Nicola A. Conners

A comprehensive substance abuse treatment program for women and their children: an initial evaluation

This article examines a comprehensive, residential substance abuse treatment program for women and their children. A majority of the 72 participants studied were African American single mothers, for whom crack/cocaine was the drug of choice. The women and their children were assessed repeatedly during treatment, and at 3, 6, and 12 months postdischarge. Program impact was estimated by comparing the outcomes of three groups that differed in the amount of treatment they received: early dropouts, late dropouts, and treatment graduates. Program graduates showed more positive outcomes than the nongraduate comparison groups in the areas of drug use and negative consequences of use, employment and self-sufficiency, and family interaction skills. Young children enrolled in treatment with their mothers were assessed using a developmental screening test, and older children with a measure of drug refusal skills. Results from both child measures suggest substantial improvement.

The Development and Evaluation of an Alcohol and Drug Prevention and Treatment Program for Women and Children: The AR-CARES Program

This study examined the evolution of the Arkansas Center for Addictions Research, Education, and Services (AR-CARES) over a 5-year period and evaluated its impact on women and children. The program was designed to provide comprehensive substance use prevention and treatment services to low-income pregnant and parenting women and their children. The program changed significantly over this time, based upon input from clients and staff, as well as in response to changing community resources. The evaluation suggests that the program had an impact on the substance use of study participants, birth outcomes, and the growth and development of children.

Using focus groups to evaluate client satisfaction in an alcohol and drug treatment program

Often in studies of the program effectiveness of alcohol and drug treatment programs, behavioral outcomes are the only focus. While important, behavioral outcomes do not explore the viewpoint of the client about the success of the program, and evaluators are now recognizing the importance of measuring the performance of addictions treatment programs in terms of client satisfaction. The primary purpose of this article is to describe the experience of evaluators in their attempts to assess client satisfaction through the use of focus groups at a comprehensive drug treatment program for women and their children. The results of these focus groups are shared, and the appropriateness of the focus group methodology in assessing client satisfaction with comprehensive drug treatment services for women is discussed.

The Family Map: Structured Family Interview to Identify Risks and Strengths in Head Start Families.

The Family Map is a semistructured interview developed to assess important aspects of the family and home environment associated with well-being in 3- to 5-year old children. The measure is designed so that it can be used during home visits with Head Start families. Accordingly, it was developed in collaboration with Head Start providers and families. The Family Map systematically identifies areas of concern and strength so that providers can design interventions to reduce risk factors (e.g., food insecurity, physical safety issues, family conflict, harsh parenting practices, parental depression) or enhance factors associated with healthy development (e.g., availability of learning materials in the home, good monitoring and supervision, or home safety). The areas assessed by the Family Map are targeted by Head Start performance standards. The Family Map has been successfully implemented in Head Start agencies and is also being adopted in non-Head Start early childcare settings.

Voucher-Based Incentives for Cigarette Smoking Reduction in a Women's Residential Treatment Program

Participants were women (N = 16) living with their children in a residential substance abuse treatment facility. In this within-subjects repeated measures study, a 1-week baseline was followed by a 4-week intervention and a 2-week follow-up (same as the baseline). The intervention consisted of exposure to an educational video and a smoking cessation workbook, brief individual support meetings, and an escalating schedule of voucher-based reinforcement of abstinence. Throughout the study, three daily breath samples (8 a.m., noon, and 4 p.m.) were collected Monday through Friday to determine carbon monoxide (CO) concentration. In addition, urine cotinine (COT) was assessed on Monday mornings to monitor weekend tobacco use. Participants received vouchers of escalating value for CO-negative breath and COT-negative urine samples. Positive samples reset the voucher value. Significantly more negative tests were submitted during the intervention than during baseline and follow-up. The intensive behavioral intervention evaluated in this study produced a substantial reduction in cigarette smoking, and 25% of participants remained abstinent 2 weeks after the intervention was suspended. Nevertheless, the percentage of CO-negative samples submitted during the follow-up returned to baseline levels. While retaining many real-world characteristics, residential treatment facilities provide important opportunities for smoking cessation treatment and research.

Dimensions of Religious Involvement and Mental Health Outcomes Among Alcohol- and Drug-Dependent Women

SUMMARY The current study examined ties between religious variables and mental health in a high-risk population: lower-income chemically dependent pregnant or parenting women participating in a residential treatment program. The primary goal of the study was to investigate the relationship between various facets of religiousness and mental health symptoms, including depression and post-traumatic stress. Negative religious coping was associated with greater PTSD symptoms, greater depressive symptoms, and greater syndromal depression after controlling for background demographic and addiction variables. Other aspects of religiousness, including positive coping and involvement with organized religion, were not associated with mental health outcomes. These results suggest that negative aspects of religiousness, particularly religious struggle, merit greater attention from clinicians and investigators.

The Unidimensionality and Reliability of the Preschool and Kindergarten Behavior Scales

The unidimensionality and reliability of the Preschool and Kindergarten Behavior Scales (PKBS) for assessing child behavior with at-risk children was examined using a sample of 1,679 2- to 6-year-old children from nine Starting Early Starting Smart study sites. The unidimensionality of the eight PKBS scales was assessed using confirmatory factor analysis for the full sample, and the comparability (invariance) of the scales was examined across gender and Black and White racial groups. The results supported the unidimensionality of six of the eight scales using the full sample. The unidimensionality of the scales varied across gender and racial subgroups. Four of the eight PKBS scales were shown to be comparable across gender subgroups, and three of the eight scales were shown to be comparable across racial subgroups. The reliability of measurements derived from the PKBS was sufficient for using the PKBS as a measure of group performance for young at-risk children.

Building a residential treatment program for dually diagnosed women with their children

SummaryThe epidemic of drug and alcohol abuse in our nation impacts millions of women, mothers, and children. Addicted mothers with complex problems and numerous co-morbidities present unique treatment challenges. This intergenerational cycle of abuse and addiction is difficult to stop. Arkansas CARES (Center for Addictions Research Education and Services, referred to in this article as CARES) initially was created to treat addicted pregnant and postpartum women and their infants. CARES evolved into a residential treatment program for dually diagnosed mothers with their children. This paper is a synopsis of a presentation delivered at the North American Society for Psychosocial Obstetrics and Gynecology. It shares a glimpse inside the treatment program and lessons learned along the way in an effort to assist others who are interested in building treatment programs for addicted women with their children.

Changing the Child Abuse Potential of Substance Abusing Pregnant and Parenting Women

&NA; This study was designed to determine if treatment for substance abuse has an impact on child abuse potential. Sixty-three pregnant and parenting substance abusing women were tested using the Child Abuse Potential Inventory (CAP) at approximately 3-month intervals from intake into treatment through post-discharge follow-up. Growth curve analysis revealed an improvement in CAP scores from Time 1 to Time 2, but the improvement was not sustained. When participants were in the initial phases of substance abuse treatment and receiving considerable support, their CAP scores dropped from the elevated range into the normal range. However, as they progressed through and left the program, their CAP scores gradually rose. The results of the study argue for continuing substance abuse treatment until child abuse potential stabilizes to within the normal range