Clinician Perspectives on Relationship, Therapeutic Strategy, and Gender Responsiveness in Child Welfare Substance Abuse Settings

Abstract

There is a growing acknowledgment of client-provider relationship as a determining factor within evidence-based practice implementation. This collective case study of 20 service providers examined the approaches used by clinicians working with substance-abusing mothers involved in child welfare to shed light on their use of empirically informed, gender-specific interventions. Analyses revealed that clinicians struggle to articulate specific evidence-based frameworks, and their approach relies on an intuitively driven clientprovider relationship. Clinicians report little institutional support for integration of empirically supported practices into settings where workforce stress plays a critical role, and thus rely on relationship skills to frame practice approach.Few would argue that alcohol and other drug (AOD) abuse pose major concerns regarding substance-abusing women who are mothers of young children or who are pregnant. Key strategies of the public child welfare service (CWS) system center on safety, permanence, and well-being of children. These strategies are often difficult to achieve in the presence of parental