Concurrent Treatment of Substance Abuse,Child Neglect,Bipolar Disorder,Post-Traumatic Stress Disorder,and Domestic Violence: A Case Examination Involving Family Behavior Therapy
Restricted accessResearch articleFirst published online April, 2010
Concurrent Treatment of Substance Abuse,Child Neglect,Bipolar Disorder,Post-Traumatic Stress Disorder,and Domestic Violence: A Case Examination Involving Family Behavior Therapy
High rates of co-occurrence between substance abuse and child neglect have been well-documented and especially difficult to treat. As a first step in developing a comprehensive evidence-based treatment for use in this population, the present case examination underscores Family Behavior Therapy (FBT) in the treatment of a mother who evidenced Substance Dependence, child neglect, Post-Traumatic Stress Disorder, Bipolar I Disorder, and domestic violence. Utilizing psychometrically validated self-report inventories and objective urinalysis, treatment was found to result in the cessation of substance use, lower risk of child maltreatment, improved parenting attitudes and practices, and reduced instances of violence in the home. The importance of utilizing validity scales in the assessment of referrals from child welfare settings is discussed, and future directions are reported in light of the results.
Allen, D.N., Donohue, B., Sutton, G., Haderlie, M., & LaPota, H. (in press). Family behavior therapy for substance abuse and other associated problems: A review of its standardized assessment methods and their applicability. Behavior Modification.
3.
Ammerman, R.T., Kolko, D.J., Kirisci, L., Blackson, T.C., & Dawes, M.A. ( 1999). Child abuse potential in parents with histories of substance abuse disorder. Child Abuse & Neglect, 23, 1225-1238.
4.
Azrin, N.H., Acierno, R., Kogan, E.S., Donohue, B., Besalel, V., & McMahon, P.T. ( 1996). Follow-up results of supportive versus behavioral therapy for illicit drug use. Behaviour Research and Therapy, 34, 41-46.
5.
Azrin, N.H., Donohue, B., Besalel, V., Kogan, E., & Acierno, R. ( 1994). Youth drug abuse treatment: A controlled outcome study . Journal of Child and Adolescent Substance Abuse, 3, 1-16.
6.
Azrin, N.H., Donohue, B., Teichner, G., Crum, T., Howell, J., & DeCato, L. (2001). A controlled evaluation and description of individual-cognitive problem solving and family-behavioral therapies in conduct-disordered and substance dependent youth. Journal of Child and Adolescent Substance Abuse, 11, 1-43.
7.
Azrin, N.H., McMahon, P., Donohue, B., Besalel, V., Lapinski, K., Kogan, E., Acierno, R., & Galloway, E. ( 1994). Behavior therapy of drug abuse: A controlled outcome study. Behaviour Research and Therapy, 32, 857-866.
8.
Barth, R.P. ( 1994). Long-term in-home services. In D. J. Besharoy (Ed.), When drug addicts have children (pp. 175-194). Washington, DC: Child Welfare League of America.
9.
Bavolek, S.J. ( 1984). Handbook for the AAPI: Adult-Adolescent Parenting Inventory . Salt Lake City, UT: Family Developmental Services.
10.
Bellack, A.S., Bennett, M.F., Gearon, J.S., Brown, C.H., & Yang, Y. ( 2006). A randomized clinical trial of a new behavioral treatment for drug abuse in people with severe and persistent mental illness. Archives of General Psychiatry, 63, 426-432.
11.
Cash, S.J., & Wilke, D.J. ( 2003). An ecological model of maternal substance abuse and child neglect: Issues, analyses, and recommendations. American Journal of Orthopsychiatry, 73, 392-404.
12.
Catalano, R.F., Gainey, R.R., Fleming, C.B., Haggerty, K.P., & Johnson, N.O. ( 1999). An experimental intervention with families of substance abusers: One-year follow-up of the Focus on Families Project. Addiction, 94, 241-254.
13.
Chaffin, M., Kelleher, K., & Hollenber, J. ( 1996). Onset of physical abuse and neglect: Psychiatric, substance abuse and social risk factors from prospective community data. Child Abuse and Neglect, 20, 191-203.
