Blending Perspectives and
Building Common Ground

A Report to Congress on Substance Abuse and Child Protection

April 1999

Department of Health and Human Services

Administration for Children and Families
Substance Abuse and Mental Health Services Administration
Office of the Assistant Secretary for Planning and Evaluation

Acknowledgments, Public Domain Notice, Electronic Access

I. Introduction

Substance Abuse is a Critical Child Welfare Issue
Timely Substance Abuse Services Are Key to Achieving Permanency for Children
Collaboration Between Child Welfare and Substance Abuse Treatment Agencies is Challenging
Improved Practice and Outcomes are Possible and Essential

II. Understanding Addiction, Substance Abuse Treatment, and Recovery

The Spectrum of Substance Use, Abuse, and Addiction
Myths and Facts About Addiction and Treatment
Substance Abuse Treatment and Recovery
Understanding Relapse and Factors Associated with Relapse
Impact of Substance Abuse on the Individual, Family, and Community

III. The Nature of Child Maltreatment

Definitions
Longer Term Effects of Abuse and Neglect
Characteristics of Persons Who Maltreat Children
Prevention and Intervention in Child Maltreatment

IV. The Extent and Scope of the Problem

How many children live with substance abusing parents?
How many of the families involved with the child welfare system have substance abuse problems?
How many families with substance abuse problems have contact with the child welfare system?
How are families with substance abuse problems different from other child welfare clients?
How are families with child maltreatment problems different from other substance abuse treatment clients?
Child Abuse as a Precursor to Substance Abuse

V. The Complexity of Child and Family Needs

Co-Occurring Health and Social Factors
Substance Abuse and Parenting
Effective Parenting and Family Interventions for Substance Abusers
Children of Substance Abusers
Implications for Intervention

VI. The Context of Collaboration and Overcoming Barriers to Quality Service

Client Identification
Defining Outcomes and Success
Balancing Competing Time Lines
Child Protection Laws and Policies
The Impact of Perpetual Crisis in the Child Welfare Field
Chronic Shortages of Substance Abuse Treatment
Confidentiality Issues
Dealing with Setbacks

VII. Service Delivery Models: Approaches to Addressing Joint Substance Abuse and Child Maltreatment Problems

Valuing Prevention
Strengthening Training and Identification Skills
Enhancing Risk Assessment, Needs Assessment, and Referral Capacity
Increasing the Availability, Access, and Appropriateness of Substance Abuse Treatment for Families
Promoting Client Retention and the Effectiveness of Services
Improving Time Lines and Decision Making for Children
Supporting Recovery

VIII. Where Do We Go From Here? Directions and Next Steps for Federal, State and Local Efforts

Building Collaborative Working Relationships
Assuring Timely Access to Comprehensive Substance Abuse Treatment
Services
Improving Our Ability to Engage and Retain Clients in Care and to Support Ongoing Recovery
Enhancing Children's Services
Filling Information Gaps
Other Activities Across Action Areas
Moving Forward, Together

Appendix A: Medicaid Services for Substance Abuse Treatment

Appendix B: Center for Substance Abuse Treatment Comprehensive Treatment Model for Alcohol and Other Drug Abusing Women and Their Children

Appendix C: Key Federal Programs Funding Substance Abuse and Child Welfare Services and Research

ACKNOWLEDGMENTS

This publication was developed jointly by the Administration for Children and Families, the Substance Abuse and Mental Health Services Administration, and the Office of the Assistant Secretary for Planning and Evaluation, in consultation with the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, and the Health Care Financing Administration.

All material appearing in this report is in the public domain and may be reproduced or copied without permission from the U.S. Department of Health and Human Services. Citation of the source is appreciated. The recommended citation for this report is:

U.S. Department of Health and Human Services. Blending Perspectives and Building Common Ground. A Report to Congress on Substance Abuse and Child Protection. Washington, D.C.: U.S. Government Printing Office, 1999.

OBTAINING COPIES OF THIS PUBLICATION

For copies of this publication, please send an e-mail request to: nccanch@calib.com or write or call:
The National Clearinghouse on Child Abuse and Neglect Information
330 C St, SW
Washington, DC 20447
1-800-FYI-3366

ELECTRONIC ACCESS TO PUBLICATION

This publication can be accessed electronically at: aspe.hhs.gov/ or www.acf.dhhs.gov/programs/cb/

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