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

Area of Science:

• Medical Ethics
• Child Welfare
• Addiction Medicine

Background:

• Clinicians face challenges assessing child protective concerns in families with parental substance use disorder.
• Lack of standardized care leads to inconsistent approaches, from avoiding assessments to reflexive reporting.

Purpose of the Study:

• To present a clinical decision-making framework for assessing parental substance use and child safety.
• To standardize clinician discussions regarding substance use and parental capacity.

Main Methods:

• Development and implementation of a multidisciplinary clinical decision-making framework.
• Discussion of five key assessment areas: child safety, parental use patterns, treatment engagement, escalation of services, and home environment stability.
• Presentation of a clinical scenario to illustrate framework application.

Main Results:

• The framework aims to standardize care and guide action planning for immediate safety, treatment, and recovery support.
• Highlights challenges and opportunities in integrating harm reduction principles into child safety assessments.

Conclusions:

• The developed framework provides a structured approach for clinicians managing families with parental substance use disorder.
• Standardizing assessment and care improves outcomes for both child safety and parental recovery.