Substance Abuse Treatment (Adult) is defined by the CEBC as the treatment of adults with a diagnosed substance use disorder, or substance use problems, addiction, dependence, or abuse. Treatment can occur in a variety of settings, including outpatient, day treatment, residential, or inpatient, and may involve detoxification, counseling, education, relapse prevention training, life skills training, and self-help groups. National data shows that approximately 8% of the population has used an illicit drug in the past month, while 23% reported binge drinking and 7% reported heavy drinking in the past month. One of the primary signs of substance abuse is the continued use of drugs or alcohol despite experiencing the serious negative consequences of heavy drug or alcohol use, such as being fired from a job or arrested. Substance use appears to be even more common among families involved in child welfare, with a recent round of Children and Family Service Reviews showing that 16% to 48% of all child welfare cases include substance use disorders. Substance use may be going unrecognized by child welfare as, according to the National Center on Substance Abuse and Child Welfare (NCSACW), 71% of caregivers who are alcohol dependent are classified by the child welfare workers as not having alcohol problems and 73% of caregivers who are drug dependent are classified by child welfare workers as not having a drug problem. The Pharmacological Treatment for Substance Abuse page has links to reputable organizations that list information on medications used to help treat substance abuse.
Downloadable Topic Area Summary
Substance Abuse Treatment (Adult) is defined by the CEBC as the treatment of adults with a diagnosed substance use disorder, or substance use problems, addiction, dependence, or abuse. Treatment can occur in a variety of settings, including outpatient, day treatment, residential, or inpatient, and may involve detoxification, counseling, education, relapse prevention training, life skills training, and self-help groups. National data shows that approximately 8% of the population has used an illicit drug in the past month, while 23% reported binge drinking and 7% reported heavy drinking in the past month. One of the primary signs of substance abuse is the continued use of drugs or alcohol despite experiencing the serious negative consequences of heavy drug or alcohol use, such as being fired from a job or arrested. Substance use appears to be even more common among families involved in child welfare, with a recent round of Children and Family Service Reviews showing that 16% to 48% of all child welfare cases include substance use disorders. Substance use may be going unrecognized by child welfare as, according to the National Center on Substance Abuse and Child Welfare (NCSACW), 71% of caregivers who are alcohol dependent are classified by the child welfare workers as not having alcohol problems and 73% of caregivers who are drug dependent are classified by child welfare workers as not having a drug problem. The Pharmacological Treatment for Substance Abuse page has links to reputable organizations that list information on medications used to help treat substance abuse.
Downloadable Topic Area Summary
The Substance Abuse Treatment (Adult) topic area is relevant to child welfare because many children are brought into the child welfare system due to their parent's substance abuse. The more significant risks to children of substance abusers include poorer developmental outcomes, depression, anxiety, and a high risk of substance abuse themselves. Research has shown that these children exhibit physical health consequences; lack of secure attachment; language delays; behavioral problems; poor social relations and skills; deficits in motor skills and cognition; and learning disabilities. The parents of these children need adequate identification by child welfare workers and these children themselves need in-depth assessments and interventions. Only by discovering evidence-based best practices can we begin to stop the destructive results of substance abusing parents and stop the cycle of addiction for the children of these parents.
Debby Jeter
Former Advisory Committee Member
The Substance Abuse Treatment (Adult) topic area is relevant to child welfare because many children are brought into the child welfare system due to their parent's substance abuse. The more significant risks to children of substance abusers include poorer developmental outcomes, depression, anxiety, and a high risk of substance abuse themselves. Research has shown that these children exhibit physical health consequences; lack of secure attachment; language delays; behavioral problems; poor social relations and skills; deficits in motor skills and cognition; and learning disabilities. The parents of these children need adequate identification by child welfare workers and these children themselves need in-depth assessments and interventions. Only by discovering evidence-based best practices can we begin to stop the destructive results of substance abusing parents and stop the cycle of addiction for the children of these parents.
