Parenting through addiction: ‘It strips you as a mother but builds you back up’

Parenting programme for high-risk families helps to turn lives around

Living on the streets of Cork and pregnant with her fifth child after the older four had been taken into care, the future looked bleak for Anne Marie Taylor. After a severe beating when she was 12 weeks into her pregnancy, she was admitted to Cork University Maternity Hospital (CUMH) where she detoxed, “mostly off alcohol”. But she was warned that neither she nor her unborn baby were likely to survive if she went back on the streets.

The daughter of an alcoholic mother, who is now sober, she reckons she started drinking at about 11 years of age: “We’d get a sup of it to keep you warm.” She was addicted to drink and drugs at 13 , was locked up in institutions from the age of 14, and imprisoned at 17.

As medical staff at the CUMH, along with members of the Arbour House drug rehabilitation centre in Cork, tried to decide what was best for Taylor, a referral to the Coolmine Therapeutic Community in Dublin was suggested. It was a big move but she decided there and then that if the baby she was carrying survived, she would never return to Cork.

Taylor went into Coolmine’s residential centre for women – Ashleigh House in Damastown, near Clonee – the day before her 33rd birthday. She was assigned a key worker and a “big sister” (a former addict) and she says “everyone rallied around me”.

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Just over two years later, she is looking well and full of optimism as she talks in Coolmine’s drop-in offices on Lord Edward Street, in the shadow of Christ Church Cathedral. She is trying to amuse 18-month-old, red-haired Jayden with a Mickey Mouse film on her phone while she recalls the “hard and intense” programme at Ashleigh House that helped to turn her life around.

Describing it as her first real home, she says initially she found it very hard to settle into her apartment there. “I was so used to living outside; I wanted to be outside.”

Part of the rehabilitation, she explains, is telling your life story. “At the start you are thinking it is easy and then, it is only as you are going through it, you start getting your own memories as a child.” You look at where things started to go wrong, and to see a pattern.

“I would have blamed a lot on things that happened when I was a child,” she says. “As I go on, I know it is part of my journey and you learn how to deal with it.”

Antenatal tests at six-and-a-half months in the Rotunda Hospital had reassured Taylor that all was well with the baby. But a care order was put on him as soon as he was born.

“Myself and a key worker from Ashleigh House brought a case and the judge wouldn’t remove Jayden from my care,” she says. The judge listened to her and gave her the chance to prove herself a capable mother.

During her time in Ashleigh House, Taylor was one of the first mothers to pilot a 10-week Parenting Under Pressure (PUP) programme there. Devised in Australia for high-risk families, it aims to help parents with addiction problems to manage their own emotions and to give them skills to care for their children more effectively.

“I remember thinking ‘this is not going to work’,” says Taylor wryly, of advice such as “get down on your knees and look into the child’s eyes and talk to the child”. But she did it anyway, and was amazed to see the difference such small steps made.

With the support of staff at Ashleigh House, she bonded with Jayden – something she admits she hadn’t done with her older children. On contact visits while they were in care, she hadn’t known how to interact with them.

The PUP programme works from the basis of looking at a mother’s strengths but, as somebody who had had very little affirmation in her life, Taylor struggled with this.

“You don’t believe in yourself as a mother. Every single week I would be in the office saying, ‘Maybe I should put Jayden into care; maybe I should sign the papers.’ ” She was always questioning her abilities as a mother, although Ashleigh House staff were constantly reassuring her that her son would not be better off in care.

Working through PUP brought up deep feelings about motherhood. “I felt guilty because I had this bond with Jayden,” and that made her realise what she had missed with her other children.

“You don’t understand how tense it is as a mother, sitting in a group and listening to other mothers about stuff: the course was very, very hard to do,” she says. “It completely strips you as a mother, but then it builds you back up as a mother as well. It gives you that bit of confidence, sitting in a room with other mothers: and even the people who are taking it are sharing their experience.”

Since “graduating” from Coolmine in April last year, Taylor has been living independently in Dublin with not only Jayden but also her 14-year-old son who has returned to her out of care.

