Treatment Approaches for Child Welfare Mothers with Addiction Problems

Abstract

This paper argues that child welfare mothers with addiction problems may require specialized treatment approaches based on their gender. The prevalence of women's problems with addiction and the unique ways addictions manifest themselves in women are discussed. The literature is then used to guide a discussion on the limitations of traditional treatment approaches that have been designed for men and may be of ill service to child welfare mothers. Alternative treatments are reviewed, and suggestions for improving treatment services to child welfare mothers with addiction problems are provided.     

In Their Own Voice: Mothers in Drug Treatment and Their Views on Parenting,Behavioral Parent Training,and Barriers to Engagement

Behavioral parent training offers mothers in drug treatment a valuable opportunity to improve their parenting skills through real-time, individualized coaching, but these mothers might be reluctant to participate with their child. Participants were 23 mothers or female guardians from 4 drug treatment programs with children 1 to 10 years old. Focus group discussions and questionnaires asked about their perspectives on parenting and their interest in and obstacles to participating in behavioral parent training. Detailed narrative responses and quantitative analyses identified some unique issues in parenting for this population as well as logistical, attitudinal, and emotional barriers to participating in behavioral parent training with their children.     

Loosening the Soil of Their Thinking: A Theoretical Integration for Contracting with Low-Income Single Mothers to Stop Physical Aggression Toward Their Children

Clinical social work with low-income single mothers at-risk for physical abuse of their children traverses multiple theoretical perspectives for viewing causality and intervention in order to prevent future abuse. Cognitive-behavioral and psychodynamic approaches have figured prominently in the discourse but are often considered as opposing viewpoints. In this paper, narrative excerpts from a study about social workers’ experiences in developing working alliances with these women are used to suggest an integrative theoretical viewpoint for contracting with them to refrain from hitting their children.     

Using an Anti-racist Framework for Assessment and Intervention in Clinical Practice with Families from Diverse Ethno-racial backgrounds

Cultural competency and cultural sensitivity are now widely considered to be essential for clinical social work practice with individuals and families from diverse cultural, racial, and ethnic backgrounds. Failing to incorporate these concepts into clinical services can be harmful to clients, can fail to meet the needs of members of diverse ethnoracial communities, and can result in inappropriate services. Yet a sole focus on culture can obliterate our understanding of the consequences of race and racism on individuals and families. The use of a discursive anti-racist framework for assessment and intervention in practice with members of diverse ethnoracial communities is suggested and explained through the use of a case example.     

Social Support: A Key to Positive Parenting Outcomes for Mothers in Residential Drug Treatment with Their Children

SUMMARY

This study explored parenting experiences of ten mothers residing with their young children in four residential drug treatment facilities in New York City and how these experiences related to the perceived support of the social environment of the facility. Through the lenses of the self-in-relations theory and family-centered service model, the study examined the supportive function of the treatment program including the program structure, the staff, and fellow mothers in affecting the mothers' parenting experience and outcomes. Programmatic, policy, and research implications of the study's findings are discussed.     

Topiramate Combined with Cognitive Restructuring for the Treatment of Gambling Disorder: A Two-Center,Randomized, Double-Blind Clinical Trial

Gambling disorder (GD) is a prevalent condition for which no pharmacological treatment has yet been approved, although there is evidence that topiramate can reduce impulsivity in GD and craving in various addictive behaviors. The goal of this study was to investigate the effectiveness of topiramate combined with cognitive restructuring for GD in a two-center, randomized, double-blind clinical trial. Participants were individuals seeking outpatient treatment for GD (n = 30), treated with either topiramate or placebo combined with a brief cognitive intervention, over a 12-week period, the dose of topiramate being tapered up during the first 8 weeks. The main outcome measures were gambling craving, behavior, and cognitive distortions; impulsivity; depression and social adjustment. Topiramate proved superior to placebo in reducing gambling craving (P = 0.017); time and money spent gambling (P = 0.007 and P = 0.047, respectively); cognitive distortions related to gambling (P = 0.003); and social adjustment (P = 0.040). We found no significant effects on impulsivity or depression. These findings are in contrast with data from a previous clinical trial with topiramate for GD. In the current study, we found that topiramate affects features specifically related to gambling addiction and had no significant effect on associated phenomena such as impulsiveness and depression. We believe that this response could be due to synergistic interaction between topiramate and the cognitive intervention.     

Using social support for LGBTQ clients with mental illness to be out of the closet,in treatment,and in the community

ABSTRACT

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) individuals are often faced with societal challenges that can lead to mental health or substance abuse issues. They may be misunderstood or mistreated when seeking services because of a lack of training in offering culturally sensitive treatment by service providers. A program, the Rainbow Heights Club, was developed to support LGBTQ individuals with a mental health diagnosis. All of the members are in treatment for their mental health and/or substance abuse problems, but prior to the development of the program did not have a place to feel accepted, supported, or have a sense of community. Members were surveyed determine if Rainbow Heights was helpful in maintaining themselves in the community. Results indicated that 75% of members are more consistent in following prescribed treatments, keeping them free from inpatient hospitalization, and 79% reported being clean and sober since coming to the Club.     

An Integrative Group Treatment Model for Women with Binge Eating Disorder: Mind,Body and Self in Connection

Binge eating disorder (BED) is the most prevalent eating disorder reported among women, and its recent diagnostic recognition in the DSM-5 (APA 2013) calls for further discussion on effective treatment. Women with BED commonly report a diet/binge cycle that can exacerbate a disconnection between mind and body and reinforce feelings of shame and isolation. This article presents an integrative group treatment model for women with BED that has shown positive outcomes in clinical practice. The group model addresses key biopsychosocial factors associated with BED and incorporates mindfulness principles tailored to problems of the disorder. A core foundation of the group model is the relational context that fosters connections between women members and promotes self-efficacy. The discussion includes etiology of BED and current empirical support for integrating mindfulness skills in treatment for binge eating problems, as well as the author’s clinical experience in formulating a short-term group model. The eight-session semi-structured group format integrates evidence-based treatments in resonance with treatment-based evidence that reflects the distinct clinical needs of women with BED. Clinical vignettes illustrate how the group model can provide an anchoring therapeutic support to women with BED for linking experiences of mind, body, and self.     

Using crushed waste bricks for urban greening with contrasting grassland mixtures: no negative effects of brick-augmented substrates varying in soil type,moisture and acid pre-treatment

Ecological restoration aims at supporting biodiversity and ecosystem services, and urban greening is a great opportunity to achieve this goal. This is facilitated by species-rich seed mixtures based on local provenances, which are designed for certain nutrient and moisture regimes based on functional plant traits. Such grassland mixtures might be cultivated on crushed waste bricks, which would be a new component of water-holding urban substrates. Thus, we studied the effects of brick quantity and quality, acid pre-treatment of bricks, soil type and moisture on biomass of designed seed mixtures. Three greenhouse experiments were conducted, with substrates consisting of different brick ratios (5% vs. 30%), brick types (clean production waste vs. demolition material), and brick treatments (acid vs. control) tested on three trait-based mixtures and a non-regional commercial standard mixture. The trait-based mixtures included information on specific leaf area, seed mass and grass-to-legume ratio. There were no negative effects of demolition bricks, soil texture and moisture on grassland biomass. Acid-treated clean porous bricks improved biomass production of the standard and intermediate mixtures, while the effect was minimal with demolition bricks. Designed seed mixtures had a biomass similar to the standard mixture under dry conditions but did not benefit from high moisture like the standard mixture. In conclusion, waste bricks are a useful additive for urban restoration substrates to save raw material, and specifically designed regional mixtures can replace commercial grassland types on these substrates.