Addressing the treatment needs of children affected by maternal addiction: challenges and solutions (original) (raw)
Related papers
Substance abuse treatment for mothers: Treatment outcomes and the impact of length of stay
Journal of Substance Abuse Treatment, 2006
This article examines the treatment outcomes of 305 women enrolled in a comprehensive, residential substance abuse treatment program for pregnant and parenting women and their children. The women were assessed at intake and three times in the year after discharge. Analyses focused on change in client functioning over time, and investigating the impact of length of stay in treatment on client outcomes. Comparisons of clients' functioning before and after treatment suggest significant improvements in a number of domains, including substance use, employment, legal involvement, mental health, parenting attitudes, and risky behaviors. For most outcome domains, results suggest that longer treatment stays are associated with more positive outcomes.
Evaluation and Program Planning, 2004
This paper summarizes outcome findings from an evaluation of residential treatment projects funded by the Center for Substance Abuse Treatment (CSAT), in the Substance Abuse and Mental Health Services Administration, under its Residential Women and Children and Pregnant and Postpartum Women demonstration programs. It first examines client-level treatment outcomes as indicated by pre-post changes in drug and alcohol use, criminal involvement, economic well-being, parenting success, and other important outcome dimensions. Post-treatment status was assessed through interviews administered 6 months after discharge to a sample of approximately 1200 former clients from 32 treatment sites. The paper also examines projects' success in obtaining continuation funding after the initial 5-year CSAT grant ended. Project sustainability provides another major indicator of the perceived value and effectiveness of the treatment program's services. Key findings were that a majority of former clients (61%) reported being completely drug-and alcohol-free throughout the followup period, large pre-post improvements were noted in other important areas of client and family functioning, and most of the projects begun with CSAT seed-money support (92%) were able to continue operations after the grant support ended.
Child Abuse & Neglect, 2006
Problem: Greater awareness of the role of parental substance abuse in child maltreatment makes it imperative that the substance abuse treatment and child welfare systems coordinate services for these parents. Yet little is known about the characteristics of child-welfare involved parents (primarily mothers) who enter into substance abuse treatment. This paper compares the characteristics of mothers in substance abuse treatment who were and were not involved with child welfare services, and discusses the treatment implications of these differences. Method: Data were obtained from a statewide treatment outcome monitoring project in California. Clients were assessed at treatment admission using the Addiction Severity Index. Bivariate analyses and multivariate logistic regression were conducted comparing mothers who were (N = 1,939) and were not (N = 2,217) involved with child welfare. Results: Mothers who were involved with child welfare were younger, had more children, and had more economic problems. They were more likely to be referred by the criminal justice system or other service providers, to have a history of physical abuse, and to be treated in outpatient programs. They had lower levels of alcohol severity, but did not differ with regard to psychiatric severity or criminal involvement. Primary users of methamphetamine were disproportionately represented among this group and had a distinct profile from primary alcohol-and opiate-users.
Journal of Substance Abuse Treatment, 2001
This article examines a comprehensive, residential substance abuse treatment program for women and their children. A majority of the 72 participants studied were African American single mothers, for whom crack/cocaine was the drug of choice. The women and their children were assessed repeatedly during treatment, and at 3, 6, and 12 months postdischarge. Program impact was estimated by comparing the outcomes of three groups that differed in the amount of treatment they received: early dropouts, late dropouts, and treatment graduates. Program graduates showed more positive outcomes than the nongraduate comparison groups in the areas of drug use and negative consequences of use, employment and self-sufficiency, and family interaction skills. Young children enrolled in treatment with their mothers were assessed using a developmental screening test, and older children with a measure of drug refusal skills. Results from both child measures suggest substantial improvement.
Treatment needs of drug-addicted mothers
Journal of Substance Abuse Treatment, 1995
Substance abuse among women is associated with several negative maternal as well as chiM outcomes. This article reviews the theoretical and empirical literature on salient domains of risk and vulnerability among addicted mothers, with a view toward identifying critical components of effective intervention programs.
Substance Abuse, 2002
A benefit-cost analysis of specialty residential treatment (Specialty) and standard residential treatment (Standard) was conducted on a sample of pregnant and parenting substance abusers from Arkansas. Economic benefits were derived from client selfreported information at treatment entry and at 6-month postdischarge with the use of an augmented version of the Addiction Severity Index (ASI). The average cost of treatment in Specialty programs was 8,035versus8,035 versus 8,035versus1,467 for Standard residential treatment. Average net benefits (benefit-cost ratios) were estimated to be 17,144(3.1)forSpecialtyand17,144 (3.1) for Specialty and 17,144(3.1)forSpecialtyand8,090 (6.5) for Standard. The main policy implication of this research is that investment in Specialty residential treatment for pregnant and parenting substance-abusing women appears to be economically justified, but future evaluations should analyze larger and more comparable samples to improve power and precision in the benefit-cost statistics.