Debby Jeter
Former Advisory Committee Member
The Substance Abuse Treatment (Adult) topic area was added in 2006. Nancy Young, MSW, PhD was the topic expert and was involved in identifying and rating any of the programs with an original load date in 2006 (as found on the bottom of the program's page on the CEBC) or others loaded earlier and added to this topic area when it launched. The topic area has grown over the years and any programs added since 2006 were identified by CEBC staff, the Scientific Panel, and/or the Advisory Committee. For these programs, Dr. Young was not involved in identifying or rating them.
The Substance Abuse Treatment (Adult) topic area was added in 2006. Nancy Young, MSW, PhD was the topic expert and was involved in identifying and rating any of the programs with an original load date in 2006 (as found on the bottom of the program's page on the CEBC) or others loaded earlier and added to this topic area when it launched. The topic area has grown over the years and any programs added since 2006 were identified by CEBC staff, the Scientific Panel, and/or the Advisory Committee. For these programs, Dr. Young was not involved in identifying or rating them.
MI is a client-centered, directive method designed to enhance client motivation for behavior change. It focuses on exploring and resolving ambivalence by increasing intrinsic motivation to change. MI can be used by itself, as well as in combination with other treatments. It has been utilized in pretreatment work to engage and motivate clients for other treatment modalities.
Adult-Focused FBT includes more than a dozen treatments including management of emergencies, treatment planning, home safety tours, behavioral goals and rewards, contingency management skills training, communication skills training, child management skills training, job-getting skills training, financial management, self-control, environmental control, home safety and aesthetics tours, and tele-therapy to improve session attendance. Therapies are consumer-driven and culturally sensitive. Adult-Focused FBT is designed to be used with adults, multiple ethnicities, differing types of substance abuse (alcohol, marijuana, and hard drugs), and across genders. Drafts of standardized client record keeping forms and quality assurance may be customized to fit agency needs. Adolescent-Focused Family Behavior Therapy (Adolescent FBT) has also been rated on this website, please click on the program name to be sent to its separate page.
CRA + Vouchers has two main components. The Community Reinforcement Approach (CRA) component is an intensive psychosocial therapy emphasizing changes in substance use; vocation; social and recreational practices; and coping skills. The Voucher Approach is a contingency- management intervention where clients earn material incentives for remaining in treatment and sustaining cocaine abstinence verified by urine toxicology testing.
The Families Facing the Future parent training curriculum consists of one five-hour family retreat and 32 hour-and-a-half parent training sessions. Sessions are conducted twice a week over a 16-week period. Children attend 12 of these sessions to practice the skills with their parents.
Parent sessions are conducted with groups of six to eight families. It is necessary to provide practice opportunities as well as skill components that address recurring problem behaviors specific to the needs of the parents. The parent training format combines a peer support and skill training model. The training curriculum teaches skills using the "guided participant modeling." Skills are modeled by trainers and other group members, then discussed by participants. Skills steps are reviewed and then parents practice the steps. Video-tape is frequently used in modeling the skills or during practice of the skills. The training focuses on affective and cognitive as well as behavioral aspects of performance.
HWR/BT is a combined intervention of 32 sessions that integrates three theories: a theory of addiction, a theory of women's psychological development, and a theory of trauma; and then adds a psychoeducational component that teaches women what trauma is, its process, and its impact. The program model is organized into seven modules. The first four: Self, Relationships, Sexuality, and Spirituality are areas that recovering women have identified as triggers for relapse and as necessary for growth and healing. The last three: Violence, Abuse, and Trauma; The Impact of Trauma on Women's Lives; and Healing from Trauma; focus on the trauma with a major emphasis on coping skills, with specific exercises for developing emotional wellness. The program comes with facilitator's manuals, two participant workbooks (A Women's Journal and A Healing Journey), and 3 DVDs. The materials are designed to be user-friendly and self-instructive. A special edition for criminal justice settings has also been developed.
Note: The Beyond Trauma materials were expanded and revised in 2017. The changes include an additional session, expanded sessions, inclusion of information from neuroscience, updated statistics, and resources. These changes have not been reviewed by the CEBC and are not included in the program's Scientific Rating. The Helping Women Recover materials were expanded and revised in 2019. The changes include adding trauma-sensitive yoga exercises, updated gender information, expanded mindfulness information, new brain research as it relates to addiction and trauma, updated statistics, Adverse Childhood Experiences (ACEs) information, and the process of trauma and its effects on the mind and body. These changes have not been reviewed by the CEBC and are not included in the program's Scientific Rating.
