Parent-Child Assistance Program (PCAP)

About This Program

Target Population: Pregnant or parenting mothers (up to 12 months postpartum) who have alcohol and/or drug use disorders and their children 0 to 3.

For children/adolescents ages: 0 – 3

For parents/caregivers of children ages: 0 – 3

Program Overview

Maternal alcohol/drug abuse puts children at risk because of possible effects of prenatal exposure on the child’s health and because of the likelihood of a compromised home environment. PCAP (1991- present) serves high-risk mothers with substance use disorders and their families using a theory-based model (relational theory, stages of change, and harm reduction). PCAP intervention is conducted by trained and supervised case managers who each work with 16 families for three years, beginning during pregnancy or postpartum. They meet with clients twice monthly, in clients’ homes and communities, to provide support, coaching, and role modelling; help clients set and reach their own personal goals; connect families and help them follow through with needed community services. Case managers are realistic role models who inspire hope.

Program Goals

The goals of the Parent-Child Assistance Program (PCAP) are:

For Mothers:

  • Obtain alcohol and drug treatment and stay in recovery
  • Use community resources that will help build and maintain healthy and independent family lives
  • Ensure any future babies are not alcohol- and drug-affected

For Children

  • Receive relevant, consistent community services including immunizations, well-child visits, and therapeutic services

Logic Model

The program representative did not provide information about a Logic Model for Parent-Child Assistance Program (PCAP).

Essential Components

The essential components of the Parent-Child Assistance Program (PCAP) include:

  • Being a three-year intensive case management model, implemented by trained and closely supervised case managers (CMs)
  • Working closely with clients and their families to offer outreach and engagement, provide structured goal-setting, problem-solving, practical assistance, and consistent coaching
  • Not providing direct alcohol or drug treatment or clinical services, and instead linking women and their families with a comprehensive array of appropriate and available community resources and services
  • Facilitating an effective service plan by having the CMs coordinate a network of client's service providers and organize regular case consultations
  • Having the CMs develop a network of contacts and relationships with client's family and friends, and provide advocacy for other family members as needed
  • Not asking the clients to leave the program because of relapse or setbacks
  • Beginning case management at enrollment (i.e., during the mother’s pregnancy or up to 12 months postpartum) and continuing for three years
  • Having the CMs conduct an initial needs assessment using The Difference Game (a card sort assessment developed by PCAP) that helps clients define individualized goals and incremental ('baby') steps required to meet those goals.
  • Adding or modifying goals and steps as client makes progress and evaluating goals every four months
  • Having one full-time clinical supervisor and six case managers to comprise a full PCAP site
  • Recommending a caseload recommendation of 16 active client families per CM
  • Having the CMs receive a minimum of twice monthly individual supervision and attend twice monthly group staffing meetings
  • Having program evaluation as an integrated part of PCAP since ongoing program evaluation allows for generation of outcomes on both current and exiting clients
  • Requiring CMs to complete evaluation instruments according to PCAP protocol

Program Delivery

Child/Adolescent Services

Parent-Child Assistance Program (PCAP) directly provides services to children/adolescents and addresses the following:

  • Problems associated with prenatal alcohol and drug use, trauma histories, custody issues

Parent/Caregiver Services

Parent-Child Assistance Program (PCAP) directly provides services to parents/caregivers and addresses the following:

  • Substance use disorders and problems associated with these disorders, including depression and other mental health disorders, trauma histories, and psychosocial difficulties that lead to poor social-emotional functioning and disrupted mother–child relationships
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: For the mother’s family members, PCAP offers outreach and engagement, problem-solving, coaching, practical assistance, and service connections. For community support systems and service providers, PCAP offers coordination and assistance with family compliance and follow-up to assure that families receive relevant, comprehensive, multidisciplinary services in areas including treatment, health, housing, child welfare, domestic violence, and legal.

Recommended Intensity:

Case manager contact is face-to-face in the home or community approximately weekly for the first 6 weeks, then an average of twice-monthly depending on client needs. In addition, case managers stay in touch via phone, email, and text as necessary.

Recommended Duration:

36 months

Delivery Settings

This program is typically conducted in a(n):

  • Birth Family Home
  • Foster / Kinship Care
  • Community-based Agency / Organization / Provider
  • Group or Residential Care

Homework

Parent-Child Assistance Program (PCAP) includes a homework component:

Clients are expected to work on their established goals and incremental steps they are taking toward meeting goals and discuss progress/modifications needed with their case manager monthly.