Substance Abuse Treatment Prevention and Policy, 2010
Background: The rate of women with substance abuse issues is increasing. Women present with a unique constellation of risk factors and presenting needs, which may include specific needs in their role as mothers. Numerous integrated programs (those with substance use treatment and pregnancy, parenting, or child services) have been developed to specifically meet the needs of pregnant and parenting women with substance abuse issues. This synthesis and meta-analysis reviews research in this important and growing area of treatment. Methods: We searched PsycINFO, MedLine, PubMed, Web of Science, EMBASE, Proquest Dissertations, Sociological Abstracts, and CINAHL and compiled a database of 21 studies (2 randomized trials, 9 quasi-experimental studies, 10 cohort studies) of integrated programs published between 1990 and 2007 with outcome data on maternal substance use. Data were summarized and where possible, meta-analyses were performed, using standardized mean differences (d) effect size estimates. Results: In the two studies comparing integrated programs to no treatment, effect sizes for urine toxicology and percent using substances significantly favored integrated programs and ranged from 0.18 to 1.41. Studies examining changes in maternal substance use from beginning to end of treatment were statistically significant and medium sized. More specifically, in the five studies measuring severity of drug and alcohol use, the average effect sizes were 0.64 and 0.40, respectively. In the four cohort studies of days of use, the average effect size was 0.52. Of studies comparing integrated to non-integrated programs, four studies assessed urine toxicology and two assessed self-reported abstinence. Overall effect sizes for each measure were not statistically significant (d = -0.09 and 0.22, respectively). Conclusions: Findings suggest that integrated programs are effective in reducing maternal substance use. However, integrated programs were not significantly more effective than non-integrated programs. Policy implications are discussed with specific attention to the need for funding of high quality randomized control trials and improved reporting practices.
Enrolling and retaining mothers of substance-exposed infants in drug abuse treatment
Journal of Consulting and Clinical Psychology, 2003
This study provided an experimental test of a drug abuse treatment enrollment and retention intervention in a sample of 103 Black mothers of substance-exposed infants. Significantly more women assigned to the Engaging Moms Program enrolled into drug abuse treatment than did women assigned to the control condition (88% vs. 46%). Sixty-seven percent of participants in the Engaging Moms Program received at least 4 weeks of drug abuse treatment compared with 38% of the control women. However, there were no differences between the groups 90 days following treatment entry. Logistic regressions revealed that readiness for treatment predicted both short-term and long-term treatment retention. The Engaging Moms Program has considerable promise in facilitating treatment entry and short-term retention, but it did not influence long-term retention.
Family Process, 2019
Behavioral health and substance use centers have started focusing efforts on creating, adopting, and implementing evidence-based practices and programs that effectively address the needs of women and, particularly, mothers entering treatment with children. However, women with substance use disorders (SUDs) remain an underserved and understudied population; even less studied are the complexities and unique SUD treatment needs of women who have children. Family therapists' systemic training is a valued approach in conceptualizing and implementing treatment for mothers with SUDs and their families. This study explored the construct of mothering children during family-centered substance use treatment using a transcendental phenomenological approach. Analysis revealed themes related to motherhood, parenting, and support for mothers and children. Two themes emerged from the data: (a) grappling with motherhood and addiction leading to the decision for treatment and (b) specific aspects of the treatment program conducive to motherhood. Results indicated the positive impact of mothers' experiences in family-centered substance use treatment, aligning with previous literature that suggests mothers are more engaged in treatment when their children remain in their care. The insights gleaned from the participants in this study provide suggestions for further improving programming that supports mothers and their children during the recovery process. Treatment considerations are offered for family therapists working with mothers with SUDs and their families.
Parental stress and child behavioral outcomes following substance abuse residential treatment
Journal of Substance Abuse Treatment, 2000
Residential treatment programs specifically designed for alcohol/drug-addicted women and their children have become a popular treatment modality across the United States. Outcome evaluation of these programs are beginning to show promising results. In this article, outcome data from a study of a residential substance abuse treatment program for women and young children in rural South Carolina will be presented. Data from 35 women and 23 children in the area of addiction severity, parenting and child emotional and behavioral development at 6 and 12 months following discharge from a substance abuse residential treatment program is examined. Results showed that women who completed treatment had better scores on addiction severity and parental stress, and their children had improved behavioral and emotional functioning at 6 and 12 months after discharge from the program. These results suggest that residential treatment has benefits for mothers and their children. This data adds to the growing body of evidence supporting intensive and inclusive care for certain groups of individuals with substance use disorders during critical periods.