THERAPEUTIC APPROACH

Therapeutic Approach to Social Welfare Families

Therapeutic Approach to Social Welfare Families

Introduction

Evidence has accumulated that parental substance abuse is a major contributing factor to child maltreatment, and may be an important issue to address among parents who come into contact with the social welfare system. Estimates of the prevalence of substance abuse problems among parents who have contact with the child welfare system (the majority of whom are mothers) are highly variable, but range from at least half to 80%. Parental substance abuse has been associated with high rates of child maltreatment in community-based epidemiologic studies as well as in studies using administrative records. Substance-abusing parents are less able to provide adequate shelter, care, and economic stability for their children, and hence their children are at high risk of neglect. Further, impaired judgment and emotional dysregulation contribute to child abuse potential in parents who have substance abuse problems. Moreover, among mothers who become involved with the child welfare system, those who have substance abuse problems are more likely to lose their parental rights, compared with nonsubstance-abusing mothers (Figley, 1999).

Discussion

As a result of growing awareness of the linkage between parental substance abuse and child maltreatment, efforts are underway to improve the coordination of services to parents and children who come into contact with the substance abuse treatment and child welfare systems. Yet at present, little is known about the characteristics of women in substance abuse treatment who are also involved with child welfare, as compared with other mothers, particularly regarding their drug use and treatment history, pathways into treatment, and clinical profile at treatment admission.

Orientations of substance abuse treatment and Social welfare systems

Greater awareness of the association between parental substance abuse and child abuse and neglect has made it imperative that the two systems interact and coordinate services for parents who are simultaneously involved with both systems. Substance abuse treatment providers and child welfare agencies are increasingly called upon to collaborate by jointly providing services and in making determinations of parental fitness and recommendations for child placement outcomes (Norton, 1998). However, historically these two service delivery systems have had differing orientations, goals, and organizational cultures, which have led to fragmentation and lack of coordination of services and case planning. Moreover, coordination of services across systems is further impeded when women fear that they may jeopardize custody of their children if they enter substance abuse treatment or when they are reluctant to admit to substance abuse problems in child welfare assessments.

Substance abuse treatment is oriented to the process of recovery from addiction, based upon a model of addiction as a chronic, relapsing disorder, which is sometimes referred to as an “addiction career”. Hence, recovery from addiction may not ensue from a single treatment episode, but may require long-term, if not lifelong, intervention, similar to other chronic diseases such as hypertension, asthma, or diabetes. Periodic relapses to substance use as well as multiple treatment episodes are viewed as typical parts of the recovery process and constitute a “ treatment career” (Brunner, ...