Resources Needed to Run Program

The typical resources for implementing the program are:

For a full PCAP site serving approximately 100 clients:

  • Office space and desks for 6 full-time case managers and a full-time supervisor
  • Office space that includes a small private room for confidential meetings or interviews
  • At least 3 computers with high-speed internet for web-based data entry
  • Cell phones for all staff for field communication
  • Agency or rental vehicles for transport of mothers and children to important appointments or reimbursement for staff using their own vehicles

Manuals and Training

Prerequisite/Minimum Provider Qualifications

Case managers are required to have a Bachelor’s Degree and at least two years of prior community-based experience with high-risk populations. PCAP values staff who have experienced some of the same types of adverse life circumstances as clients 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 are required to have a Bachelor’s Degree, with Master's Degree preferred, in the mental health, substance abuse, or social work fields. Supervisors must have extensive clinical supervisory experience.

Manual Information

There is a manual that describes how to deliver this program.

Program Manual(s)

Grant, T. & Callahan, T. (2020). The Parent-Child Assistance Program e-manual: A model of effective community intervention with high-risk families (Rev. ed). University of Washington, Department of Psychiatry & Behavioral. https://pcap.psychiatry.uw.edu/training/

Training Information

There is training available for this program.

Training Contact:
Training Type/Location:

In Washington State: Training provided in person at regional trainings, or remotely via Zoom. Field observation and practice provided in person at regional PCAP sites.

Outside Washington State: Training provided onsite at trainee organization, or in person at regional trainings in Washington State, or remotely via Zoom. Field observation and practice provided in person in Washington state, or remotely via Zoom.

Number of days/hours:

In Washington State:

  • For supervisor, case manager, office assistant* roles:
  • Training on model: 2-day initial training and annual 2-day refresher training
  • Field observation and practice: 40 hours
  • Training on evaluation: 8 hours
  • *Office assistant role: field observation not required.
  • For exit interviewer role: Only training on evaluation is required.

Outside Washington State (subject to site-specific needs and funding):

  • Training on model: 2-day initial training and monthly follow-up consultation for up to 12 months
  • Field observation and practice: 2 to 3 days
  • Training on evaluation (recommended): 8 hours
Additional Resources:

There currently are additional qualified resources for training:

Additional University of Washington qualified trainers:

  • Cara Ernst, MA
    email: ccernst@u.washington.edu
  • Ron Jackson, MSW
    email: ronjack@u.washington.edu
  • Michelle Peavy, Ph.D.
    email: Peavy@evergreentx.org

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

Implementation Information

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for Parent-Child Assistance Program (PCAP) as listed below:

The following pre-implementation tools and materials are available:

  • Pre-implementation Checklist: In implementing PCAP in a new community, it is essential that core components of the model be maintained if PCAP demonstrated outcomes are to be achieved. The pre-implementation checklist helps providers assesses readiness to adopt the model. It first asks questions regarding the community setting and the hosting agency setting, then asks questions regarding eight core components of the model. Each component has an “anchor” statement that describes what the ideal implementation of the PCAP model would look like relevant to that characteristic.
  • PCAP comprehensive manual including all necessary implementation components.
  • PCAP comprehensive manual including all necessary implementation components.
  • These materials are available on the PCAP website (http://depts.washington.edu/pcapuw/).

In Washington State, the University of Washington (UW) Fetal Alcohol and Drug Unit staff provide technical assistance and oversight to sites funded to implement new PCAP sites.

Outside Washington State, the UW Fetal Alcohol and Drug Unit staff provide pre-implementation consultation (email, phone, Zoom meetings) and ongoing technical assistance as contracted.

The following resources are also available on the PCAP website (http://depts.washington.edu/pcapuw/):

  • PCAP Manual
  • Administrative forms and protocols
  • Evaluation forms and protocols
  • Training videos and demonstrations of PCAP methods
  • Complete list of PCAP peer-reviewed publications and book chapters

Formal Support for Implementation

There is formal support available for implementation of Parent-Child Assistance Program (PCAP) as listed below:

In Washington State, formal support for implementation is required by state contract and is provided by PCAP staff at the University of Washington Fetal Alcohol and Drug Unit (staff include statewide director, evaluator, research coordinator). Support includes annual “refresher training” on PCAP implementation (a ten-hour web-based training); annual evaluation site visits and feedback on site process and effectiveness measures; monthly interactive support meetings with FADU staff and state clinical supervisors; and regular email contact.

