Research suggests that programs that provide coordinated, comprehensive, and family-centered care are better at attracting pregnant and parenting substance-abusing women into treatment and provide more effective treatment. This article examines the history of substance abuse treatment for women; identifies barriers to treatment access; and explores the socioeconomic, clinical, and systemic issues in the treatment of alcohol- and drug-dependent women. Special attention is given to the effects of substance abuse on women's relationship as daughters, partners, and parents and to its role in violence against women.

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National concern regarding the problem of alcohol and drug use during pregnancy has brought to the forefront the lack of treatment programs specifically targeted to pregnant women. Many programs are seeking guidance in establishing services for pregnant women. Research suggests that programs that provide comprehensive, coordinated, and "holistic" treatment are better able to draw pregnant women into care as well as provide more effective treatment. This paper presents an overview of written guidelines and protocols for treating pregnant chemically dependent women, including an elaboration of guiding principles for care. Unresolved policy issues are identified as well as recommendations for future research directions.

Children exposed to parental substance abuse, mental illness, and violence face profound challenges, including increased risk for emotional and behavioral problems, substance abuse, and victimization. In this article, we describe the characteristics of a sample of children of women entering treatment. These children had been exposed to domestic violence, frequent child welfare involvement, and residential instability. Parental entry into treatment affords treatment providers an opportunity to intervene early with these children, enabling them to offer supportive and preventive services and to help children build skills to avoid problems later. Treatment providers are encouraged to offer assessment and services to children of parents entering treatment, capitalizing on the opportunity to intervene early with a group of children who are at risk for problems with significant individual and social consequences. © 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 445–459, 2005.