MST-BSF is an ecologically based treatment model for families involved with child welfare services due to physical abuse and/or neglect plus parental substance misuse. MST-BSF is designed to provide all families with intensive safety planning, Reinforcement-Based Treatment for adult substance misuse, a relapse prevention group, and clarification of the abuse or neglect. On an individualized, as-needed basis, children and adults receive treatment for clinical challenges such as posttraumatic stress disorder (PTSD), parenting, and family communication. To assure model fidelity, an array of quality assurance procedures is integrated into the model. The model is operated through a team consisting of a supervisor, a family resource specialist who focuses on basic needs, and three therapists that carry a caseload maximum of 4 families. Services are provided a minimum of 3 times per week plus there are on-call services for crises available 24 hours a day and 7 days a week. A psychiatrist is available 10-20% time. A close working relationship with child welfare services is important.
Seeking Safety is a present-focused, coping skills therapy to help people attain safety from trauma and/or substance abuse. The treatment is available as a book, providing both client handouts and clinician guidelines. The treatment may be conducted in group or individual format; with females and males; and in various settings (e.g., outpatient, inpatient, residential, home care, schools). Seeking Safety consists of 25 topics that can be conducted in as many sessions as time allows, and in any order. Examples of topics are Safety, Asking for Help, Setting Boundaries in Relationships, Healthy Relationships, Community Resources, Compassion, Creating Meaning, Discovery, Recovery Thinking, Taking Good Care of Yourself, Commitment, Coping with Triggers, Self-Nurturing, Red and Green Flags, and Life Choices. Seeking Safety is also rated on the CEBC in the Substance Abuse Treatment (Child & Adolescent) and Trauma Treatment - Client-Level Interventions (Child & Adolescent) topic areas, click here to go to this entry.
A.A. Preamble (Revised 2021*)
Alcoholics Anonymous (A.A.) is a fellowship of people who share their experience, strength, and hope with each other that they may solve their common problem and help others to recover from alcoholism. The only requirement for membership is a desire to stop drinking. There are no dues or fees for A.A. membership; we are self-supporting through our own contributions. A.A. is not allied with any sect, denomination, politics, organization, or institution; does not wish to engage in any controversy, neither endorses nor opposes any causes. Our Primary Purpose is to stay sober and help other alcoholics to achieve sobriety.
*The A.A. Preamble was revised in 2021 to replace the words “men and women” with “people” in the first sentence of the Preamble. The revision was approved through advisory action at the 71st General Service Conference annual meeting held online over April 17 to April 25, 2021.
Any A.A. Literature referenced on this Website, is a Copyright of Alcoholics Anonymous World Services, Inc.
Arkansas CARES provides services to mothers with dual diagnosis of substance abuse and mental health problems. Treatment is primarily provided in a long-term residential setting with family support and treatment services based on the Teaching-Family Model. Mothers are referred either when they are pregnant or enter treatment with their children. Additional services include maternal and child health care, parent training, vocational and educational training, and children's mental health and early education services.
CRA is a comprehensive cognitive-behavioral intervention for the treatment of substance abuse problems. CRA seeks to treat substance abuse problems through focusing on environmental contingencies that impact and influence the client's behavior. Developed in accordance with the belief that these environmental contingencies play a crucial role in an individual's addictive behavior and recovery, CRA utilizes familial, social, recreational, and occupational events to support the individual in changing his or her drinking/using behaviors and in creating a successful sobriety. Two other versions of CRA are highlighted on the CEBC: Adolescent Community Reinforcement Approach (A-CRA) and Community Reinforcement + Vouchers Approach (CRA+Vouchers).
