policy and practice debates, including studies of training that have changed the curriculum for social work education and for local authority training;
• Developing capacity in quantitative expertise in social work research and education as a direct spin-off from our research on substance use and misuse.

Underpinning research

TGC has undertaken 28 funded research studies over the last 10 years worth over £2.5m.

Identification: Forrester (Professor, May 2007-) undertook the first large-scale study of the extent of substance use and outcomes among families receiving children's services (Nuffield Foundation 1999-2002). This lay the groundwork for our understanding of the high proportion of families affected by substance misuse, of the lack of preparation among social workers for working with alcohol or drug issues and of the poor outcomes for children. Wadd's (Research Fellow, 2010-) groundbreaking work on the extent of alcohol problems in older people used epidemiological analysis of existing datasets to establish the unexpectedly large number of older people with alcohol issues, the impact on services and the effectiveness of treatment (Social Care Trust (SCT), 2012-14). Galvani (Assistant Director of TGC and Principal Research Fellow (2008-) has used online survey and rapid review methods to identify that, despite working with many clients with drug or alcohol problems, social workers receive little training either at qualifying level or subsequently (SCT, 2011-12; Alcohol Research UK (ARUK), 2012-13; Home Office, 2010; Scottish Office, 2012). Currently, Galvani is researching new areas where alcohol use is under-explored, using mixed methods in work with people with visual impairments and with the Sikh community.

Improving effective practice: Forrester's subsequent research has focused on evaluating different interventions for such families. This included the first studies in the world looking at Motivational Interviewing (an effective intervention for alcohol issues) in child and family social work, including a pilot study and a current randomized controlled trial (Alcohol Education and Research Council [AERC — now Alcohol Research UK] 2002-4; Social Care Trust 2011-12), the first studies evaluating intensive family preservation services in the UK (Welsh Government 2006-8; (AERC 2009-11) and a companion systematic review of the outcomes for children entering care. Galvani and Wadd have carried out important evaluations of small but innovative services for families and older drinkers respectively (Camden, 2011; SCT, 2011).

Influencing policy and practice: many of our studies have been commissioned by policy-makers to inform decision-making. Forrester's evaluations for the Welsh Government led to funded consultancy work to influence policy change from 2008. Galvani and Forrester reviewed the literature on substance use and social work for the Scottish Government to inform the `recovery' policy development from 2011.

Capacity development: Improving the capacity for quantitative research is a national priority in the social sciences, and in social work in particular, with the aim of improving quantitative expertise among social work teachers and qualifying social workers. The Centre's work on substance use demanded high quality quantitative analysis evident in Wadd's epidemiological analysis and Forrester's current RCT. As a result of developing this expertise, we were described as a centre of excellence for quantitative research (Sharland, 2009 p.120). On behalf of the Joint University Council Social Work Education Committee (JUCSWEC) and funded by the ESRC, the Centre is leading two national programmes to develop the teaching of quantitative skills for social work academics, as well as being involved in leading the two previous ESRC RDI programmes.

References to the research

Rated as "5-star" by the AERC, this is the first study exploring the use of Motivational Interviewing in child and family social work.

A key output from the Nuffield Foundation study that was the first to establish the extent and nature of substance misuse in children's services

The first evaluation of intensive family preservation services in the UK, this led to further funded research and extensive policy and practice reform in Wales.

An important policy-relevant review challenging the (then) orthodoxy that care necessarily causes poor outcomes for children.

A key source identifying the lack of training in this area.

One of the first qualitative studies to explore alcohol misuse amongst older adults.

Details of the impact

Identification: Wadd's work on drinking in older people was used in the Big Lottery fund (BLF) proposal for £25 million investment to improve evidence-based responses to problem drinking in older age (www.biglotteryfund.org.uk/global-content/press-releases/uk-wide/030613_uk_rgh_alcohol-misuse). This led to a request to brief Age UK, which then decided to engage with the BLF, in partnership with Alcohol Concern and other multi disciplinary organisations. Galvani's studies of training for social workers in substance use have directly contributed to the higher profile of substance use in social work education for the last decade, resulting in a commission to write The College of Social Work's (TCSW) guidance for social work educators on substance use for the revised qualifying programmes in England (2012). (See www.tcsw.org.uk/uploadedFiles/TheCollege/Media_centre/Curriculum%20Guide_Substance_17Jul y2012_proofed.pdf).

