As substance abuse treatment programs design services for parents, children's needs must also be addressed. Services for infants and children are designed to foster healthy development, linking primary health care, prenatal, hospital inpatient and postnatal care, and mental health and social services. Activities and services may be provided for the children either on-site or through linkages with other appropriate and qualified community service providers. Whenever possible these services should include extensive joint parent-child activities focused on improving substance abusing parents' ability to avoid emotional or physical abuse and neglect. These include interventions such as therapeutic play, family skills training or family therapy. For children in foster care, increased attention to children's healthy emotional, social and cognitive development is needed. In addition, program models are needed to address the particularly high risk of substance abuse and other risky behaviors among children in foster care. A family history of drug disorder is one of the most potent risk factors for the development of the child and the child's development of drug disorders at an early age. This suggests that substance abuse prevention and intervention programs should target offspring of parents with substance use disorders.
ACF intends to focus new attention on issues of preventive services. These activities will include:
- Highlighting opportunities to address substance abuse within the Independent Living Program.
- Developing training materials for foster parents on working with the children they care for to prevent future substance abuse.
- Focusing attention on substance abuse issues within the Community Based Family Resource and Support (CBRFS) Program (Title II of the Child Abuse Prevention and Treatment Act), which provides services in every State for the prevention of child abuse and neglect and coordinates a Statewide network of family resource services. Agencies supported by the CBFRS Program offer a variety of training programs that help all parents reduce stress, teach basic child development and parenting skills, and support adults in creating safe and stable environments for their children.
SAMHSA has in recent years significantly expanded its attention to early childhood issues. These efforts include:
- SAMHSA's three Centers in collaboration with the Health Resources and Services Administration, The Administration for Children and Families, the Department of Education, the National Institutes of Health and the Casey Family Program support the Starting Early Starting Smart (SESS) Program which is a child-centered, family-focused, and community-based initiative designed to test the effectiveness of integrating behavioral health services within primary care and early childhood service settings for children age 0 - 7.
- SAMHSA's Center for Substance Abuse Prevention (CSAP) has funded 15 community sites for three years to field test effective, research-based models of prevention interventions for children of substance abusers from diverse cultural populations. Some of these children and their older siblings are already in the child welfare system due to neglect and/or abuse or from the need for temporary placement while their mothers are in treatment.
We challenge State and local service providers to identify opportunities for prevention and treatment services for children who are in foster care and for those under protective supervision in their own homes. Efforts should be made to work with prevention service providers to identify maltreated children as a priority for such services.