children, families & substance abuse impact and treatment
TRANSCRIPT
Children, Families & Substance Abuse
Impact and Treatment
Specialized Female Treatment Services
• DSHS must spend 13.9 million on specialized female services to include:– Gender specific counseling for relationship
issues.– Reproductive health education & care.– Perinatal service support.– Childcare.– Transport.
Pregnant, Post-Partum Intervention (PPI) Programs
• Based in perinatal clinics, WIC sites, CPS offices:– Provide intervention services for women at
risk for substance abuse.– Risk factors: teen pregnant, resident with
substance abuser, past or present use of the client, domestic violence, mental health problems or other significant indicator of need.
PPI Services
• Education on the effects of alcohol, tobacco & other drugs on the fetus.
• Problem identification and referral.• Parenting education.• Alternative activities to promote child
well being and family bonds• Referral for substance abuse, domestic
violence and mental health services.
Specialized Female Services
• Pregnant adult & adolescent women and women, adult & adolescent, who have dependent children including those whose children are in foster care.– Women meeting these criteria are a priority
population for access to treatment.
HIV Related Required Services
• Priority population adult & adolescent women must be provided:– Education & service referral for infectious
diseases including:• HIV
• Other STD’s
• TB
But…
• DSHS substance abuse programs cannot require women to reveal test results or current HIV status
• HIV information & education is often male oriented in content, lacking in adequate detail and does not include information about HIV and pregnancy
Yet in FY05
• DSHS funded substance abuse specialized female programs served:– 459 pregnant women entered residential
substance abuse treatment.– 424 pregnant women entered outpatient
treatment.
And?
• We have no information to show that these pregnant clients received:– HIV counseling & referral– Education on HIV and pregnancy– Pregnancy related HIV treatment
Nor can we show that
• Children born to pregnant women in substance abuse treatment are HIV –.
CLINICAL PROFILE OF ADULT & ADOLESCENT FEMALE CLIENTS
•50-75% history of sexual, emotional & physical abuse from early childhood•50-85% have abuse related PTSD & associated depression•Pattern of multiple drug use•Lack of basic medical and prenatal care•Family history of ATOD abuse•Impoverished & unstable living environment•Partners who are addicted•Poor or few educational/vocational skills•Poor self-esteem, guilt, shame•Children vulnerable to developmental, behavioral & emotional problems
Please note:
Research shows:
• Women WILL NOT engage in treatment unless & until they feel that they AND their children are safe
• Safety, childcare and transportation are the three major access, engagement & retention barriers cited by women
Other key points
• Treatment must be trauma informed.
• Needs of all family members must be addressed.
• Close coordination key to outcomes.
• Services must address:• domestic violence• mental health • housing• employment
Where do we go from here?
• To maximize resources and service impact:– We need a state-wide structure to provide
adequate and accurate information on HIV, women and pregnancy.
– We need outreach workers and efforts to outreach WHERE women can be found: STD, reproductive health & perinatal clinics and WIC sites.
Basic Clinical Reading
• Treatment Improvement Protocols:
• TIP 02: Pregnant, Substance-Using Women• TIP 05: Improving Treatment for Drug Exposed Infants• TIP 09: Assessment and Treatment of Patients With Coexisting Mental
Illness and Alcohol and Other Drug Abuse• TIP 19: Detoxification from Alcohol and Other Drugs• TIP 23: Treatment Drug Courts: Integrating Substance Abuse Treatment
with Legal Case Processing• TIP 25: Substance Abuse Treatment and Domestic Violence• TIP 27: Comprehensive Case Management for Substance Abuse Treatment• TIP 36C: Substance Abuse Treatment for Persons With Child Abuse and
Neglect Issues (Clinician's Version)• TIP 38: Integrating Substance Abuse Treatment and Vocational Services
Some Websites
• SAMSHA Treatment Improvement Exchange: http://www.treatment.org/Topics/archive/women.html
• Children and Families Futures: www.cff.org
• National Center on Substance Abuse & Child Welfare: www.ncsacw.samhsa.gov
• The National Center on Addiction and Substance Abuse (CASA): www.casacolumbia.org. Recommended publications:
– Food for Thought: Substance Abuse and Eating Disorders– The Formative Years: Pathways to Substance Abuse Among Girls and Young Women Ages
8-22– No Safe Haven: Children of Substance-Abusing Parents– Substance Abuse and The American Woman
Treatment Assistance Protocols:
• http://www.treatment.org/Taps/index.html– TAP 23: Substance Abuse Treatment for Women
Offenders, Guide to Promising Practices
– TAP 26: Identifying Substance Abuse Among TANF-Eligible Families
– TAP 27: Navigating the Pathways: Lessons and Promising Practices in Linking Alcohol and Drug Services with Child Welfare
CSAP Resource Guides
• http://store.health.org/catalog/
– Violence Against Women
– Children Witnessing Violence and Substance Abuse
– Children of Alcoholics
– Pregnant/Postpartum Women and Their Infants
– Women
CONTACT
Judy Brow
Specialized Female Services Coordinator
Community Mental Health & Substance Abuse Services
Texas Department of State Health Services
512-206-5884