‘Remarkable change’

Sitting in the corner listening to Taylor tell her story is one of the co-founders of PUP, Prof Sharon Dawe of Griffith University in Brisbane, Australia. Although she is used to hearing about the positive impacts of the programme, it is still “remarkable that she has changed her life to that extent”, she says of Taylor after we climb two flights of narrow stairs to talk in an office above.

Dawe is a clinical psychologist, and PUP is the result of collaboration with her husband and fellow psychologist Dr Paul Harnett. She was working in a London drug clinic setting up liaison services for pregnant women while he was involved in child protection, deciding whether addicted mothers should keep their babies.

When the couple went to Australia together, about 17 years ago, they decided to try a parenting project, using traditional programmes.

“We didn’t set out to create our own programme but we found that the programmes were really structured and expected families not to be in a state of chaos. And the families we were working with were really chaotic.”

The focus of traditional parenting programmes was behaviour management and, “while that’s very important, the parents we worked with had come with a history of trauma; their own [abuse as a child]; their incapacity to manage their own emotions. So in a way it wasn’t about how to do parenting but telling them how to get into a state of mind when you can be an effective parent.” That is where mindfulness came in.

“We don’t say, ‘You can’t manage your emotions, come to PUP’. We say ‘Best parents are calm parents most of the time; let’s work out how we can help you to be calm most of the time.’ ”

The need for an individualised approach soon became apparent. Instead of being coached through a series of identical stages, each family starts with an assessment to decide on key target areas.

PUP has been evaluated in several pieces of research in Australia and is now the subject of a major study in the UK, among families with children aged up to three, by the University of Warwick in conjunction with the National Society for the Prevention of Cruelty to Children (NSPCC), which provides a 20-week, home-visiting version of the programme.

Dawe says generally about one-third of participants in PUP succeed in turning their lives around while another one in three will make some gains and may need long-term support.

“Unfortunately,” she continues, “about one-third of the families make no change, or deteriorate.” Those are families where social services need to make good decisions earlier, she argues, “and not have children bounce around the care system in the first five years of their life before somebody makes a call. The timeframe is ticking for the child.”

Age and intervention

While, in an ideal world, PUP would be used for children as young as possible, she believes that the drive for early intervention in recent years has meant the possibilities of intervening slightly later have been overlooked or lost.

“I think that notion about irreversible damage has been overstated,” she says. “It is actually rather a poor reading of science because what we have is ongoing evidence of neuroplasticity throughout childhood.”

Between the ages of three and six there is a surge in brain development and an increase in self-regulatory abilities, she explains, and she is keen to do more with that age group.

Governments are very enthusiastic about running group parenting programmes, as they are seen as being cost-effective. But the evidence for involving high-risk, complex families in parenting groups is very poor, she says. They simply don’t turn up.

In developing the individualised, home-based approach of PUP, she and Harnett realised that life “matters”, as she puts it. “You’re not going to engage in a programme around parenting if your electricity is going to be cut off next week.”

A lot of social work is about fixing people’s problems. She often hears those in the field say they work with a family for six months and all that happens is that it goes from one crisis to the next.

“The problem with that is the family never learns to take responsibility, or learns how to solve problems,” she says.

“One of the things that is embedded in the PUP programme is setting a goal and then working with the parent about how – we call it an action plan – you get to that goal.”

With considerable achievements behind her, Taylor has her sights on plenty more goals.

Jayden has just started attending a creche five afternoons a week, giving her time to go to life coaching and take a course in computers, as well as study for her driver theory test.

“It’s really good to have a routine – for the three of us,” remarks Taylor, who says she has not lapsed back into drink or drugs since doing the Coolmine programme. She feels her future is bright.

“I have stable housing, a home for myself and the two boys and a great relationship with my children – and I am going to my first family wedding [that of a niece] on May 15th, which I can’t believe.”

For more information, see pupprogram.net.au

swayman@irishtimes.com