Creating Change is a past-focused model for trauma and addiction for a very broad range of clients. It can be conducted in individual or group format by any provider. The program is designed to be highly accessible, flexible, and engaging from a public health standpoint. Each treatment topic helps clients face their past by addressing a theme, for example:
Creating Change has the same format and compassionate tone as Seeking Safety (a present-focused model for trauma and/or addiction) and can be used with that model if desired.
Using a well-specified behavioral approach, FAIR treatment is individualized to fit the unique circumstances and needs of families presenting with opioid, methamphetamine, and other drugs of abuse. FAIR clinicians coordinate with child welfare staff to ensure that parents are meeting their child welfare treatment plan goals. Parents are incentivized to work toward their treatment goals that increase child safety and permanency. The model allows for service delivery within a flexible environment including meeting times and places (in-home, community, shelter). Sessions occur in the community where clients have the opportunity to practice success, and other places most likely for parenting to occur (e.g., home, school, playground, visitations). With the overall goal of creating safe and sober households, treatment includes a focus on addressing progress in the following areas:
The FAIR team is available 24/7 for on-call support and ongoing engagement strategies.
The Matrix Model Intensive Outpatient Program is an intensive outpatient treatment approach for substance abuse and dependence. The intervention consists of relapse-prevention groups, education groups, social-support groups, individual counseling, and urine and breath-alcohol testing delivered over a 16-week period. Patients learn about addiction and relapse, receive direction and support from a trained therapist, become familiar with self-help programs, and are monitored by urine testing. It is a cognitive/behavioral approach imbued with a motivational interviewing style.
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.
The A Woman's Way through The Twelve Steps program materials meet the needs of women and teenage girls who struggle to relate to the traditional language of Twelve Step programs, as well as those who find this woman-centered perspective an important addition to traditional recovery materials. The A Woman's Way through The Twelve Steps book is a compilation of a diverse group of women's voices explaining what the Steps mean to them and how they have incorporated these principles in their lives. The women interviewed for this book are members of Alcoholics Anonymous, Cocaine Anonymous, Overeaters Anonymous, Al-Anon and Debtors Anonymous. The women also discuss the four issues that reflect the areas of change in their lives from addiction to recovery. These issues are also key triggers to relapse: self, relationship, sexuality, and spirituality.
The workbook helps to increase a woman's or a teenage girl's understanding of the Steps through simple exercises and journaling activities. There is a facilitator guide which describes a thirteen-session process with lesson plans.
F4C is an individual clinical intervention for fathers who have used violence with their partners and/or children and may have co-occurring substance misuse. F4C addresses 9 individually focused core topics, 4 co-parent communication topics, and 5 father-child focused topics in 60-minute individual therapy sessions over 18-24 weeks. In the context of a strong working alliance developed through focus on fatherhood, F4C employs a continual emphasis on reflective functioning and emotion regulation skills. Improvement in these targets in turn leads to reduced IPV and child maltreatment. F4C motivates the father to change by continually recognizing his desire to be a better parent and facilitating his ability to reflect on the experiences of his co-parent and children and learn skills to manage his emotions to improve outcomes for his family. It offers optional coparent and child participation in some sessions of the intervention when deemed appropriate and safe by the treating therapist.
Helping Men Recover (HMR) is a gender-responsive, trauma-informed treatment program for men. The materials include a facilitator’s guide and a participant’s workbook. This is the men’s version of the women’s curriculum, Helping Women Recover, which is highlighted on the CEBC as part of a combined Helping Women Recover & Beyond Trauma (HWR/BT) intervention. HMR addresses what is often missing in prevailing treatment modes: a clear understanding of the impact of male socialization on the recovery process, a consideration of the relational needs of men, a healthy exploration of sex and sexuality, investigation of concepts of power, and a focus on the issues of abuse and trauma (both experienced and perpetrated). The Helping Men Recover Facilitator’s Guide for the 18-session program is a step-by-step manual containing the theory, structure, and content needed for running groups. The participant’s workbook allows men to process and record the therapeutic experience. The program model is organized into four modules that emphasize the core areas of men’s recovery: Self, Relationships, Sexuality, and Spirituality. The materials are designed to be user-friendly and self-instructive. There is a community version and a criminal justice version of the materials; neither of these versions has been reviewed by the CEBC.
