This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cebc4cw.org/
This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cebc4cw.org/
Child Welfare Outcomes: Safety, permanency, and child/family well-being.
Type of Maltreatment: Not specified
Target Population: Women who used alcohol or drugs heavily during pregnancy and who are not effectively connected with community service providers, and their children. Women are enrolled during pregnancy or up to 6 months postpartum.
Brief Description:(The information in this program outline is provided by the program representative and edited by the CEBC staff.)
The Parent-Child Assistance Program (PCAP) has been rated by the CEBC in the area of Substance Abuse Treatment (Adult). Maternal alcohol/drug abuse puts children at risk because of possible effects of prenatal exposure on the child’s health and because these mothers are likely to provide a compromised home environment. These problems are preventable by helping the mothers build healthy and independent lives. Since 1991, PCAP has served high-risk mothers who abuse alcohol/drugs during pregnancy, and their families, using a theory-based model (relational theory; stages of change; and harm reduction). PCAP intervention activities are conducted by trained and supervised case managers who each work with 16 families for 3 years, beginning during pregnancy or postpartum. PCAP case managers have experienced similar adverse life circumstances as clients, have subsequently achieved success in important ways, are positive role models, and offer hope from a realistic perspective. They provide regular home visitation, and help clients obtain treatment and stay in recovery. They connect families with comprehensive services including health, housing, parenting, and vocational services. Since PCAP is highly rated on the Scientific Rating Scale, information on available pre-implementation assessments, implementation tools, and fidelity measures was requested from the program representative. Please see the program's separate Implementation Information page for details.
Parent-Child Assistance Program (PCAP) was not designed to be conducted in a group.
Parent-Child Assistance Program (PCAP) has not been tested for use in a group setting.
Recommended intensity: Case managers visit client homes approximately weekly for the first 6 weeks, then twice a month depending on client needs. Average contact with client across the 3 years is approximately 1 hour a week.
Recommended duration: The intervention duration is 36 months.
Parent-Child Assistance Program (PCAP) does not include a homework component.
Parent-Child Assistance Program (PCAP) is typically conducted in a(n): Birth Family Home, Community Agency, Foster Home, and Residential Care Facility.
Parent-Child Assistance Program (PCAP) was designed with a Parent Component.
Parent-Child Assistance Program (PCAP) addresses the following presenting problems and symptoms: Co-occurring substance abuse and mental health disorders, and problems associated with these disorders including health, domestic violence, housing, child welfare, and legal issues.
Parent-Child Assistance Program (PCAP) was designed with a Child Component.
Parent-Child Assistance Program (PCAP) addresses the following presenting problems and symptoms: Health risks (including lack of immunizations), possibility of an unsafe or unstable home, risk of out-of-home placement
Age range(s): 0-5
Parent-Child Assistance Program (PCAP) was not developed for children with developmental delays.
Parent-Child Assistance Program (PCAP) has not been tested for children with developmental delays.
Parent-Child Assistance Program (PCAP) has materials available in a language other than English.
Language(s) available:
The "Difference Game" card sort needs assessment (cards and instructions) are available in Spanish.
There is a manual that describes how to implement this program.
There is training available for Parent-Child Assistance Program (PCAP).
Training contact: Therese M. Grant, PhD, Director, Washington State Parent-Child Assistance Program, Email: granttm@u.washington.edu, Phone: 206-543-7155
Number of days/hours: Training on model: 5-day training and follow-up consultation
Field observation and practice: 5-day
Training on evaluation (recommended): 4-day training
Training is obtained: Training provided onsite or in Seattle.
Field observation and practice provided in Seattle.
There currently are additional qualified resources for training.
List of additional qualified resources: Additional University of Washington qualified trainers:
-For evaluation: Cara Ernst, MA and Ron Jackson, MSW
Cara Ernst, MA: ccernst@u.washington.edu
Ron Jackson, MSW: ronjack@u.washington.edu
-For intervention model: Nancy Whitney, MS
Nancy Whitney: nwhitney@u.washington.edu
Website with protocols and evaluation materials:
http://depts.washington.edu/pcapuw/index.html
The typical resources for implementing Parent-Child Assistance Program (PCAP) are: • Office space and desks for 6 CMs and a supervisor.
- At least 3 computers with high-speed internet for web-based data entry
- Cell phones for field communication
- Recommended: vehicles for transport of mothers and children to important appointments
Case Managers need at least four years of prior community–based experience, or the equivalent combination of education and experience. From this pool of people, the program seeks out those who have experienced some of the same types of adverse life circumstances as clients (but usually not to the same degree), and who have subsequently achieved success in important ways to be staff members. If staff are in recovery, they must be clean and sober for at least 5 years and be maintaining a recovery-oriented lifestyle.
Supervisors need at least Master's level training in a mental health field and extensive clinical supervisory experience.
Parent-Child Assistance Program (PCAP) is rated a "2 - Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one rigorous randomized controlled trial with a sustained effect of at least 6 months. For more information on the rating of a "2 - Supported by Research Evidence," please see the Scientific Rating Scale.
Ernst, C. C., Grant, T. M., Streissguth, A. P., & Samson, P. D. (1999). Intervention with high-risk alcohol and drug-abusing mothers: II. Three-year findings from the Seattle model of paraprofessional advocacy. Journal of Community Psychology, 27(1), 19-38.
