The implicit theory within child welfare practice is that the reason many substance-abusing mothers lose custody of their children is that they are more motivated by their next procurement of drugs than by regaining custody of their children (Smith, 1999). This study's findings compel us to reconsider this implicit theory and consider alternative explanations.
Method: Using a multiple embedded Case Study design, interviews were conducted with 26 African American mothers receiving inpatient substance abuse treatment, the substance abuse treatment counselors of all the mothers, 16 of the mothers' parenting professionals, and 6 of the mothers' child welfare agency caseworkers. A total of 46 (26 mothers and 20 professionals) in-depth semi-structured interviews were conducted, along with 14 months of observation at the program site. Transcripts of the interviews were analyzed using pattern analysis (Stake, 1995; Yin, 2003) to examine individual cases and build a conceptual explanation that accounted for both the interview and the observational data (Yin, 2003). This study used a number of methods to ensure rigor, including testing rival or alternative explanations (Yin, 2003). NVIVO was used to manage data during the analytic process.
Results: Although the professionals in this study continued to adhere to the belief that mothers would rather “get high” than parent their children, a more powerful narrative emerged. The trauma that these mothers experienced was insidious and profound. Their trauma histories affected not only their abilities to become and remain drug-free but also their abilities to develop trusting, positive relationships with professionals. The multiple ways women coped with and made meaning of their trauma histories often became the determining factor in whether they retained, regained, or permanently lost custody of their children.
Conclusions: A great deal of research has been conducted on the extensive histories of trauma prevalent among substance-abusing women. This knowledge, however, has not translated into effective practice in child welfare and has resulted in fragmented services within substance abuse treatment with this population. The findings of this study support a shift from an exclusively motivation-focused paradigm to the creation of trauma-sensitive systems and services that include increasing awareness among social service providers regarding the prevalence of trauma, as well as understanding how the socioemotional and behavioral effects of trauma impact all aspects of service delivery.