The Nurturing Program for Families in Substance Abuse Treatment and Recovery focuses on the effects of substance abuse on families, parenting, and the parent-child relationship. Combining experiential and didactic exercises, the approach is designed to enhance parents' self-awareness and thereby increase their capacity to understand their children. Parents may experience loss of self-image as being capable, effective parents. They may have a diminished capacity for empathy. In addition, the parent-child bond may be weakened by periods of physical and/or emotional unavailability of parents; thus resulting in gaps in parents' knowledge of the experiences, milestones and growth of their children. This program is designed to assist parents in re-establishing the strength of their connections with their children.
The Recovery Coach (RC) program is an intensive, community-based case management intervention for people who have entered an addiction treatment program or need support to access treatment. The program is designed as an integrated component of a comprehensive addiction treatment continuum. The primary purpose of the recovery coach program is to help individuals gain access to needed resources, services, or supports that will help them achieve recovery from their substance use disorder (SUD). Recovery coaches can help individuals address multiple domains in the their life that have been impacted by their SUD but are difficult to address within conventional treatment programs, such as returning to employment or finding stable housing. Recovery coaches can also help individuals transition through the continuum of addiction treatment. Finally, recovery coaches can help individuals sustain their recovery after the formal addiction treatment component has been completed through consultation and in vivo skills training.
Solution-Focused Brief Therapy (SFBT) is a therapy model that asserts the importance of building on the resources and motivation of clients because they know their problems best and are capable of generating solutions to solve their own problems. Central to SFBT is client strengths and resiliencies, client's prior ability to develop solutions, and exceptions to problems. Discussion of exceptions and movement towards future adaptive behaviors allows the clinician and client to focus on solutions to the client's problem, rather than dwelling on the problem itself. The emphasis of SFBT is on the process of developing an image of a realistic solution rather than dwelling on the past manifestation of the problem, with the focus being on identifying past successes and exceptions to the problem in an effort to accomplish set goals.
STARS is operated by a local non-profit community-based organization that provides substance abuse treatment services through a contract with Sacramento County to serve families who have entered the County's Dependency Drug Court. STARS is designed to assist parents in entering and completing substance abuse treatment and other court requirements. Each parent who is referred to STARS is matched with a recovery specialist who assists the parent(s) in accessing substance abuse treatment services, develops a liaison role with Child Protective Services (CPS) and other professionals and provides monitoring and accountability for the parent(s) in complying with treatment requirements.
MI is a client-centered, directive method designed to enhance client motivation for behavior change. It focuses on exploring and resolving ambivalence by increasing intrinsic motivation to change. MI can be used by itself, as well as in combination with other treatments. It has been utilized in pretreatment work to engage and motivate clients for other treatment modalities.
Adult-Focused FBT includes more than a dozen treatments including management of emergencies, treatment planning, home safety tours, behavioral goals and rewards, contingency management skills training, communication skills training, child management skills training, job-getting skills training, financial management, self-control, environmental control, home safety and aesthetics tours, and tele-therapy to improve session attendance. Therapies are consumer-driven and culturally sensitive. Adult-Focused FBT is designed to be used with adults, multiple ethnicities, differing types of substance abuse (alcohol, marijuana, and hard drugs), and across genders. Drafts of standardized client record keeping forms and quality assurance may be customized to fit agency needs. Adolescent-Focused Family Behavior Therapy (Adolescent FBT) has also been rated on this website, please click on the program name to be sent to its separate page.
CRA + Vouchers has two main components. The Community Reinforcement Approach (CRA) component is an intensive psychosocial therapy emphasizing changes in substance use; vocation; social and recreational practices; and coping skills. The Voucher Approach is a contingency- management intervention where clients earn material incentives for remaining in treatment and sustaining cocaine abstinence verified by urine toxicology testing.
The Families Facing the Future parent training curriculum consists of one five-hour family retreat and 32 hour-and-a-half parent training sessions. Sessions are conducted twice a week over a 16-week period. Children attend 12 of these sessions to practice the skills with their parents.