Outside Washington State, formal support is optional but strongly encouraged as budgets allow.

Fidelity Measures

There are fidelity measures for Parent-Child Assistance Program (PCAP) as listed below:

The PCAP fidelity measure is a quality assurance checklist tool that helps assess a provider's degree of adherence to the model. The assessment is organized into ten core components of the model. Each characteristic has one "anchor" statement that describes what the ideal replication of the PCAP model would look like relevant to that characteristic. The fidelity measure can be used to help agencies or communities determine how well they meet criteria for implementing the evidence-based model; determine whether changes need to be made in implementation; and track improvements over time. The measure can also be used to help outside evaluators understand the PCAP model elements. The Fidelity measure is available on PCAP website at http://depts.washington.edu/pcapuw/

Implementation Guides or Manuals

There are implementation guides or manuals for Parent-Child Assistance Program (PCAP) as listed below:

The PCAP manual is a 132-page PDF document organized into eight sections. The manual is publicly available at: https://depts.washington.edu/pcapuw/manual-and-forms/manual 

Implementation Cost

There have been studies of the costs of implementing Parent-Child Assistance Program (PCAP) which are listed below:

Grant, T., & Casey Family Programs (2013). Parent-Child Assistance Program outcomes suggest sources of cost savings for Washington State. University of Washington. http://depts.washington.edu/pcapuw/inhouse/PCAP_Cost_Savings_Brief_Feb_2013.pdf

Thanh, N.X., Jonsson, E., Moffatt, J., Dennett, L., Chuck, A.W., Birchard, S. (2015). An economic evaluation of the Parent–Child Assistance Program for preventing fetal alcohol spectrum disorder in Alberta, Canada. Administration and Policy in Mental Health and Mental Health Services Research, 42, 10–18. https://doi.org/10.1007/s10488-014-0537-5

Research on How to Implement the Program

Research has been conducted on how to implement Parent-Child Assistance Program (PCAP) as listed below:

There is one published article on PCAP implementation in rural versus urban areas:

Shaw, M.R., Grant, T., Barbosa-Leiker, C., Fleming, S., Henley, S., & Graham, J.C. (2015). Intervention with substance-abusing mothers: Are there rural-urban differences? The American Journal on Addictions, 24(2), 144–152. https://doi.org/10.1111/ajad.12155

There are three published articles on Canadian PCAP implementation:

Rasmussen, C., Kully-Martens, K., Denys, K., Badry, D., Henneveld, D., Wyper, K., & Grant, T. (2012). The effectiveness of a community-based intervention program for women at-risk for giving birth to a child with fetal alcohol spectrum disorder (FASD). Community Mental Health Journal, 48(1), 12–21. https://doi.org/10.1007/s10597-010-9342-0

Thanh, N.X., Jonsson, E., Moffatt, J., Dennett, L., Chuck, A.W., Birchard, S. (2015). An economic evaluation of the Parent–Child Assistance Program for preventing fetal alcohol spectrum disorder in Alberta, Canada. Administration and Policy in Mental Health and Mental Health Services Research, 42, 10–18. https://doi.org/10.1007/s10488-014-0537-5

Umlah, C., & Grant, T. (2003). Intervening to prevent prenatal alcohol and drug exposure: The Manitoba experience in replicating a paraprofessional model. Envision: The Manitoba Journal of Child Welfare, 2(1), 1–12. http://depts.washington.edu/pcapuw/inhouse/Manitoba%20Paper%20Envision%20Online%202003.pdf

There is one published article on implementing PCAP with women who have fetal alcohol spectrum disorders (FASD): 

Grant, T., Huggins, J., Connor, P., Pedersen, J., Whitney, N., & Streissguth, A. (2004). A pilot community intervention for young women with fetal alcohol spectrum disorders. Community Mental Health Journal, 40(6), 499–511. https://doi.org/10.1007/s10597-004-6124-6

Relevant Published, Peer-Reviewed Research

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

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. https://doi.org/10.1002/(SICI)1520-6629(199901)27:13.0.CO;2-K

Type of Study: Randomized controlled trial
Number of Participants: 96

Population:

  • Age — Intervention: Mean=27.5 years; Control Mean=27.8 years
  • Race/Ethnicity — Intervention: 48% African American, 29% White, 15% Native American, and 8% Hispanic/Asian/Other; Control: 42% White, 36% African American, 16% Native American, and 6% Hispanic/Asian/Other
  • Gender — 100% Female
  • Status — Participants were women who abused alcohol/drugs during pregnancy, and their infants; recruited via hospital postpartum screening or from community provider referrals.

