Gender-responsive service provision is more essential than ever at this critical point in the sector’s development, say Francesca Carpenter and Laura Ward.
Oasis Project was established in Brighton and Hove over 24 years ago by four women who felt their needs were not being met by mainstream substance misuse services. Since then, the service has vastly grown to provide a range of gender-responsive services to women, children and families affected by substance misuse across Brighton and East Sussex. Oasis is part of the commissioned structured drug and alcohol treatment delivery partnership in Brighton and Hove.
Unfortunately, women’s needs are rarely met by generic substance misuse treatment services, which are known to be male-dominated environments accessed mainly by male opiate users. For women who have experienced trauma including domestic/sexual violence perpetrated by men, male-dominated settings can be threatening and overwhelming. Whilst it is widely recognised that experience of trauma is a contributing factor in the prevalence of substance misuse across all populations, there are specific connections between women, domestic abuse and substance misuse. Women who have experienced domestic abuse are eight times more likely to develop a substance misuse problem when compared to the general population and may experience specific forms of abuse in relation to their substance misuse, such as control being exerted over their access to substances and prevention of access to support services.
Oasis’ approach includes delivery of treatment in a women-only building, providing a physically and emotionally safe place for women to access support in an environment which recognises the prevalence of trauma and actively seeks to prevent re-traumatisation and promote recovery. Women report feeling more comfortable in a setting they know is women-only, sharing space with peers and drawing on shared connections, without risk of being in groups and settings with a partner, or ex-partner.
Women who misuse drugs or alcohol are often judged more harshly by wider society than their male peers, leading to greater experiences of stigma and shame which can make accessing services more difficult. These experiences are exacerbated further still in the context of parenting, with many women fearing a disclosure of substance use will lead to separation from their children.
Services often work with either adults or with children, which can lead to age-centric thinking and approaches. The context of family at Oasis Project runs through the whole organisation and bridges gaps through wraparound family support for both parents with drug and alcohol misuse needs and children affected by familial substance misuse.
Staff are well-trained and confident in exploring children’s needs with parents and potential risks associated with substance use, and Oasis has an organisational strength around child safeguarding through our work. Our approach is to sit alongside parents to proactively reduce shame, listen to their worries and provide targeted support to reduce risks in the family including delivery of POCAR, a programme for parents whose children are in contact with social services. The relationship established with parents continues through any involvement from children’s social care, and we support parents to understand local authority processes and their rights as parents.
Childcare is a widely reported barrier for parents who need to access services, and Oasis provides a free crèche for any child affected by parental drug and alcohol use. The crèche is a therapeutic setting for children that recognises the importance of the child’s voice, views, feelings, emotions, and personality, giving every child an opportunity for space to thrive. The crèche is also a vital resource for parents, providing the opportunity to participate in activities that support their recovery, including time in the day for themselves.
Oasis provides free arts-based individual therapy for children and young people aged 5-18 years affected by a parent or family members’ substance use. This service is restorative to children who have experienced abuse and neglect in their families and seeks to provide a safe space for their own recovery. It’s important that the needs of children and young people are considered within the context of substance misuse treatment, and the families’ experience held in mind when working with parents. Parents who access Oasis Project tell us they value support being extended to their children.
It is through our specialist experience and dedication to working with women experiencing substance misuse and associated issues that we have been able to embed a responsive and trauma informed culture, practice and environment. Although necessary components, we consider gender responsive care extends beyond the provision of a women-only space, or a women’s worker, but relies upon an ethos which prioritises understanding of and responsiveness to the intersectional and specific needs and structural challenges women experience. This requires an organisational and systemic commitment to working with the root causes of addiction such as trauma, and responding through approaches which enhance safety and empowerment to promote meaningful recovery.
The promise of increased funding for treatment services through Dame Carol Black’s report and the resulting government drug strategy is really welcomed at such a critical point. Our experience has taught us that to meet the needs of women, children, and families through substance misuse treatment providers, we need gender-responsive service provision, and opportunities for joint children and adult commissioning both locally and nationally. This is essential for breaking down silos and creating greater potential for family focused approaches.
Oasis Project has recently been accredited with the One Small Thing Silver Quality Mark for working with trauma.
Francesca Carpenter is head of client services and Laura Ward is CEO of Oasis Project
Case studies
Sally’s story
Sally (24) is mum to Daniel (3). Children’s social services were involved in the family due to concerns about Sally’s alcohol use. Sally had also experienced domestic abuse from Daniel’s father before Daniel was born. Sally had been in care as a child and found social work involvement with Daniel very difficult. Sally and Daniel’s social worker referred Sally to Oasis’ POCAR programme. Sally had a dedicated keyworker, and Daniel would use the crèche whilst Sally attended appointments and groups. Sally told her keyworker she was scared that Daniel would not be able to live with her, that she had no other family support and felt lonely. Sally would drink to cope with her worries.
In POCAR Sally learnt new strategies to cope with stress and worry. Sally’s self-esteem grew which enabled her to re-connect with old friends. With support from her keyworker, Sally stopped drinking and children’s social services reduced their involvement. Sally completed POCAR and continued to use the crèche to give her opportunity to focus on her recovery. Sally is due to start therapy with Oasis to explore some of her past experiences of trauma and build resilience for future.
Taking Control
‘I’m now looking to the future and taking control of my life. It’s not been easy at all, and I have made some mistakes, but I’m learning from them. I’ve got a long way to go but I want to keep getting better and I’m willing to do whatever it takes to get there. I am slowly getting better, I’ve just got to stick at it and trust the process. I have hope which Oasis has given to me. A massive thank you to my key worker, the Oasis staff, and all the women at Oasis. I wouldn’t be where I am today without you.’ Oasis service user
Alongside adult treatment, Oasis also delivers:
- Young Oasis therapeutic services to children/young people affected by a parent or family member’s substance misuse
- A free crèche to provide childcare where families are accessing recovery support and parenting programmes including Mellow Parenting
- POCAR, an intensive psychosocial intervention for parents whose children are in contact with social services due to risks around parental substance misuse
- Tailored services for young people aged 18-25 including a Young Women’s therapy service and dedicated support to young adults new to treatment
- Looking Forward, for mothers who have experienced child separation following involvement from family courts
- SWOP, a specialist sex workers’ outreach service