Parent sessions are conducted with groups of six to eight families. It is necessary to provide practice opportunities as well as skill components that address recurring problem behaviors specific to the needs of the parents. The parent training format combines a peer support and skill training model. The training curriculum teaches skills using the "guided participant modeling." Skills are modeled by trainers and other group members, then discussed by participants. Skills steps are reviewed and then parents practice the steps. Video-tape is frequently used in modeling the skills or during practice of the skills. The training focuses on affective and cognitive as well as behavioral aspects of performance.
HWR/BT is a combined intervention of 32 sessions that integrates three theories: a theory of addiction, a theory of women's psychological development, and a theory of trauma; and then adds a psychoeducational component that teaches women what trauma is, its process, and its impact. The program model is organized into seven modules. The first four: Self, Relationships, Sexuality, and Spirituality are areas that recovering women have identified as triggers for relapse and as necessary for growth and healing. The last three: Violence, Abuse, and Trauma; The Impact of Trauma on Women's Lives; and Healing from Trauma; focus on the trauma with a major emphasis on coping skills, with specific exercises for developing emotional wellness. The program comes with facilitator's manuals, two participant workbooks (A Women's Journal and A Healing Journey), and 3 DVDs. The materials are designed to be user-friendly and self-instructive. A special edition for criminal justice settings has also been developed.
Note: The Beyond Trauma materials were expanded and revised in 2017. The changes include an additional session, expanded sessions, inclusion of information from neuroscience, updated statistics, and resources. These changes have not been reviewed by the CEBC and are not included in the program's Scientific Rating. The Helping Women Recover materials were expanded and revised in 2019. The changes include adding trauma-sensitive yoga exercises, updated gender information, expanded mindfulness information, new brain research as it relates to addiction and trauma, updated statistics, Adverse Childhood Experiences (ACEs) information, and the process of trauma and its effects on the mind and body. These changes have not been reviewed by the CEBC and are not included in the program's Scientific Rating.
MST-BSF is an ecologically based treatment model for families involved with child welfare services due to physical abuse and/or neglect plus parental substance misuse. MST-BSF is designed to provide all families with intensive safety planning, Reinforcement-Based Treatment for adult substance misuse, a relapse prevention group, and clarification of the abuse or neglect. On an individualized, as-needed basis, children and adults receive treatment for clinical challenges such as posttraumatic stress disorder (PTSD), parenting, and family communication. To assure model fidelity, an array of quality assurance procedures is integrated into the model. The model is operated through a team consisting of a supervisor, a family resource specialist who focuses on basic needs, and three therapists that carry a caseload maximum of 4 families. Services are provided a minimum of 3 times per week plus there are on-call services for crises available 24 hours a day and 7 days a week. A psychiatrist is available 10-20% time. A close working relationship with child welfare services is important.
Seeking Safety is a present-focused, coping skills therapy to help people attain safety from trauma and/or substance abuse. The treatment is available as a book, providing both client handouts and clinician guidelines. The treatment may be conducted in group or individual format; with females and males; and in various settings (e.g., outpatient, inpatient, residential, home care, schools). Seeking Safety consists of 25 topics that can be conducted in as many sessions as time allows, and in any order. Examples of topics are Safety, Asking for Help, Setting Boundaries in Relationships, Healthy Relationships, Community Resources, Compassion, Creating Meaning, Discovery, Recovery Thinking, Taking Good Care of Yourself, Commitment, Coping with Triggers, Self-Nurturing, Red and Green Flags, and Life Choices. Seeking Safety is also rated on the CEBC in the Substance Abuse Treatment (Child & Adolescent) and Trauma Treatment - Client-Level Interventions (Child & Adolescent) topic areas, click here to go to this entry.
A.A. Preamble (Revised 2021*)
Alcoholics Anonymous (A.A.) is a fellowship of people who share their experience, strength, and hope with each other that they may solve their common problem and help others to recover from alcoholism. The only requirement for membership is a desire to stop drinking. There are no dues or fees for A.A. membership; we are self-supporting through our own contributions. A.A. is not allied with any sect, denomination, politics, organization, or institution; does not wish to engage in any controversy, neither endorses nor opposes any causes. Our Primary Purpose is to stay sober and help other alcoholics to achieve sobriety.
