The information in this program outline is provided by the program representative and edited by the CEBC staff. The Parent-Child Assistance Program (PCAP) program has been rated by the CEBC in the area of: Substance Abuse Treatment (Adult).

• Types of Maltreatment: Does not target any specific kind of maltreatment
• 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.

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.

• PCAP is a three-year home visitation model, implemented by trained and closely supervised paraprofessional case managers (CMs).
• PCAP does not provide direct alcohol or drug treatment or clinical services, and instead links women and their families with a comprehensive array of appropriate and available community resources and services.
• To facilitate an effective service plan, CMs coordinate with the network of client’s service providers and organize regular team case consultations.
• CMs develop a network of contacts and relationships with client’s family and friends, and provide advocacy for other family members as needed.
• Clients are not asked to leave the program because of relapse or setbacks.
• Case management begins at enrollment during the mother’s pregnancy or postpartum.
• CMs conduct an initial needs assessment using The Difference Game, (a card sort assessment developed by PCAP in 1997 and being used in U.S. and Canada). They use this assessment to help clients define individualized goals and incremental (‘baby’) steps required to meet those goals. Goals and steps are added and modified as client makes progress. Goals are evaluated every four months.
• A full PCAP site is comprised of one full-time clinical supervisor and six case managers. Caseload recommendation is 16 active client families per CM.
• CMs receive a minimum of twice monthly individual supervision and attend twice monthly group staffing meetings.
• Program evaluation is an integrated part of PCAP. Ongoing program evaluation allows for generation of outcomes on both current and exiting clients.
• CMs are required to complete evaluation instruments according to PCAP protocol.

Parent-Child Assistance Program (PCAP) was designed with a child component that 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, infants heavily exposed to alcohol or drugs in utero.

Age range: 0 – 3

Developmental Delays:

This program was not developed for children with developmental delays, and has not been tested for children with developmental delays.

Parent-Child Assistance Program (PCAP) was designed with a parent/caregiver component that 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 not designed to be conducted in a group setting, and 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.

This program is typically conducted in a(n):

• Birth Family Home
• Community Agency
• Foster Home
• Residential Care Facility

This program does not include a homework component.

Parent-Child Assistance Program (PCAP) has materials available in a language other than English:

Spanish

The "Difference Game" card sort needs assessment (cards and instructions) is available in Spanish.

The typical resources for implementing the program 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 an A.A. degree and at least four years of prior community-based experience, or the equivalent combination of education and experience. From this pool of people, the program values staff 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. If staff are in recovery, at the time of hire 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.

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:

• Therese M. Grant, PhD, Director
  Washington State Parent-Child Assistance Program
  granttm@u.washington.edu
  phone: (206) 543-7155

Training is obtained:

Training provided onsite or in Seattle. Field observation and practice provided in Seattle.

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

Additional Resources:

There currently are additional qualified resources for training:

Additional University of Washington qualified trainers:

For evaluation:

• Cara Ernst, MA
  email: ccernst@u.washington.edu
• Ron Jackson, MSW
  email: ronjack@u.washington.edu

For intervention model:

• Nancy Whitney, MS
  email: nwhitney@u.washington.edu

Website with protocols and evaluation materials: depts.washington.edu/pcapuw/

Since Parent-Child Assistance Program (PCAP) is highly rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

This program 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. Please see the Scientific Rating Scale for more information.

Child Welfare Outcomes: Safety, Permanency and Child/Family Well-Being