Bosk Emily A, Paris Ruth, Hanson Karen E, Ruisard Debra, Suchman Nancy E
Assistant Professor of Social Work, Rutgers University, the State University of New Jersey.
Associate Professor and Chair, Clinical Practice Department, Boston University School of Social Work.
Child Youth Serv Rev. 2019 Jun;101:99-112. doi: 10.1016/j.childyouth.2019.03.040. Epub 2019 Mar 25.
Families who enter the Child Welfare System (CWS) as a result of a caregiver's substance use fare worse at every stage from investigation to removal to reunification (Marsh et. al 2007). Intervening with caregivers with Substance Use Disorders (SUDs) and their children poses unique challenges related to the structure and focus of the current CWS. Research demonstrates that caregivers with SUDs are at a greater risk for maladaptive parenting practices, including patterns of insecure attachment and difficulties with attunement and responsiveness (Suchman, 2006). Caregivers with SUDs have also often experienced early adversity and trauma. However, traditional addiction services generally offer limited opportunities to focus on parenting or trauma, and traditional parenting programs rarely address the special needs of parents with SUDs. This article details four innovative interventions that integrate trauma-informed addiction treatments with parenting for families involved in the child welfare system. Common mechanisms for change across programs are identified as critical components for intervention. This work suggests the need for a paradigm shift in how cases involving caregivers with substance use disorders are approached in the child welfare system.
由于照顾者使用药物而进入儿童福利系统（CWS）的家庭，从调查到移送再到团聚的每个阶段情况都更糟（马什等人，2007年）。对患有物质使用障碍（SUDs）的照顾者及其子女进行干预，会带来与当前儿童福利系统的结构和重点相关的独特挑战。研究表明，患有物质使用障碍的照顾者出现适应不良养育方式的风险更高，包括不安全依恋模式以及协调和反应方面的困难（苏克曼，2006年）。患有物质使用障碍的照顾者也经常经历早期逆境和创伤。然而，传统的成瘾服务通常提供的关注养育或创伤的机会有限，而传统的养育项目很少解决患有物质使用障碍的父母的特殊需求。本文详细介绍了四种创新干预措施，这些措施将创伤知情的成瘾治疗与针对参与儿童福利系统的家庭的养育相结合。确定了各项目中共同的改变机制，作为干预的关键组成部分。这项工作表明，儿童福利系统在处理涉及患有物质使用障碍的照顾者的案件时，需要进行范式转变。