*The A.A. Preamble was revised in 2021 to replace the words “men and women” with “people” in the first sentence of the Preamble. The revision was approved through advisory action at the 71st General Service Conference annual meeting held online over April 17 to April 25, 2021.
Any A.A. Literature referenced on this Website, is a Copyright of Alcoholics Anonymous World Services, Inc.
Arkansas CARES provides services to mothers with dual diagnosis of substance abuse and mental health problems. Treatment is primarily provided in a long-term residential setting with family support and treatment services based on the Teaching-Family Model. Mothers are referred either when they are pregnant or enter treatment with their children. Additional services include maternal and child health care, parent training, vocational and educational training, and children's mental health and early education services.
CRA is a comprehensive cognitive-behavioral intervention for the treatment of substance abuse problems. CRA seeks to treat substance abuse problems through focusing on environmental contingencies that impact and influence the client's behavior. Developed in accordance with the belief that these environmental contingencies play a crucial role in an individual's addictive behavior and recovery, CRA utilizes familial, social, recreational, and occupational events to support the individual in changing his or her drinking/using behaviors and in creating a successful sobriety. Two other versions of CRA are highlighted on the CEBC: Adolescent Community Reinforcement Approach (A-CRA) and Community Reinforcement + Vouchers Approach (CRA+Vouchers).
Creating Change is a past-focused model for trauma and addiction for a very broad range of clients. It can be conducted in individual or group format by any provider. The program is designed to be highly accessible, flexible, and engaging from a public health standpoint. Each treatment topic helps clients face their past by addressing a theme, for example:
Creating Change has the same format and compassionate tone as Seeking Safety (a present-focused model for trauma and/or addiction) and can be used with that model if desired.
Using a well-specified behavioral approach, FAIR treatment is individualized to fit the unique circumstances and needs of families presenting with opioid, methamphetamine, and other drugs of abuse. FAIR clinicians coordinate with child welfare staff to ensure that parents are meeting their child welfare treatment plan goals. Parents are incentivized to work toward their treatment goals that increase child safety and permanency. The model allows for service delivery within a flexible environment including meeting times and places (in-home, community, shelter). Sessions occur in the community where clients have the opportunity to practice success, and other places most likely for parenting to occur (e.g., home, school, playground, visitations). With the overall goal of creating safe and sober households, treatment includes a focus on addressing progress in the following areas:
The FAIR team is available 24/7 for on-call support and ongoing engagement strategies.
The Matrix Model Intensive Outpatient Program is an intensive outpatient treatment approach for substance abuse and dependence. The intervention consists of relapse-prevention groups, education groups, social-support groups, individual counseling, and urine and breath-alcohol testing delivered over a 16-week period. Patients learn about addiction and relapse, receive direction and support from a trained therapist, become familiar with self-help programs, and are monitored by urine testing. It is a cognitive/behavioral approach imbued with a motivational interviewing style.
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.
The A Woman's Way through The Twelve Steps program materials meet the needs of women and teenage girls who struggle to relate to the traditional language of Twelve Step programs, as well as those who find this woman-centered perspective an important addition to traditional recovery materials. The A Woman's Way through The Twelve Steps book is a compilation of a diverse group of women's voices explaining what the Steps mean to them and how they have incorporated these principles in their lives. The women interviewed for this book are members of Alcoholics Anonymous, Cocaine Anonymous, Overeaters Anonymous, Al-Anon and Debtors Anonymous. The women also discuss the four issues that reflect the areas of change in their lives from addiction to recovery. These issues are also key triggers to relapse: self, relationship, sexuality, and spirituality.
The workbook helps to increase a woman's or a teenage girl's understanding of the Steps through simple exercises and journaling activities. There is a facilitator guide which describes a thirteen-session process with lesson plans.