Location/Institution: Seattle, WA

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of this study was to examine the efficacy of the Parent-Child Assistance Program (PCAP) for improving health and social outcomes of high-risk substance-abusing mothers and their children. Measures utilized include the Bayley Scales of Infant Development and the Shipley-Hartford Intelligence Scale. Participants were randomly assigned to three years of intensive home visitation/case management (P-CAP) or the community standard of care (control group). Results indicate that the intervention group obtained significantly higher outcome summary scores; those who spent more time with case managers had more positive outcomes. Limitations include reliance on self-reported measures, small sample size, and lack of follow-up.

Length of postintervention 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. https://doi.org/10.1097/01.PEP.0000029345.98713.EE

Type of Study: Randomized controlled trial
Number of Participants: Intervention: 53; Control: 25

Population:

  • Age — Mothers, Intervention: Mean=28.1 years; Control Mean=28 years
  • Race/Ethnicity — Intervention: 50.9% African American, 26.4% White, 15.1% Native American, and 7.6% Other; Control: 50.0% White, 25.5% African American, 20.8% Native American, and 4.2% Other (Hispanic, Asian)
  • Gender — 100% Female
  • Status — Participants were women who abused alcohol/drugs during pregnancy, and their infants; recruited via hospital post-partum screening or from community provider referrals.

Location/Institution: Seattle, WA

Summary: (To include basic study design, measures, results, and notable limitations)
This study used children from the sample described in Ernst et al. (1999). The purpose of this study was to describe the performance of children whose mothers were enrolled in the Seattle Birth to 3 Program (now called Parent-Child Assistance Program [PCAP]) at three years, and to examine the effects of study group, prenatal binge alcohol exposure, and prematurity on developmental outcome. Measures utilized include the Bayley Scales of Infant Development Second Edition (BSID-II). Results indicate that scores, on average, were lower than expected for age among both the intervention and control groups. Limitations include examiner bias, small sample size, and lack of follow-up.

Length of postintervention follow-up: None.

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. https://doi.org/doi:10.1002/jcop.10048

Type of Study: Randomized controlled trial
Number of Participants: 45 clients

Population:

  • Age — Not specified
  • Race/Ethnicity — Not specified
  • Gender — 100% Female
  • Status — Participants were mothers at-risk for alcohol/drug abuse; former PCAP participants originally recruited via hospital postpartum screening or from community provider referrals.

Location/Institution: Seattle, WA

Summary: (To include basic study design, measures, results, and notable limitations)
This study uses the same sample as Ernst et al. (1999). The purpose of this study was to examine the postprogram follow-up status of mothers who abused alcohol and drugs heavily during a target pregnancy, were enrolled in the Parent-Child Assistance Program (PCAP) and received paraprofessional home visitation and advocacy for 3 years after delivery. Measures utilized include items on demographics, quantity, frequency, and pattern of alcohol and drug use prior to and during pregnancy, problems associated with alcohol and drug use, family history of substance abuse problems, use of family planning and community services during pregnancy. Results indicate that at postprogram follow-up a significant increase in abstinence from alcohol and drugs for 6 months or more and significant decreases in subsequent pregnancies and deliveries were observed. A significant postprogram increase in living in permanent housing and a significant decrease in incarceration were other notable findings. Limitations include a lack of follow-up data on the control group, attrition, small sample size, and lack of information about measure psychometrics.

Length of postintervention follow-up: 2.5 years.

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. https://doi.org/10.1081/ADA-200056813

Type of Study: Pretest-posttest study with nonequivalent control group (Quasi-experimental)
Number of Participants: 216

Population:

  • Age — Original demonstration: Mean=27.6 years; Replications combined: Mean=28.6
  • Race/Ethnicity — Original demonstration: 45% African American, 30% White, 17% Native American, and 8% Other (Hispanic, Asian); Replications combined: 47% White, 37% African American, 9% Native American, and 7% Other (Hispanic, Asian)
  • Gender — 100% Female
  • Status — Participants were women who abused alcohol/drugs during pregnancy, and their infants; recruited via hospital post-partum screening or from community provider referrals.

