“Trial for change”: How hair testing for alcohol and drug can help in family court cases

The welfare of children is paramount in family courts, and these principles are enshrined in both the Universal Declaration of Human Rights (1948) and the UN Convention on the Rights of the Child (1989).

The only UN member state not to ratify the Convention on the Rights of the Child is the US - so, it is perhaps odd that we looked to the US’s adoption of specialist drug courts for inspiration to improve family court outcomes for children.

The FDAC began in January 2008 and replaces traditional care proceedings. It supports parents with overcoming entrenched substance use problems that have triggered the proceedings, taking a problem-solving approach to an issue that has historically seen punitive action take centre stage. It literally tests parents’ motivation to change, by regularly testing to see if they have used alcohol or drugs.

Testing times in family life

Substance misuse, domestic abuse, mental ill health and other trauma make it more likely families will end up in court while exacerbating circumstances include poor housing, poverty, unemployment and wider deprivation. If a family’s case has come to court, they are in crisis. Something needs to change.

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Whatever the reason for the case, the preferred outcome is to keep families together, so long as that ensures the safety and wellbeing of children. The usual time limit for court proceedings in England to conclude is 26 weeks. It’s a long time in a child’s life, but it’s not long for parents to prove they have changed, and that they are on their way to rehabilitation from often deeply entrenched substance misuse.

All change please, all change

In our regular court system, most proceedings are adversarial. In family court everyone is on the side of the children.

The FDAC works because it takes into account the subtle nuances of family law cases, on a case by case basis. It also embodies the idea of ‘trial for change’, shunning immediate punitive measures and aiming to replace them with workable solutions to the issue.

Family Drug and Alcohol Court judges are far more hands on than regular law courts. Their role is to be proactive in motivating parents to change. The same judge hears the case throughout, and between fortnightly review hearings, without lawyers, the family will have input from a multi-disciplinary team who provide regular reports on progress. Unusually the family also have a dialogue with the judge.

FDAC is intense. It is no soft option. Almost all parents say they want to do what is best for their children: FDAC challenges them to prove it.

Addiction care and treatment plans aim towards abstinence. Most parents will already have tried to change, without lasting success. Through the FDAC, parents are tested so they can demonstrate the changes they have made to the FDAC team. All aspects of their childcare are investigated, and, crucially, they are regularly tested for substance use.

To help parents demonstrate their commitment to change, FDAC has fully embraced hair testing. Breath, oral fluid and urine tests show what people have been doing in the past day or so; hair testing, meanwhile, reveals alcohol or drug use for as long as the hair has been growing. Hair grows about 1 cm per month, so testing a 6 cm strand of hair can reveal use over the 26 week FDAC target period.

Hair testing can also enhance motivation. Parents can show the courts, their partner, the world and their children they can stop using over a period. Knowing a test is coming and can’t be cheated can sustain motivation in moments of temptation.

Making a difference

Research evaluations show more parents stop using under FDAC. More are reunited with their children and more successfully sustain the improved parenting over time.

Is there a ‘but’? There is. Money. FDAC interventions cost more than standard care proceedings, but they also show a return on the investment, with every £1 spent on FDAC resulting in a saving of £2.30 (Reeder & Whitehead 2016).

The next test

FDAC is gradually being rolled out across the UK, and there are reasons to be optimistic. Problem solving courts have consistently produced results both here and in the US; it’s not a fluke.

We already knew intensive family interventions can support lasting positive change. All we need now, in a time of austerity, is a willingness to replicate this good practice more widely. If the welfare and wellbeing of children really is paramount we should be able to invest (to save a lot more) in hair testing, and all the other elements that contribute to the success of Family Drug and Alcohol Courts.