Topic: Substance Abuse Treatment (Adult)
Definition for Substance Abuse Treatment (Adult):
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.
- Target population: Adults with a diagnosed substance use disorder, or substance use problems, addiction, dependence, or abuse
- Services/types that fit: Outpatient, day treatment, and residential services in individual or group formats
- Delivered by: Mental health professionals or trained paraprofessionals
- In order to be included: Program must specifically target adult substance use as a goal
- In order to be rated: There must be research evidence (as specified by the Scientific Rating Scale) that examines outcomes related to substance abuse, such changes in symptom levels, behaviors, and/or functioning
Programs in this Topic Area
The programs listed below have been reviewed by the CEBC and, if appropriate, been rated using the Scientific Rating Scale.
One Program with a Scientific Rating of 1 - Well-Supported by Research Evidence:
- Motivational Interviewing (MI)Caregivers of children referred to the child welfare system, has been used with adolescents
Six Programs with a Scientific Rating of 2 - Supported by Research Evidence:
- Adult-Focused Family Behavior Therapy (Adult-Focused FBT)Adults with drug abuse and dependence, as well as other co-existing problems such as depression, family dysfunction, trauma, child maltreatment, ...
- Community Reinforcement + Vouchers Approach (CRA + Vouchers)Adults age 18 or older with a diagnosis of cocaine abuse or dependence
- Families Facing the FutureParents receiving methadone treatment and their children ages 5-14
- Helping Women Recover & Beyond Trauma (HWR/BT)Adult women with addictive disorders and a trauma history (e.g., abuse, domestic violence, community violence, etc.)
- Multisystemic Therapy – Building Stronger Families (MST-BSF)Families who are involved with child welfare services due to physical abuse and/or neglect plus parental substance misuse
- Seeking Safety (Adult version)Adults who have a history of trauma and/or substance abuse
Eight Programs with a Scientific Rating of 3 - Promising Research Evidence:
- Alcoholics Anonymous (A.A.)Adults who have identified themselves as alcoholics and are trying to maintain sobriety
- Arkansas Center for Addictions Research, Education, and Services (Arkansas CARES) – non-responderMothers with dual diagnosis of substance abuse and mental health problems
- Community Reinforcement Approach (CRA)Individuals ages 18 and over who have a primary diagnosis of any Substance-Related Disorder (DSM-IV-R); individuals with co-occurring disorders also respond ...
- Creating ChangeAdults ages 18 and above who have experienced trauma and addiction
- Families Actively Improving Relationships (FAIR)Parents with parental rights for at least one of their minor children, in utero to age 17, who have been referred ...
- Matrix Model Intensive Outpatient ProgramAdults with substance abuse disorders
- Parent-Child Assistance Program (PCAP)Pregnant or parenting mothers (up to 12 months postpartum) who have alcohol and/or drug use disorders and their children 0 to 3.
- Project LinkPregnant and parenting women of childbearing age
Seven Programs with a Scientific Rating of NR - Not able to be Rated:
- Helping Men Recover: A Program for Treating Addiction (HMR)Men with substance use disorders
- Nurturing Program for Families in Substance Abuse Treatment and RecoveryParents who are in substance abuse treatment and recovery; and may have current or past mental health issues and/or ...
- Recovery Coach (RC)Adults 18 years or older who have a primary substance use disorder (co-occurring conditions are expected)
- Reno Family Drug CourtParents whose children have been placed within the child welfare system, due to child abuse and/or neglect related to ...
- Solution-Focused Brief Therapy (SFBT)Parents who have had their children removed from their custody and into foster care by Child Welfare Services (CWS), have ...
- Specialized Treatment and Recovery Services (STARS)Parents with substance abuse issues involved with the child welfare system
- Woman's Way through The Twelve Steps, AA Woman's Way through The Twelve StepsWomen and teenage girls with addictive disorders
Why was this topic chosen by the Advisory Committee?
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.
Former Advisory Committee Member
Nancy Young, PhD, Executive Director, Children and Family Futures;
Director, National Center on Substance Abuse and Child Welfare
University of California-Irvine