Location/Institution: Washington State

Summary: (To include basic study design, measures, results, and notable limitations)
This study includes some participants from Ernst et al. (1999). The purpose of this study was to examine outcomes among women enrolled in the Washington State Parent-Child Assistance Program (PCAP) for women who abuse alcohol and drugs during an index pregnancy. Measures utilized include the Addiction Severity Index with supplemental questions on pregnancy substance use, contraception, and use of community services. Results indicate that each of the replication samples performed significantly better than the OD, 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). In addition, outcomes were also improved for alcohol/drug treatment completed; alcohol/drug abstinence; and subsequent delivery (i.e., child born) unexposed to alcohol/drugs. Limitations include self-report biases, the PCAP model might not affect the same degree of change among mothers whose baseline profile is not as severe, and lack of follow-up.

Length of postintervention follow-up: None.

Grant, T., Huggins, J., Graham, C., Ernst, C., Whitney, N., & Wilson, D. (2011). Maternal substance abuse and disrupted parenting: Distinguishing mothers who keep their children from those who do not. Children and Youth Services Review, 33, 2176–2185. https://doi.org/10.1016/j.childyouth.2011.07.001

Type of Study: One-group pretest-posttest
Number of Participants: 458

Population:

  • Age — Mean=27 years
  • Race/Ethnicity — 60% White, 20% Native American, 13% African American, and 7% Other
  • Gender — 100% Female
  • Status — Participants were substance-abusing mothers enrolled during pregnancy or postpartum in the Washington State Parent-Child Assistance Program (PCAP).

Location/Institution: Five counties in Washington State

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of this study was to explore how maternal risk and protective characteristics and service elements are associated with reunification among a sample of women participating in the Parent-Child Assistance Program (PCAP). Measures utilized include the Addiction Severity Index (ASI), 5th edition, as well as self-report of both alcohol and drug use, as well as services needed and received. Results indicate that, at program exit, 60% of the mothers were caring for their index child. These mothers had more treatment and mental health service needs met, had more time abstinent from alcohol and drugs, secure housing, higher income, and support for staying clean and sober. Results also showed that among women with multiple psychiatric diagnoses, the odds of regaining custody were increased when they completed substance abuse treatment and also had a supportive partner. Mothers who lost and did not regain custody had more serious psychiatric problems and had fewer service needs met. Limitations included lack of a control group and possible self-report biases.

Length of postintervention follow-up: None.

Grant, T. M., Graham, J. C., Ernst, C. C., Peavy, K. M., & Brown, N. N. (2014). Improving pregnancy outcomes among high-risk mothers who abuse alcohol and drugs: Factors associated with subsequent exposed births. Children and Youth Services Review, 46, 11–18. https://doi.org/10.1016/j.childyouth.2014.07.014

Type of Study: One-group pretest-posttest
Number of Participants: 795

Population:

  • Age — No subsequent birth: Mean=28 years; Subsequent birth: Mean=24.4 years
  • Race/Ethnicity — No subsequent birth: 61% White, 16% Native American, 13% Black, 7% Hispanic and 2% Asian/Pacific Islander/Hawaiian; Subsequent birth: 50% White, 26% Native American, 12% Black, 12% Hispanic and 1% Asian/Pacific Islander/Hawaiian
  • Gender — 100% Female
  • Status — Participants were women who abused alcohol/drugs during pregnancy and enrolled in the Washington State Parent-Child Assistance Program (PCAP).

Location/Institution: Nine counties in Washington State (King, Pierce, Yakima, Spokane, Grant, Cowlitz, Skagit, Clallam, and Kitsap)

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of this study was to explore whether loss of an index child due to substance abuse is associated with risk of a subsequent alcohol/drug-exposed birth in a sample of women participating in the Parent-Child Assistance Program (PCAP). Measures utilized include the Addiction Severity Index (ASI), 5th edition, as well as biannual assessment by case managers regarding client status based on observations of substance use and participation in treatment, family planning and number of pregnancies, index child status, stability indicators, and connection to community services for the mother and her family members. Results indicate that at program exit, over one-fifth of these women had a subsequent birth (SB) after the birth of their index child. Among these women, over half (i.e., 56.3% or 12.3% of the entire sample) used alcohol and/or drugs during the subsequent pregnancy. The adjusted odds of having a SB were increased nearly two-fold for women who had the index child removed from their care. Furthermore, among mothers with subsequent births, the adjusted odds of having an exposed SB were increased three-fold if the index child had been removed from the mother's care. Limitations include lack of control group, reliability on self-reported measures, and attrition.  

