Blending Perspectives and Building Common Ground

A Report to Congress on Substance Abuse and Child Protection
April 1999

Appendix B

Center for Substance Abuse Treatment
Comprehensive Treatment Model for Alcohol and Other Drug Abusing Women and Their Children

The purpose of this model is to foster the development of state-of-the-art recovery for women with alcohol and other drug dependence and to foster the healthy development of the children of substance-abusing women.  The model is a guide that can be adapted by communities and used to build comprehensive programs over time.  The goal of alcohol and other drug treatment is to support a woman's journey to a healthy lifestyle for herself, and for her family whenever possible.  Because alcohol and drug dependent women tend to have few economic and social resources, comprehensive treatment is extremely important.  The purpose of comprehensive treatment is to address a woman's substance abuse in the context of her health and her relationship to family, community, and society.  This relationship is influenced by gender, culture, race and ethnicity, social class, sexual orientation, and age.

Treatment that addresses the full range of a woman's needs is associated with increasing abstinence and improvement in other measures of recovery, including parenting skills and overall emotional health.  Treatment that addresses alcohol and other drug abuse only may well fail and contribute to a higher potential for relapse.

Confidentiality and informed consent, as well as the establishment of universal precautions against spread of communicable diseases, are essential throughout all aspects of treatment.

Although this treatment model has been designed specifically for women and their families, many components apply to men as well.

I.  Program Structure and Administration

II.  Clinical Interventions and Other Services

Intake Screening and Comprehensive Health Assessment

Medical Interventions

Linkages and Collaboration

Substance Abuse Counseling and Psychological Counseling

Substance abuse education and counseling, psychological counseling (where appropriate), and other therapeutic activities should be provided by practitioners who are licensed or certified to provide these services and matched in competency to the populations served.

Services should be offered in the context of families and relationships, including individual/group/family therapy.  Counseling for partners and fathers of babies should be promoted/provided at critical times throughout treatment.

Counseling should address low self-esteem; race and ethnicity issues; gender-specific issues; family of origin relationships; attachment to unhealthy interpersonal relationships; interpersonal violence, including incest, rape, and other abuse; eating disorders; sexuality; parenting issues; grief related to loss of alcohol and other drugs, children, family, partner, work, and appearance; creating a support system that may or may not include family and/or partner; developing a vision for the future and creating a life plan; and therapeutic recreational activities for women alone and with their children.

Parenting Education.  Counseling, including information on child development, child safety, injury prevention, and child abuse prevention should be provided.  Parenting education should be integrated with substance abuse counseling in order to be recovery-oriented.  A woman's family of origin issues that affect parenting should be addressed in a way that supports rather than compromises her stage of recovery.

Relapse prevention should be a discrete component or phase of each woman's recovery plan.

Flexibility and creativity should be stressed in the use and timing of therapeutic approaches.  Accusatory, judgmental, and humiliation techniques are inappropriate and have not been proven to be effective.

Health Education and Prevention Activities

Life Skills Education.  Life skills education should be offered and should cover practical life skills such as parenting (where appropriate); vocational evaluation, financial management, negotiating access to services, stress management and coping skills; and personal image building.

Educational Training and Remediation Services

Transportation.  Transportation to programs is needed to access treatment and related community services.

Housing.  Access to safe, drug-free housing throughout treatment is all-important.

Childcare Services.  Age-appropriate care of infants and children should be provided at treatment facilities using a developmental model.  Respite care should also be available.  If space or licensing requirements prohibit on-site care, contractual arrangements with local licensed childcare providers should be provided.

Continuing Care.  Continuing Care should be provided, planned for, and should include sustained and frequent interaction with recovering individuals who have graduated from the intensive or primary phase of treatment.


Where to?

Top | Report's Main Page | Table of Contents of Report | References ]
HHS | ACF | ASPE | HCFA | NIAAA | NIDA | SAMHSA ]