Session: Where Does the Young Child Fit in Treatment for Substance Use Disorders (SUDs)?: Examining Evidence-Based Approaches to the Integration of Infant Mental Health and Treatment for Substance Use Disorders (Society for Social Work and Research 23rd Annual Conference - Ending Gender Based, Family and Community Violence)

With more young families affected by parents' substance misuse, programs are challenged to provide accessible, effective dyadic treatment to caregivers and their young children. Even though an estimated 70% of women who enter treatment for substance use disorders (SUDs) are parents (Brady & Ashley, 2005), traditional programs typically view these clients as individuals rather than as caregivers located in a family system. Within treatment for SUDs, opportunities to include issues related to parenting, the client's family and/or child are seen as adjunctive or, more commonly, do not occur at all. At the same time, decades of research in infant mental health (IMH) identifies the cumulative negative impacts of caregiver SUDs on young children's emotional, cognitive and physical development (Suchman, Pajulo & Mayes, 2013). Not only are SUD treatment strategies unlikely to address the intersection of substance misuse and parenting, they also are likely to rely on models that are inappropriate for clients with extensive trauma histories, especially those who have experienced gender-based violence, a predictor of SUDs (Suchman, Pajulo & Decoste, 2006). This research highlights the need for sustained trauma-informed intervention within family systems to interrupt the relational and developmental consequences of problematic parenting behaviors that often occur both as a result of, and alongside, caregiver substance misuse.

The goal of this symposium is to examine different perspectives and debates related to best practices for the integration of treatment for SUDs and IMH. The first presentation examines paradigmatic differences in SUD treatment models and IMH interventions, focusing on fundamental challenges to integration that cannot be addressed by simply adding parenting components to established substance use disorder treatment and which, instead, must be overcome in implementation. The second presentation examines SUD program staff experiences implementing an evidence-informed IMH intervention for parents and young children within substance use treatment programs to demonstrate the feasibility, acceptability and appropriateness of integration. The final presentation presents an innovative model for concurrently treating both caregiver SUDs and the parent-child dyad in the home, reviewing outcome data from 1400 families. This approach represents a new way of conceptualizing integrated treatment that may be of particular benefit for those with extensive trauma histories. After the presentations, an international expert on IMH and parents with SUDs will serve as a discussant.

This symposium brings together scholars from four institutions with diverse perspectives to explore best practices related to the design, adoption, and implementation of interventions for caregivers with SUDs and their children. These presentations and discussion offer some innovative strategies which contribute to addressing larger grand challenges within the field of social work including ensuring the healthy development of all youth and closing the health gap.