Current Treatment For Pregnant And Parenting Women
by Marca McCallie
We last discussed the importance of noticing context and critically evaluating interventions. We hope you’ll join us in extending compassion to parents struggling with addiction while also critically evaluating how interventions can either promote healthy healing or hinder it.
Do you remember the image of a river we used in our last blog to discuss what’s happening in the here and now and what's happening both up- and downstream? Today we want to draw your attention to what is currently offered for pregnant and parenting women (PPW) in Coconino County who are receiving services provided by the Department of Child Safety (DCS) - what is happening on the river right now?
Currently, there are three main treatment options available for PPW that vary in detail depending on the case. They are:
In-Home Dependency with a safety monitor
The SENSE program
Foster Care/Kinship care placement
Before we dive into each of the three options, let’s first discuss the goal of these interventions. The optimal goal is family preservation or family reunification where the child can safely live with their biological parents who are sober, have stable housing, and have financial means to care for their baby. A further hope is that these parents will learn healthy parenting skills to foster secure attachment in their children and correct or change course from any generational trauma their parents endured (more on this in the next blog post). So, in general, the healthier the parents, the healthier the child. Now let’s dive into these three interventions and examine how they impact parenting skills, child attachment, and long term permanency with the biological family.
Option One: In-Home Dependency with a Safety Monitor
For this option to be chosen, DCS will have deemed the mother (and father) safe enough to return home with their child as long as they are being constantly supervised by a safety monitor. The safety monitor can be a member of the family or a close friend who has passed a background check and agrees to follow the guidelines set out by DCS. This typically includes being onsite with the biological parent(s) in a supervisory role when the child(ren) is/are present.
Benefits
This is an excellent option where mom and child can stay together and avoid the harm caused by child removal.
Mom (and dad) can receive outpatient services for their substance misuse and attend outpatient parenting classes.
They also can receive support from their safety monitor and hopefully find or stay in current stable housing.
They can work towards financial stability.
This option supports healthy attachment, teaches necessary parenting skills, and increases permanency chances for the child(ren) to stay with their biological family in the future.
Limitations
A significant burden is placed on the safety monitor to be consistently present and on-site with the children. This can be difficult if the safety monitor works or has other obligations outside of the home (for more on this see Marca’s weekly interview with Holland Fields HERE).
Even though the parent is able to stay in the home, their parenting skills training is limited to parenting classes or with their safety monitor. They might not have the same level of support they would have with other parents/children present who were also learning skills in real time with trained staff on site.
Many parents are unable to find a safety monitor or have stable housing to even consider this option.
Where Sage Home Could Help
One way Sage Home could address the limitations in cases where In-Home Dependency with a safety monitor occurs is by providing day program services where mothers have a place to go during the day to receive treatment, parenting classes, and parenting support while staying on site with their children. This option would ease some of the burden placed on the safety monitor and would allow the mother more support and opportunities to connect with other mothers and to practice new parenting skills in the presence of trained staff. Sage Home could also ease some of the burden on the parent by offering a “one stop shop” to help them complete requirements set out by DCS including substance abuse treatment, weekly Urine Drug Screens (UDS), parenting classes, and vocational and housing support.
Option Two: The SENSE Program
The SENSE program stands for Substance Exposed Newborn Safe Environment Program. This is another excellent option that allows for substance exposed newborns to return home with their mother and receive services that come directly to their home. For more in depth information on the SENSE program check out this brochure.
Benefits
All SENSE cases are referred to In-Home intensive services that include intensive case management, frequent home visits (1-12 times monthly), referrals to appropriate services, collaboration with service providers, and possible assistance with housing, food boxes, child care, and transportation.
Intensive services include individual, family and couples counseling, parenting skills education, child development education, positive discipline education, coordination of services and treatment planning with other providers, referrals to other agencies, linkage with community resources such as long-term counseling, home management and budgeting education, and medical & developmental consultation.
The SENSE Program is awesome in many ways and provides the support needed to foster healthy attachments, teach healthy parenting skills, and supports permanency with the biological family.
Limitations
A major limitation is the mothers have to have access to stable housing before qualifying for the SENSE program and services are limited to substance exposed newborns and not to parents with older children.
The SENSE program also requires a safety monitor and has the same limitations as the previous option.
In order for the SENSE program to be successful, a tremendous amount of resources need to be utilized and organized to provide for each individual case which is both costly and inefficient at times.
Where Sage Home Could Help
Again, the day program Sage Home could provide would help centralize resources and provide the necessary community support needed to help mothers feel connected to other parents that are also working towards the same parenting and personal goals. Addiction can be a deeply disconnecting experience that needs treatment options that promote connection and encourage getting out of the house and into the world. Sage Home could help provide this for parents involved in the wonderful services provided by the SENSE program and help ease some of the resource burden by providing a centralized location where services can be received.
Option Three: Out of Home Placement through Kinship Care/Foster Care
Since stable housing is typically a challenge for parents actively abusing substances and because it’s hard to find a qualified safety monitor, this option is far too common for parents involved with DCS. This option is the worst case scenario because it breaks the attachment bond between parent and child and impacts parental motivation to move through the steps necessary to get their children back. This option has lower reunification success rates than the previously mentioned options and more long-term consequences if reunification is achieved. Even if the child is placed in the best foster family imaginable, there is still a major wound inherent in separation for the child and parents alike. This is the option most frequently discussed in Sage Home because it’s the option that needs to be minimized immediately to mitigate the harmful effects of child removal. The benefit to child removal is children are removed from an environment that may be unsafe and hopefully placed in a safer home while their parents engage in treatment.
Where Sage Home Could Help
For Sage Home, these parents are our prime focus and mission because they are the ones that do not meet the requirements for the previous two interventions. Sage Home will provide a space for parents to receive intensive inpatient/outpatient services with their children on site and provide both the parents and children with services necessary for health and well-being. Sage Home will be a longer term treatment option that supports the parents all the way through finding stable housing, work, and recovery from addiction all while learning how to parent effectively without breaking the parent-child bond or attachment. While child removal may be inevitable in some cases, the child would experience long-term benefits from the safety and attachment they encountered with their parent(s) while in the safe space of treatment. Additionally, by focusing on prevention, overall rates of child removal will be greatly reduced if Sage Home is the primary option utilized first by child welfare before any removal considerations.
Sage Home believes that parents are capable of providing great care for their children if they have the appropriate amount of support, encouragement, and healing. We also believe that systems in Coconino County have the capacity to provide great care when more support and resources are present within the community and can effectively move towards increased reunification rates and family preservation successes together. Together our community has what it takes to support struggling families in their journey to recover from addiction, learn and provide healthy parenting for their children, and correct and heal generational wounds.
For more information on current services offered in Coconino Country for families in the DCS system click HERE and HERE to listen to Marca’s recent interview with Virginia Watahomigie, M.ADM with Coconino Coalition for Children and Youth (CCC&Y).
We believe that families should be able to safely stay together while on their addiction healing journey.
You can help us keep families together so that no child has to be separated from their family, and no mother separated from their child.
Are you with us?