The complexity of these families often makes it difficult for child protective services workers to determine the extent to which substance abuse presents a risk to children. Again, it is important to recognize that not all those who abuse or are dependent on alcohol or other drugs abuse or neglect their children, and that danger to a child may or may not be the direct result of a parent's substance abuse. Child welfare workers struggle with trying to evaluate the role of substance abuse in the dynamics of a given family and what a child is experiencing. In many cases, while a parent's substance use may impair his or her parenting ability, these parenting deficiencies do not rise to the level of neglect or abuse at which a child welfare agency would intervene.
Substance abuse has profound effects on parental disciplinary choices and child rearing styles. Research has shown that parents with substance abuse problems employ less effective discipline than other parents (Tarter et al, 1993). Research through taped clinical observations have shown that drug abusing parents are very limited in their ability to attend to their children's emotional and social cues and to respond appropriately (Hans, 1995). As a consequence, substance abusing parents can overreact with harsh discipline or neglectful child support leading to the higher levels of child abuse and neglect in substance abusing parents (Kumpfer & Bayes, 1995). They also tend to be poor role models for the use of alcohol and drugs and effective conflict resolution and family management skills (Kumpfer, 1987). However, research also demonstrates that substance abusing parents, whether in treatment or not in treatment, can be taught through therapeutic child play and behavioral parent training to be more empathetic and effective parents. Through these family interventions child abuse and neglect and harsh and ineffective discipline can be decreased, while also decreasing the child's emotional and behavioral risk factors for later substance abuse and other adolescent problems (Egeland & Erickson, 1990; Kumpfer, Molgaard & Spoth, 1996; Kumpfer & Alvarado, 1995, 1998; Kumpfer, Williams & Baxley, 1997, Kumpfer, 1999).
Kearney and colleagues (1994) studied the parental attitudes and behaviors of drug dependent mothers. They found that these women felt a strong responsibility toward their children and were quite proud of them. Studying how these mothers try, unsuccessfully, to balance their addictions with their parenting responsibilities, they found that "the basic problem crack cocaine presented to mothers was its drain on their attentiveness, their financial resources and their efforts to be appropriate role models for their children" (p. 354). Hawley and colleagues (1995) also found that motherhood was often the only legitimate social role valued by drug dependent women and that most women in treatment were very concerned about how their substance abuse had affected their children - indeed such concern was a powerful treatment motivation. Catalano and associates (1999) have found that providing a parenting program to parents while in drug treatment, in fact, also reduces relapse after treatment. Because of the importance of being a good parent, offering effective parenting programs during outpatient or inpatient residential treatment improves recruitment, retention and outcomes for parents and children in addition to reducing relapse.