Data from SAMHSA's evaluation of grant initiatives to provide residential substance abuse treatment for pregnant women and women with children indicate that female substance abuse treatment clients who have ever had children removed from the home by child protective services tend to be older than other clients, have more children, and have more other problems such as having been homeless and unemployed, than do other clients entering these substance abuse treatment programs (Dowell and Roberts, 1998).
Among substance abuse treatment clients who are parents, child custody issues are a major reason for treatment entry. In the National Treatment Improvement Evaluation Study (NTIES), 44 percent of female clients with children under 18 (and 15 percent of male clients with such children) reported that they entered substance abuse treatment in order to keep and/or regain custody of their children (Figure 4-13).
Of female clients who entered treatment within a year of their most recent birth, two-thirds did so because of custody concerns and 86 percent of these women had already lost custody of this child (HHS/SAMHSA, 1996). Findings from a California study of substance abuse treatment outcomes further confirm that parenting and custody issues are an important motivation for treatment entry (Gerstein et al, 1997).