A Promising Approach in Home Visiting to Support Families Affected by Maternal Substance Use
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FROM THE FIELD
A Promising Approach in Home Visiting to Support Families Affected by Maternal Substance Use Donna O’Malley1 · Danielle F. Chiang2 · Emily A. Siedlik1 · Katharine Ragon2 · Marcia Dutcher2 · Oneta Templeton1 Accepted: 23 September 2020 © The Author(s) 2020
Abstract Introduction Many factors influence women’s use of alcohol and other drugs while pregnant and postpartum. Substance use impacts the maternal-child relationship during the critical neonatal period. The first days and months of human development lay the foundation for health and well-being across the lifespan, making this period an important window of opportunity to interrupt the transmission of trauma and stress to the next generation. Pregnant and postpartum women with a history of substance use require specialized support services. Methods The Team for Infants Exposed to Substance abuse (TIES) Program provides a holistic, multi-disciplinary, community-based model to address the complex needs of families with young children affected by maternal substance use. Results A multi-year implementation study of the model yielded results that indicate the effectiveness of this home-based family support intervention. The model focuses on reducing maternal alcohol and other drug use, increasing positive parenting, promoting child and maternal health, and improving family income and family housing. A key component of the model is establishing a mutual, trusting relationship between the home visiting specialists and the family. Foundational to the TIES model is a family-centered, culturally competent, trauma-informed approach that includes formal interagency community partnerships Discussion This article describes elements of the model that lead to high retention and completion rates and family goal attainment for this unique population. Keywords Home visiting · Substance use · Parent–child interaction · Goal attainment
Significance Statement Prenatal and postpartum home visiting models are widely used to prevent child maltreatment, promote child-caregiver attachment, and foster positive parenting skills. Home visiting models target high-risk families, often with mental and behavioral health or substance use issues. Studies have shown that home visitors often feel ill-equipped to address the complex needs of families affected by substance use. This article describes a model developed specifically to * Donna O’Malley [email protected] 1
Community Programs, Department of Social Work, Children’s Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA
Institute for Human Development, University of Missouri Kansas City, 215 W Pershing Road, Kansas City, MO 64108, USA
2
provide specialized support to families affected by maternal substance use and presents data on family goal attainment.
Introduction During the twentieth century, infectious diseases were the main cause of childhood morbidity and mortality. Today, the social determinants of health and adverse childhood experiences are recognized as important predictors of health and wel
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