Options for Recovery: California's Perinatal Projects

Abstract

In response to the increasing magnitude of problems related to perinatal exposure to alcohol and other drugs, a novel interagency collaboration was formed that involved the California Departments of Alcohol and Drug Programs, Developmental Services. Health Services, and Social Services. This collaboration was named Options for Recovery (OFR). Its mission was to promote the recovery of pregnant, postpartum, and parenting chemically dependent women and the enhancement of the health of their children by providing comprehensive and coordinated alcohol and other drug treatment, case management, and recruitment and training of foster parents and relative caregivers. Seven OFR pilot projects were selected. Findings from the three-year evaluation of the pilot projects showed that the initiative was successful in connecting women with essential services, promoting perinatal recovery and child health, and increasing family reunification of children in foster care. Women who were most likely to complete alcohol and other drug treatment were younger, high school graduates, mandated to treatment, or those who participated in treatment 150 days or more. Participants reported high levels of satisfaction with OFR. The findings indicate that OFR served the unique needs of high-risk perinatal populations. Future efforts should try to reach women early in their pregnancies and should provide a wide array of alcohol and other drug treatment approaches that are responsive to the myriad needs of women and their children.

Extrinsic Barriers to Substance Abuse Treatment among Pregnant Drug Dependent Women

“…Yet, few women enter substance abuse treatment programs during pregnancy. Among those who do, many enter late -in the third trimester (Brindis, Clayson, & Berkowitz, 1997;Svikis, Gorenstein, Paluzzi & Fingerhood, 1998). In this light, identification of extrinsic barriers to treatment is critical and may facilitate help-seeking behavior, including early-in-pregnancy enrollment in substance abuse treatment and essential prenatal care.…”

“…In this light, identification of extrinsic barriers to treatment is critical and may facilitate help-seeking behavior, including early-in-pregnancy enrollment in substance abuse treatment and essential prenatal care. As findings accumulate about substance abuse treatment effectiveness (Brindis, Clayson, & Berkowitz, 1997;Egelko, Galanter, Edwards, & Marinelli, 1996;Gerstein et al, 1994; Center for Substance Abuse Treatment [CSAT], 2001), increasing timely enrollment in treatment among pregnant women, by eliminating barriers that impede access to care, is a public health priority.…”

Pathways to Collaboration: Exploring Values and Collaborative Practice Between Child Welfare and Substance Abuse Treatment Fields

“…The promise of improved outcomes for clients may be a significant motivating force for collaboration (Young & Gardner, 2002). Evidence suggests that substance abuse treatment appears to help prevent out-of-home placements (Dore & Doris, 1998) and improve opportunities for family reunification (Brindis, Clayson, & Berkowitz, 1997;Smith, 2003). Studies of treatment services targeting pregnant and parenting women suggest that length of stay in treatment is a major predictor of treatment effectiveness (Greenfield et al, 2004), and retention, in turn, appears to be significantly improved when women are mandated to treatment by child protective services or the criminal justice system (Chen et al, 2004).…”

Substance use during pregnancy: time for policy to catch up with research

“…Cost effectiveness was also assessed for Options for Recovery. Options for Recovery, as compared to the combined cost of incarceration and other drug and alcohol treatment, was significantly more cost effective [203]. …”