14.
Cleaver, H., Nicholson, D., Tarr, S., & Cleaver, D. ( 2007). Child protection, domestic violence and parental substance misuse: Family experiences and effective practice. London : Jessica Kingsley Publishers.
15.
Donohue, B., Allen, D.N., & Lapota, H. ( 2009). Family behavior therapy for substance abuse and other associated problems. In D. W. Springer & A Rubin (Eds.), Clinician’s guide to evidence-based practice: Substance abuse treatment for youths and adults (pp. 205-225). New York: John Wiley.
16.
Donohue, B., Azrin, N., Allen, D.N., Romero, V., Hill, H.H., Tracy, K., et al. (in press). Family behavior therapy for substance abuse: A review of its intervention components and applicability. Behavior Modification.
17.
Donohue, B., Azrin, N.H., Lawson, H., Friedlander, J., Teichner, G., & Rindsberg, J. ( 1998). Improving initial session attendance in conduct disordered and substance abusing adolescents: A controlled study. Journal of Child and Adolescent Drug Abuse, 8, 1-13.
18.
Donohue, B., DeCato, L.A., Azrin, N.H., & Teichner, G.A. (2001). Satisfaction of parents with their conduct-disordered and substance-abusing youth. Behavior Modification, 25, 21-44.
19.
Donohue, B., Romero, V., & Hill, H.H. ( 2006). Treatment of co-occurring child maltreatment and substance abuse. Aggression and Violent Behavior, 11, 626-640.
20.
Donohue, B., Teichner, G., Azrin, N., Weintraub, N., Crum, T.A., Murphy, L., et al. (2003). Initial reliability and validity of the life satisfaction scale for problem youth in a sample of drug abusing and conduct disordered youth. Journal of Child & Family Studies , 12, 453-465.
21.
Donohue, B., & Van Hasselt, V.B. (1999). Development and description of an empirically based ecobehavioral treatment program for child maltreatment . Behavioral Interventions, 14, 55-82.
22.
Fals-Stewart, W., Birchler, G.R., & Kelley, M.L. ( 2003). The time-line follow-back spousal violence interview to assess physical aggression between partners: Reliability and validity. Journal of Family Violence, 18, 131-142.
23.
Fals-Stewart, W., Birchler, G.R., & Kelley, M.L. ( 2006). Learning sobriety together: A randomized clinical trial examining behavioral couples therapy with alcoholic female patients. Journal of Consulting and Clinical Psychology, 74, 579-591.
24.
Fals-Stewart, W., Klostermann, K., Yates, B.T., O’Farrell, T.J., & Birchler, G.R. (2005). Brief relationship therapy for Alcoholism: A randomized clinical trial examining clinical efficacy and cost-effectiveness. Psychology of Addictive Behaviors, 19, 363-371.
25.
Fals-Stewart, W., & Lam, W.K.K. (2008). Brief behavioral couples therapy for drug abuse: A randomized clinical trial examining clinical efficacy and cost-effectiveness. Families, Systems, & Health, 26, 377-392.
26.
Field, T.M., Scafidi, F., Pickens, J., Prodromidis, M., Pelaez-Nogueras, M., Torquati, J., et al. (1998). Poly-drug-using adolescent mothers and their infants receiving early intervention. Adolescence, 33, 117-143.
27.
First, M.B., Spitzer, R.L., Gibbon, M., & Williams, J.B.W. (2002). Structured clinical interview for DSM-IV-TR axis I disorders, research version, patient edition (SCID-I/P) . New York: Biometrics Research, New York State Psychiatric Institute.
28.
Grella, C.E., Hser, Y., & Huang, Y. ( 2006). Mothers in substance abuse treatment: Differences in characteristics based on involvement with child welfare services. Child Abuse and Neglect, 30, 55-73.
29.
Gully, K.J., Price, B.L., & Johnson, M.K. ( 2008). Increasing abused children’s access to evidence-Based treatment: Diffusion via parents as consumers. Child Maltreatment , 13, 280-288.
