Improving Treatment for Drug-Exposed Infants
Treatment Improvement Protocol (TIP) Series 5

Treatment For Parents

The best way to help the drug-exposed child is to help the mother (and the father when possible) recover from addiction. Treatment should occur within the context of the mother-child dyad, with particular attention paid to the mother's drug use and its impact on parenting skills. Every effort should be made to include fathers as well as mothers. Treatment should be nonthreatening, nonstigmatizing, and supportive. The treatment team should also work with other siblings and members of the extended family, especially drug-free family members. The treatment team should be culturally competent and well trained and understand how services provided with cultural awareness of the mother's and father's background can play a positive role in recovery.

Pregnant women should not be denied such treatment or have treatment postponed merely because of pregnancy. In fact, since the health and welfare of both the mother and the unborn child are at stake, efforts should be made to give pregnant women priority access to AOD abuse treatment services.

Such priority status is now a requirement for all programs receiving Substance Abuse Block Grant funds. Programs serving an injecting drug use population must give preferential treatment in the following order: (1) pregnant injecting drug users; (2) pregnant substance abusers; (3) injecting drug users; (4) all others.

If the program does not have the capacity to provide treatment services to a pregnant woman, the woman must be referred (with the use of a toll-free number or similar mechanism) to the State. The State is then required to refer the woman to a treatment program that has room to serve her not later than 48 hours after seeking treatment. Thus, the State must have a capacity tracking system to track all open AOD treatment slots available to pregnant women in the State.

Detailed treatment guidelines, including a description of an appropriate continuum of care that includes medical stabilization and detoxification guidelines, are available in the TIP, Pregnant, Substance-Using Women. Many of these guidelines are equally applicable to women in the postpartum period.

Treatment should focus on the dual goals of abstinence from drugs and successful parenting. Within the context of AOD abuse treatment programs, parenting skills should be addressed or reinforced. The program and its staff can serve as a secure base from which the mother can try new approaches to parenting, often ones that she did not experience as a child. The treatment component must acknowledge each woman's role as a mother struggling to rear young children. This parenting role must be supported by all staff, who support the mothers in their relationships with their babies and praise their ability to comfort their children, make their children smile, and know when their children are sick. These daily interactions support the mother in her parenting abilities and allow her to feel successful as a good mother to her children. Please refer to Appendix A for materials on parenting skills.