Family‐Based Recovery: An Innovative Collaboration between Community Mental Health Agencies and Child Protective Services to Treat Families Impacted by Parental Substance Use

Abstract

To meet the needs of families who have very young children and are involved with child protective services due to substance use, the State of Connecticut Department of Children and Families, Yale Child Study Center and Johns Hopkins University created an innovative treatment model. This public–private collaboration required a paradigm shift for both child protective services staff and treatment providers. This brief description of the Family‐Based Recovery model highlights the family‐focused practice elements that allow children to remain safely at home with parents who are in treatment. Outcomes suggest that Family‐Based Recovery is a promising practice, and collaborations between child protective services and substance use treatment providers can yield positive results for families with young children. Key Practitioner Messages Strong collaboration between child protective services and treatment providers can mitigate the risk of out‐of‐home placement for children impacted by parental substance use. In‐home treatment that provides concurrent psychotherapy, substance use treatment and parent–child dyadic therapy is an important part of the service array for families involved with child protective services.

Challenging Belief Systems and Professional Perspectives to Protect Children from Harm

“…A similar perspective was found in relation to families with parental substance misuse by Karen Hanson and colleagues () from the State of Connecticut Department of Children and Families and the Yale Child Study Center. They report on the development and implementation of a novel treatment model: Family‐Based Recovery.…”

Parental Mental Health Problems and the Risk of Child Maltreatment: The Potential Role of Psychotherapy

“…Alongside treatment for parents with mental health problems and substance abuse, it is important to provide services to meet the needs of children and adolescents. There are some successful programs and projects (e.g., [9,36,40]) which can serve as models for intervention in families dealing with parental mental health problems or substance abuse. In this context, it is appropriate to adopt programs that provide integrated interventions that meet the needs of a family (as a system) rather than interventions targeted at individuals alone [41].…”

Mothering from the Inside Out: Addressing the Intersection of Addiction, Adversity, and Attachment with Evidence-Based Parenting Intervention

“…To best meet the identified needs of mothers with addictions, a growing number of researchers and clinicians have recognized the utility of taking a reflective approach to intervention, grounded in the framework of mentalization [11,[48][49][50][51][52][53][54][55]. Mentalization is defined as the ability to make sense of behavior-in oneself and others-in terms of underlying thoughts, emotions, wishes, and intentions [56].…”

“…Given that mothers with addictions are at risk for a range of caregiving challenges [2][3][4][5][6][7][8], mothers in substance use treatment are often referred for parenting support by their treatment clinics, child protective services, and obstetrics, gynecology, and neonatal staff [9][10][11][12]. Despite consensus about the need to effectively support the caregiving of mothers struggling with addiction, most addiction treatment programs utilize skills-based parenting interventions that have not been tested in clinical trials and ultimately yield modest and inconsistent improvement in caregiving, substance use, psychiatric symptoms, and child outcomes [13-16,17•,18•].…”