Length of postintervention follow-up: None.

Grant, T. M., Graham, J. C., Carlini, B. H., Ernst, C. C., & Brown, N. N. (2018). Use of marijuana and other substances among pregnant and parenting women with substance use disorders: Changes in Washington State after marijuana legalization. Journal of Studies on Alcohol and Drugs, 79(1), 88–95. https://doi.org/10.15288/jsad.2018.79.88

Type of Study: One-group pretest-posttest
Number of Participants: 1,359

Population:

  • Age — Cohort 1: Mean=26.9 years and Cohort 2: Mean=26.3 years
  • Race/Ethnicity — Cohort 1: 59% White, 18% Native American, 12% Black, 9% Hispanic, and 2% Other; Cohort 2: 59% White, 20% Native American, 10% Black, 10% Hispanic, and 1% Other
  • Gender — 100% Female
  • Status — Participants were women who abused alcohol/drugs during pregnancy and enrolled in the Washington State Parent-Child Assistance Program (PCAP).

Location/Institution: Nine counties in Washington State (King, Pierce, Yakima, Spokane, Grant, Cowlitz, Skagit, Clallam, and Kitsap)

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of this study was to examine how legalization affected alcohol and drug use in a sample of pregnant and parenting women with substance use disorders at completion of the Parent-Child Assistance Program (PCAP). Measures utilized include the Addiction Severity Index (ASI), 5th edition, as well as biannual assessment by case managers regarding client status based on observations of client activity, index child status, and connection to community services. Results indicate most study participants reported complete abstinence from alcohol and nonprescription drugs at program exit. Among those who were still using substances, women who completed the intervention after marijuana legalization were significantly more likely to report marijuana use at program exit compared with women who completed the intervention before marijuana legalization. Across both cohorts (pre- and post-legalization), a positive association of exit marijuana use with alcohol, illegal methadone, other opioids, amphetamines, and cocaine use was found; even when controlled for historical period, the association with some of these substances with marijuana use remained evident. Independent of marijuana use, there was increased use of alcohol, illicit methadone, and other opioids during the post-legalization period. Limitations include lack of control group, reliability on self-reported measures, and attrition.  

Length of postintervention follow-up: None.

Additional References

Grant, T. M. (2011). Maternal alcohol and drug abuse: Effective case management with high-risk mothers and their children. In A. Rubin (Ed.), The Clinician's Guide to Evidence-Based Practice: Programs and Interventions for Maltreated Children and Families at Risk (pp. 207–221). Wiley Blackwell Publishers.

Grant, T. M. (2015). Supporting mothers to prevent subsequent prenatal substance use (Research To Practice Brief, May 2015). National Abandoned Infants Assistance Resource Center, University of California, Berkeley. https://radarcart.boisestate.edu/library/files/2017/07/supporting-mothers.pdf

Grant, T. M., & Huggins, J. E. (2013). Intervention with mothers who abuse alcohol and drugs: How relationship and motivation affect the process of change in an evidence-based model. In N. E. Suchman, M. Pajulo, & L. C. Mayes (Eds.), Parenting and Substance Addiction: Developmental Approaches to Intervention (pp. 365–385). Oxford University Press.

Contact Information

Therese M. Grant, PhD
Title: Director, Washington State Parent-Child Assistance Program (PCAP)
Agency/Affiliation: University of Washington School of Medicine
Department: University of Washington Department of Psychiatry and Behavioral Sciences, Addictions, Drug & Alcohol Institute
Website: depts.washington.edu/pcapuw
Email:
Phone: (206) 543-7155
Fax: (206) 685-2903

Date Research Evidence Last Reviewed by CEBC: February 2021

Date Program Content Last Reviewed by Program Staff: December 2018

Date Program Originally Loaded onto CEBC: October 2009