Parental Substance Abuse : Interagency Approaches

by Child Welfare Information Gateway

(Page 10 of 10)

Interagency Coordinating Councils

A child's health often relies upon the coordination and integration of social, environmental, and health-based strategies.

In the absence of an umbrella agency capable of providing the continuum of services needed by substance-exposed children and their parents, communities across the country have developed local coordinating bodies to promote collaboration among professionals and the development of needed services for chemically involved families.

County-based interagency perinatal councils are one example of a successful organizational strategy that has been used in California to effectively mobilize community resources and develop interagency cooperation around issues of parental substance abuse. Perinatal councils are currently active in 29 California counties, and members on each council include representatives from local departments of health, public social services, CPS agencies, drug and alcohol treatment services, and education. Public and private hospitals, private treatment agencies, and interested community members also are represented. In bringing together the local public and private agencies that serve chemically involved families, these councils have provided a catalyst for the development of coordinated policies and services among member organizations. Councils also have sponsored community awareness and training programs, developed locally relevant educational materials, and served as conduits for collaborative, interagency funding requests.

Interagency, Interdisciplinary Training

Staff of all courts, human service, and law enforcement agencies should be jointly trained in identification of substance-abusing parents and drug-exposed children and the appropriate interventions.

Interdisciplinary training for the various professionals who serve chemically involved families within local communities represents another strategy used successfully to improve services for substance-affected children and their caregivers. Commonly, the goals of interagency training are threefold:

• to help professionals gain a better understanding of the characteristics and treatment needs of children and parents;
• to provide trainees from various professional backgrounds with a common knowledge base and framework for working with families; and
• to familiarize professionals with each other's agencies, policies, and services.

To maximize the impact of cross-training ventures, experts recommend that programs target professionals from across the service delivery spectrum, including hospital-based physicians, nurses, and social workers; CPS caseworkers; judges and attorneys; public health nurses; substance abuse treatment specialists; educators; developmental disabilities counselors; and law enforcement personnel.

Model programs frequently use an interdisciplinary training staff. Curricula address the medical, developmental, and psychosocial characteristics of chemically involved families; the special service needs of this population; effective approaches for addressing the family's complex health, social, and educational problems; community resources; and strategies for developing interdisciplinary and interagency collaboration in case planning and management efforts.

Interagency Service Teams

In developing case plans, and even during the original investigation, CPS personnel may be dealing in issues beyond their expertise. It is critical that child protection and child welfare work in concert with alcohol and substance abuse departments.

Chemically involved families often require simultaneous services from a variety of health care, child welfare, and substance abuse treatment agencies. Interagency service teams that include public health nurses, CPS caseworkers, and chemical dependency counselors have proven to be another very successful strategy for promoting a unified treatment approach across agencies. Such teams help coordinate and integrate social, medical, and substance abuse treatment services and reduce service fragmentation for families.

Commonly, these "teams" make joint home visits for the purpose of assessment and planning with birth and foster families, meet on a regular basis for formal staffing and sharing of information and ideas, and participate in ongoing joint training to enhance the team's overall knowledge of substance abuse and to develop common approaches for assessment and intervention with families. To support the team case management approach, collaborating agencies in some communities have developed interagency agreements that describe each agency's role and responsibilities, specify guidelines for the exchange of information, and clarify issues of confidentiality.

In rural areas or in communities that lack a comprehensive intervention program, the team case management approach can help ensure appropriate health care, substance abuse treatment, and social services for family members as well as promote continuity and coordination of the various services provided through multiple agencies.

Summary

Substance abuse can devastate families. However, alcohol and other drug abuse is treatable, and appropriate interventions can protect children as well as help parents better care for themselves and their offspring. Because of the complex needs of chemically involved families, it is clear that a multitude of services is needed to achieve recovery and rehabilitation. Further, even individuals who are already in recovery commonly require ongoing support because new stressors as well as contact with substance-abusing friends and family members can interfere with maintenance of a sober lifestyle.

Although there remain many unanswered questions about the types of intervention that are most effective, our understanding of substance abuse and the needs of families suggests we are most successful when we provide programs that are family-focused, nonpunitive, and supportive in orientation. It also is important that programs are sensitive to cultural and language issues and that staff are well-trained with respect to the special needs of this high-risk population of parents and children. Furthermore, we have a greater chance of being successful when we use an interdisciplinary approach and insist on collaboration among professionals and agencies.

Substance abuse among families with young children has increased during the past decades, and service providers need to keep in mind the fact that effective treatment strategies are just beginning to emerge. Long-term effects have not yet been reported, and, likewise, we know very little about interventions that can be beneficial over time for older children and adolescents from substance-abusing families. However, we do know that chemical dependency is a chronic, relapsing problem, and that a long-term commitment to supporting families by reducing stresses, enhancing overall family health, providing opportunities for learning, and improving the family and community environment can make a difference. Such carefully crafted, multidisciplinary interventions can improve the odds that all members of a family affected by parental substance abuse will more fully realize their potential. Patterns of intergenerational substance abuse and child abuse that are a tragic part of many parents' histories need not be written into the futures of their children.

About the Author

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Formerly the National Clearinghouse on Child Abuse and Neglect Information and the National Adoption Information Clearinghouse, Child Welfare Information Gateway provides access to information and resources to help protect children and strengthen families. A service of the Children's Bureau, Administration for Children and Families, U.S. Department of Health and Human Services.