Type of Study: Randomized controlled trial
Number of participants: 65 clients, 31 controls
Population:
Location/Institution: Seattle, WA.
Summary: (To include comparison groups, outcomes, measures, notable limitations) Women were randomly assigned to three years of intensive home visitation/case management (intervention group) or the community standard of care (control group). Participants were interviewed pre and post-intervention regarding substance use, risk and protective factors, and use of community services. A composite summary score was computed for overall well-being. The intervention group participants obtained significantly higher outcome summary scores; those who spent more time with case managers had more positive outcomes.
Length of post-intervention follow-up: None.
Kartin, D., Grant, T. M., Streissguth, A. P., Sampson, P. D., & Ernst, C. C. (2002). Three year development outcomes in children with prenatal alcohol and drug exposure. Pediatric Physical Therapy, 14, 145-153.
Type of Study: Randomized controlled trial
Number of participants: 53 clients, 25 controls
Population:
Location/Institution: Seattle, WA.
Summary: (To include comparison groups, outcomes, measures, notable limitations) (Note: this analysis uses children from the sample described in Ernst et al., 1999). Women were randomly assigned to three years of intensive home visitation/case management (intervention group) or the community standard of care (control group). At intervention exit, children were evaluated using the Mental, Motor, and Behavior Rating Scales of the Bayley Scales of Infant Development Second Edition (BSID-II). Results indicated that scores, on average, were lower than expected for age among both the intervention and control groups. Previous research suggests that the home-visiting intervention showed positive results for mothers; however it was not sufficient to address the needs of children exposed to prenatal alcohol and drugs.
Length of post-intervention follow-up: 3 years after program enrollment.
Grant, T., Ernst, C. C., Pagaliauan, G., & Streissguth, A. (2003). Post-program follow-up effects of a paraprofessional intervention with high-risk women who abused alcohol and drugs during pregnancy. Journal of Community Psychology, 31(3), 211-222.
Type of Study: Post-program follow-up descriptive study
Number of participants: 48 clients
Population:
Location/Institution: Seattle, WA
Summary: (To include comparison groups, outcomes, measures, notable limitations) (Note: This study uses the same sample as Ernst et al. 1999.) Interviews were conducted to obtain information on alcohol and drug use, use of family planning and community services. Clients were interviewed at intervention enrollment, at intervention completion 3 years later, and 2.5 years after completing the intervention. Located mothers were significantly more likely to have abstained from alcohol and drugs for 6 months or more and had fewer subsequent children. They were also more likely to be living in permanent housing and less likely to have been incarcerated. A limitation to this analysis is the lack of comparison with the control group.
Length of post-intervention follow-up: 2.5 years post-treatment
Grant, T. M., Ernst, C. C., Streissguth, A., & Stark, K. (2005). Preventing alcohol and drug exposed births in Washington State: Intervention findings from three Parent-Child Assistance Program sites. The American Journal of Drug and Alcohol Abuse, 31, 471-490.
Type of Study: Pretest/Posttest
Number of participants: 216 women
Population:
Location/Institution: Washington State
Summary: (To include comparison groups, outcomes, measures, notable limitations): (Note: This study includes some participants from the Ernst et al. 1999 study.) Pretest-posttest comparison was made across three PCAP sites: the original demonstration (OD) (1991-1995), and two replication sites (1996-2003). Women were interviewed using the Addiction Severity Index with supplemental questions on pregnancy substance use, contraception, and use of community services. On an endpoint summary score, each the replication samples performed significantly better than the OD (p<.02), adjusting for baseline. Compared to the OD, outcomes at replication sites were maintained (for regular use of contraception and use of a reliable method of birth control; and number of subsequent deliveries [i.e., children born]), or improved (for alcohol/drug treatment completed; alcohol/drug abstinence; subsequent delivery [i.e., child born] unexposed to alcohol/drugs). Study findings suggest that this community-based intervention model is effective over time and across venues.
Length of post-intervention follow-up: None.
Grant, T. M., Ernst, C. C., McAuliff, S., & Streissguth A. P. (1997). The Difference Game: Facilitating change in high-risk clients. Families in Society: The Journal of Contemporary Human Services, 78(4): 429–432.
Grant, T. M., Ernst, C. C., & Streissguth, A. P. (1999). Intervention with high-risk alcohol and drug-abusing mothers: I. Administrative strategies of the Seattle model of paraprofessional advocacy. Journal of Community Psychology, 27(1): 1–18.
Grant, T. M., Youngblood Pedersen, J., Whitney, N., & Ernst, E. (2007). The role of therapeutic intervention with substance abusing mothers: Preventing FASD in the next generation. In Attention Deficit Hyperactivity Disorder and Fetal Alcohol Spectrum Disorders: The Diagnostic, Natural History and Therapeutic Issues Through the Lifespan. K. O’Malley (Ed.). Hauppauge, NY: Nova Science Publishers, Inc.
Contact name: Therese M. Grant, PhD
Affiliation/Agency: Director, Washington State Parent-Child Assistance Program (PCAP), Director, Fetal Alcohol and Drug Unit, Dept. Psychiatry and Behavioral Sciences, University of Washington School of Medicine
Email: granttm@u.washington.edu
Phone: 206-543-7155
Fax: 206-685-2903
Website: http://depts.washington.edu/pcapuw/index.html