Promoting Recovery

Women with Children and Youth

Providing treatment and recovery supports that take into account the family context is especially important for women with co-occurring disorders who have children and for youth with these disorders. In addition, in order to address their multiple needs, treatment should be provided as part of a comprehensive, integrated package that coordinates care across multiple systems.

Women with Children

Significant numbers of women who have co-occurring disorders are also pregnant or parents. For many, their role as mothers is central and a major source of identity and self-worth. It also can be a primary motivation for entering treatment and achieving recovery. Their children may live with them, or not, but either way it is essential that treatment and services take into account both:

• the needs and issues of the women in their role as parents
• the developmental and other needs of the children, so as to minimize future health and behavioral health problems.

Treatment and services should be family-centered, comprehensive, and multidisciplinary to ensure that the full-range of needs of both mothers and children are addressed. Programs are most effective when they incorporate the following strategies:

• Identify and build on each woman's strengths, including her desire to be a good mother to her children
• Offer trauma-informed treatment and services in recognition of high rates of violence, abuse and victimization
• Acknowledge women's roles as mothers in all service delivery activities, including assessment, individual and group therapies, treatment, discharge planning, and after care and recovery supports
• Offer program components that teach parenting skills, help women reduce the stress associated with parenting, and improve interactions between parent and child
• Provide age-specific interventions and support services for children (whether infants, pre-school, elementary school or adolescents)
• Directly provide or link women with ancillary services to help them sustain recovery, including legal services, housing assistance, childcare, education and employment and health care
• Build healthy support networks, including with extended family, where possible

Youth

Youth with co-occurring disorders typically are struggling with a mixture of mental health problems, alcohol and other drug abuse problems, health problems, immaturities, broken relationships with families, disrupted schooling, and involvement with the criminal justice system. These problems affect the entire family and cannot be effectively addressed without including everyone who plays a key role in the youth's life. Likewise, the values and attitudes of the family about mental health and substance use influence how youth think about themselves and their ability to seek help and respond to treatment.

Though many youth with co-occurring disorders are estranged or have significant tension with their families, most return to their families after treatment. Family involvement and support are absolutely essential to their being able to achieve and sustain recovery. As such, the culture and beliefs of the family as well as their strengths and problems should inform the design of treatment and recovery support services.

In order to effectively engage in treatment and achieve recovery, youth need:

• To be listened to and treated with respect
• To be empowered to make decisions and choices about their treatment plan
• To receive care that is age-appropriate, addresses their full range of needs and is integrated across systems
• To learn coping skills for handling their illness
• To be able to access peer supports, and to be given opportunities to turn their experience into positive growth, such as by becoming peer mentors
• To have the support and understanding of their family

In order to effectively support their children's recovery, families need:

• Clear and accessible information about the warning signs and symptoms of co-occurring disorders, treatment, and recovery and support resources.
• To be treated with respect and included in the treatment process so that they can provide input about service choices
• Access to therapy, peer supports and other services
• Assistance in developing new strategies for interacting with and supporting their child, including how to recognize and respond to signs of relapse, set realistic boundaries and enforce rules, and support progress

---

Resources and Links

• Parenting Issues for Women with Co-Occurring Mental Health and Substance Abuse Disorders Who Have Histories of Trauma

   

• Substance Abuse Treatment for Persons With Co-Occurring Disorders. Treatment Improvement Protocol (TIP) Series 42, Chapter 7: Special Settings and Specific Populations

  Provides substance abuse treatment providers with updated information on co-occurring substance use and mental disorders and advances in treatment for people with co-occurring disorders. Chapter 7: Special Settings and Specific Populations discusses issues around serving women with co-occurring disorders.

• Blamed and Ashamed: The Treatment Experiences of Youth with Co-occurring Substance Abuse and Mental Health Disorders and Their Families

  This report presents the findings of a two-year project which documented the experiences of youth with co-occurring substance use and mental disorders and their families and which offers recommendations for improving treatment and services based on their experiences.

• The Partnership at DrugFree.org

  This is a website for The Partnership at Drugfree.org, a nonprofit organization that helps parents prevent, intervene in and find treatment for drug and alcohol use by their children. The website allows parents to connect with each other, tap into expert advice and find support in their role as hero to their kids.

• Pathways to Positive Futures

  This website aims to improve the lives of youth and young adults with mental disorders, including co-occurring disorders, through rigorous research and effective training and dissemination. This site includes a variety of publications and training and technical assistance materials.

• The National Federation of Families for Children's Mental Health

  This website is a family-run organization focused on the needs and rights of children and youth with emotional, behavioral and mental health challenges and their families. The site includes training, technical assistance, publications and other resources, including on co-occurring disorders.

• The Technical Assistance Partnership for Child and Family Mental Health

  This website is a collaboration between the National Federation of Families for Children's Mental Health and the American Institutes for Research . The Partnership provides technical assistance to system of care communities that are currently funded through SAMHSA's Comprehensive Community Mental Health Services for Children and their Families Program. This program funds efforts to improve and expand their systems of care to meet the needs children and youth with serious emotional disturbances and their families. Systems of care must involve a family driven and youth-guided framework for service delivery. The site includes a variety of reports and technical assistance materials.