F4C is an individual clinical intervention for fathers who have used violence with their partners and/or children and may have co-occurring substance misuse. F4C addresses 9 individually focused core topics, 4 co-parent communication topics, and 5 father-child focused topics in 60-minute individual therapy sessions over 18-24 weeks. In the context of a strong working alliance developed through focus on fatherhood, F4C employs a continual emphasis on reflective functioning and emotion regulation skills. Improvement in these targets in turn leads to reduced IPV and child maltreatment. F4C motivates the father to change by continually recognizing his desire to be a better parent and facilitating his ability to reflect on the experiences of his co-parent and children and learn skills to manage his emotions to improve outcomes for his family. It offers optional coparent and child participation in some sessions of the intervention when deemed appropriate and safe by the treating therapist.
Helping Men Recover (HMR) is a gender-responsive, trauma-informed treatment program for men. The materials include a facilitator’s guide and a participant’s workbook. This is the men’s version of the women’s curriculum, Helping Women Recover, which is highlighted on the CEBC as part of a combined Helping Women Recover & Beyond Trauma (HWR/BT) intervention. HMR addresses what is often missing in prevailing treatment modes: a clear understanding of the impact of male socialization on the recovery process, a consideration of the relational needs of men, a healthy exploration of sex and sexuality, investigation of concepts of power, and a focus on the issues of abuse and trauma (both experienced and perpetrated). The Helping Men Recover Facilitator’s Guide for the 18-session program is a step-by-step manual containing the theory, structure, and content needed for running groups. The participant’s workbook allows men to process and record the therapeutic experience. The program model is organized into four modules that emphasize the core areas of men’s recovery: Self, Relationships, Sexuality, and Spirituality. The materials are designed to be user-friendly and self-instructive. There is a community version and a criminal justice version of the materials; neither of these versions has been reviewed by the CEBC.
The Nurturing Program for Families in Substance Abuse Treatment and Recovery focuses on the effects of substance abuse on families, parenting, and the parent-child relationship. Combining experiential and didactic exercises, the approach is designed to enhance parents' self-awareness and thereby increase their capacity to understand their children. Parents may experience loss of self-image as being capable, effective parents. They may have a diminished capacity for empathy. In addition, the parent-child bond may be weakened by periods of physical and/or emotional unavailability of parents; thus resulting in gaps in parents' knowledge of the experiences, milestones and growth of their children. This program is designed to assist parents in re-establishing the strength of their connections with their children.
The Recovery Coach (RC) program is an intensive, community-based case management intervention for people who have entered an addiction treatment program or need support to access treatment. The program is designed as an integrated component of a comprehensive addiction treatment continuum. The primary purpose of the recovery coach program is to help individuals gain access to needed resources, services, or supports that will help them achieve recovery from their substance use disorder (SUD). Recovery coaches can help individuals address multiple domains in the their life that have been impacted by their SUD but are difficult to address within conventional treatment programs, such as returning to employment or finding stable housing. Recovery coaches can also help individuals transition through the continuum of addiction treatment. Finally, recovery coaches can help individuals sustain their recovery after the formal addiction treatment component has been completed through consultation and in vivo skills training.
Solution-Focused Brief Therapy (SFBT) is a therapy model that asserts the importance of building on the resources and motivation of clients because they know their problems best and are capable of generating solutions to solve their own problems. Central to SFBT is client strengths and resiliencies, client's prior ability to develop solutions, and exceptions to problems. Discussion of exceptions and movement towards future adaptive behaviors allows the clinician and client to focus on solutions to the client's problem, rather than dwelling on the problem itself. The emphasis of SFBT is on the process of developing an image of a realistic solution rather than dwelling on the past manifestation of the problem, with the focus being on identifying past successes and exceptions to the problem in an effort to accomplish set goals.
STARS is operated by a local non-profit community-based organization that provides substance abuse treatment services through a contract with Sacramento County to serve families who have entered the County's Dependency Drug Court. STARS is designed to assist parents in entering and completing substance abuse treatment and other court requirements. Each parent who is referred to STARS is matched with a recovery specialist who assists the parent(s) in accessing substance abuse treatment services, develops a liaison role with Child Protective Services (CPS) and other professionals and provides monitoring and accountability for the parent(s) in complying with treatment requirements.