30.
Hutchins, E., & DiPietro, J. ( 1997). Psychosocial risk factors associated with cocaine use during pregnancy: A case-controlled study. Obstetrics & Gynecology, 90, 142-147.
31.
Kazdin, A.E. ( 2008a). Evidence-based treatment and delivery of psychological services: Shifting our emphases to increase impact. Psychological Services, 5, 201-215.
32.
Kazdin, A.E. ( 2008b). Evidence-based treatment and practice: New opportunities to bridge clinical research and practice, enhance the knowledge base, and improve patient care. American Psychologist, 63, 146-159.
33.
Kelleher, K., Chaffin, M., Hollenberg, J., & Fischer, E. ( 1994). Alcohol and drug disorders among physically abusive and neglectful parents in a community-based sample. American Journal of Public Health, 84, 1586-1590.
34.
Kerwin, M.E. ( 2005). Collaboration between child welfare and substance-abuse fields: Combined treatment programs for mothers. Journal of Pediatric Psychology, 30, 581-597.
35.
Kinsely, J.S., Barker, S.B., Ingersoll, K.S., & Dawson, K.S. ( 2000). Psychopathology in substance abusing women reporting childhood sexual abuse. Journal of Addictive Diseases, 19, 31-44.
36.
Marcenko, M.O., Kemp, S.P., & Larson, N.C. ( 2000). Childhood experiences of abuse, later substance use, and parenting outcomes among low-income mothers. American Journal of Orthopsychiatry, 70, 316-326.
37.
Milner, J.S., Murphy, W.D., Valle, L.A., & Tolliver, R.M. (1998). Assessment issues in child abuse evaluations. In J. R. Lutzker (Ed.), Handbook of child abuse research and treatment (pp. 75-115). New York: Plenum.
38.
Moos, R., & Moos, B. ( 1984). Family environment scale. Palo Alto, CA: Consulting Psychologists Press.
39.
Mullins, S.M., Suarez, M.S., Ondersma, S.J., & Page, M.C. ( 2004). The impact of motivational interviewing on substance abuse treatment retention: A randomized control trial of women involved with child welfare. Journal of Substance Abuse Treatment, 27, 51-58.
40.
Murphy, J.M., Jellinek, M., Quinn, D., Smith, G., Poitrast, F.G., & Goshko, M. ( 1991). Substance abuse and serious child mistreatment: Prevalence, risk, and outcome in a court sample. Child Abuse & Neglect , 15, 197-211.
41.
Rittner, B., & Dozier, C.D. ( 2000). Effects of court-ordered substance abuse treatment in child protective services cases. Social Work, 45, 131-140.
42.
Schuler, M.E., Nair, P., & Black, M. ( 2002). Ongoing maternal drug use, parenting attitudes, and a home intervention: Effects on mother-child interaction at 18 months. Journal of Developmental & Behavioral Pediatrics, 23, 87-95.
43.
Schuler, M.E., Nair, P., Black, M.M., & Kettinger, L. ( 2000). Mother-infant interaction: Effects of home intervention and ongoing maternal drug use. Journal of Clinical Child Psychology , 29, 424-431.
44.
Searles, J.S., Helzer, J.E., & Walker, D.E. ( 2000). Comparison pattern measured by daily reports and timeline follow back. Psychology of Addictive Behaviors, 14, 277-286.
45.
Semidei, J., Radel, L.F., & Nolan, C. ( 2001). Substance abuse and child welfare: Clear linkages and promising responses. Child Welfare, 80, 109-128.
46.
U.S. Department of Health and Human Services ( 2006). Child Maltreatment 2006: Reports from the States to the National Child Abuse and Neglect Data System. Washington, DC: US Govt. Printing Office.
47.
Weisz, J.R., Jensen-Doss, A., & Hawley, K.M. ( 2006). Evidence-based youth psychotherapies versus usual clinical care: A meta-analysis of direct comparisons. American Psychologist , 61, 671-689.
