Intervention with high-risk alcohol and drug-abusing mothers: II. Three-year findings from the Seattle model of paraprofessional advocacy

Abstract

We examine the efficacy of a paraprofessional advocacy program for improving health and social outcomes of high-risk substance-abusing mothers and their children. This intervention included 3 years of home visitation, advocacy, and connection with appropriate community services. To assess the overall effectiveness of the model, clients were compared to concurrently enrolled controls on a composite variable comprised of indicators of alcohol/drug treatment, abstinence, family planning, child well-being, and connection to services. Clients obtained higher scores, on average, than controls on the composite variable-as well as on every indicator. Clients who spent more time with advocates had more positive outcomes. Results suggest that this paraprofessional advocacy model can help protect the safety of the children of substance-abusing mothers, while helping mothers take the steps they need to take in order to make fundamental changes in their lives.

Pathways to Resilience: Enhancing Family Well-Being with a Home Visitation Model

“…This primary prevention model dictates that service delivery be coordinated, family-centered and must be provided within communitybased systems of care (Strickland, & McPherson, 1994;Goodson, Layzer, St. Pierre, et al, 2000). However, families at risk pose a challenge to social service providers because of barriers including poverty, violence, chaotic living conditions, and alienation from community health and social services (Ernst, Grant, Streissguth & Sampson, 1999;Kaplan, 1986). Moreover, the fragmented nature of service delivery systems often fails as a holistic approach to developing family well-being.…”

“…However, many risks (e.g. delayed prenatal care and lack of immunizations) are considered preventable by intervention during pregnancy and in the fist three years of a child's life (Campbell, 1994;Ernst, Grant, Streissguth, & Sampson, 1999;Navaie-Waliser, et al, 2000;Slaughter, & Issel, 2012).…”

Relational Psychotherapy Mothers' Group: A randomized clinical trial for substance abusing mothers

“…During the last 10 years, a wide range of parenting programs for drug dependent mothers have been developed, encompassing diverse approaches in terms of format, intensity, and targeted outcomes (see Black et al, 1994;Camp & Finkelstein, 1997;Catalano et al, 1999;Ernst, Grant, & Streissguth, 1999;Huebner, 2002;Kumpfer, 1998;Schuler, Nair, & Black, 2002). In general, the treatment outcomes have shown improvements in parental psychosocial adjustment (e.g., maternal drug abuse, self-reported parenting stress, coping skills) but relatively little improvement in the mother-child relationship or children's psychosocial adjustment.…”

Three-Year Developmental Outcomes in Children with Prenatal Alcohol and Drug Exposure

“…They were more likely to complete substance abuse treatment, stay in recovery, use an effective family planning method, and obtain health and social services for themselves and their children. 26 Improvements such as these have a positive impact on the home environment and may contribute indirectly to more optimal development of a mother's children. However, intervention directed at compromised mothers is unlikely to have an effect on the developmental outcomes of children who have severe delays.…”

“…If the child did not remain in the mother's custody, advocates made every attempt to work with the child's caregiver. 25,26 The Seattle Birth to 3 Program did not include a developmental intervention component for the enrolled infants or specific parenting training for the mothers. Advocates, however, linked clients with health care, parenting classes, and therapeutic childcare as available in the mothers' communities and substance abuse treatment programs.…”