Development of a Clinical Decision-Making Framework to Address Parental Substance Use and Child Safety

Five main assessment areas will be discussed, including: 1). Safety of the child while substance use is occurring; 2). Safety of parental use patterns; 3). Parental treatment engagement; 4). Willingness to escalate treatment services; and 5). Stability of the home environment. We will present a clinical scenario to highlight how the framework is used as an aid to determine action planning with respect to immediate safety concerns, treatment escalation, and opportunities to maximize recovery supports. We discuss the challenges we've experienced and opportunities that arise in attempting to incorporate the principles of harm reduction within the context of assessments of child safety and well-being.