Improving effective practice: Forrester's evaluation of a service to prevent care led to a consultancy (2008-09) for the Welsh Government on the reform of social services (`Stronger Families'), and recommendations (in the Children and Families (Wales) Measure 2010) on new services for families with serious problems and the career structure for social workers. Specialist teams are being set up in every authority, contributing to better preventive services for tens of thousands of families in contact with social services in Wales. Of Forrester's six reports for the Welsh Government, two informed policy formation and four underpinned the roll-out of the Stronger Families reform. Forrester's work on the outcomes for children in care led the Welsh Government to remove the proposal that local authorities should have a legal duty to reduce the number of children entering care, replacing it with a focus on intervening to reduce the need for care while recognising that care can be a positive choice. It has also influenced English policy on adoption. A Demos report (2010) and Narey's report for the English government (2011) both extensively quoted Forrester's research [5.1]. These reports led to policies that increased the number of children being adopted between 2011 and 2013. Galvani's work has had a similar impact on services for families where substance misuse is linked to domestic violence. For example, Galvani worked with Adfam and AVA to develop resources for families on living with substance use and domestic abuse, improving the quality and scope of staff training [5.2, 5.3]. Forrester's work currently focuses on creating evidence based organisations where policies and practices are designed to produce effective helping relationships. The work involves transformational change programmes in 6 local authorities, with current and future impact on outcomes for the tens of thousands of vulnerable families these authorities serve. This work informed the analysis during early 2013 of the implications for training and education in social work, which developed into TGC's successful tender later in 2013 for the delivery of Frontline, a training programme aimed at increasing the skills of qualifying social workers.

Influencing policy and practice: Galvani's research influenced the profile of substance use teaching, including the provision of materials for TCSW as good practice exemplars. The materials she produced with Forrester for the Higher Education Academy (e.g. www.swapbox.ac.uk/8/) were identified by the Subject Centre for Social Work and Social Policy (SWAP) as an example of excellence in teaching. They have been distributed to all 157 qualifying social work programmes in England. The TCSW endorsement underpins the use of these resources in core teaching on social work programmes in England. Galvani's work has influenced BASW's approach to professional updating [5.4]. Each of five BASW pocket guides (www.basw.co.uk/group/?id=10) was distributed to over 20,000 social workers and other materials from this research are being distributed to every UK qualifying programme. Wadd's research provided a focus for a Panorama programme (Old, drunk and disorderly? September 2012) on drinking in older people, which was seen by an estimated 3m viewers and which contributed to the development of the Big Lottery initiative. Forrester's research was the focus of a BBC Scotland documentary (Home is where the hurt is, July 2009). Forrester completed the British Association for Adoption and Fostering guidance (Parenting a child affected by parental substance misuse, 2012) about children affected by parental drug or alcohol issues, which is used to improve the preparation of all prospective adopters.

Capacity development: Finally, the Centre has had an impact on the development of greater quantitative research literacy among practitioners. Our work has ensured that quantitative analysis plays a greater role both in social work research and in social work education. Of particular relevance is Forrester's lead on two current ESRC programmes to develop and deliver a core curriculum for quantitative research in social work. This has been incorporated into the qualifying training in 15 (of 80) universities, influencing the research literacy and confidence in at least 770 social work students each year (or around 17% of the social work students qualifying each year).

Sources to corroborate the impact

5.1 Statement from M Narey (Special Adviser to the Department for Education)

5.2 Statement from ADFAM

5.3 Statement from AVA

5.4 Statement from BASW

Policy or Practice References to the work:

5.5 Advisory Council on the Misuse of Drugs (2003) Hidden Harm: Responding to the needs of children of problem drug users, ACMD/Home Office (republished on GOV.UK, June 2011) www.gov.uk/government/publications/amcd-inquiry-hidden-harm-report-on-children-of-drug-users

5.6 DEMOS (2010) In Loco Parentis, by Hannon, C., Bazalgette, L. and Wood, C. Online www.demos.co.uk/publications/inlocoparentis

5.7 Six Reports and briefings disseminated by the Welsh Assembly Government available here: wales.gov.uk/topics/childrenyoungpeople/parenting/help/ifst/ifsspublications/?lang=en

5.8 Report for Scottish Government, scotland.gov.uk/Publications/2011/03/18085806/0

5.9 Sharland, E. (2009) Report of the Strategic Adviser to ESRC on Social Work and Social Care Research, www.esrc.ac.uk/_images/Main_report_SW_and_SC_tcm8-4647.pdf (p.120)