Integrated treatment programs for women and their children

The New Choices program in Hamilton, Ontario has been in the media recently as it will be losing its major source of funding at the end of March. (See Addiction treatment ‘lifeline’ losing major funding, January 5 2012).

The New Choices program is an example of a “one-stop shopping” model for women with substance use issues who are pregnant and/or parenting young children. The program components include addiction groups and counselling, nutrition counselling and skill development, parenting education, peer support, and an enriched children’s program.

In addition, it provides linkages with prenatal services, a family physician, a perinatal home visiting program, and other services as needed. The program is not set in terms of a specific structure or length of time which allows services to be tailored to meet the needs of individual women. Attendance at New Choices ranges from 1 to 12 months, with the average length of involvement being 4 months. Sometimes clients will be involved for a few months, leave, and then return to the program at a later date.

Other similar “one-stop shop” models in Canada include Breaking the Cycle in Toronto, Sheway in Vancouver’s Downtown Eastside, the Maxxine Wright Community Health Centre in Surrey, and Streetworks’ Supports for Homeless Pregnant Women in Edmonton.

Many of these programs have been designed to address barriers to accessing prenatal services that exist for many women who use substances. These include: fear of losing custody of children; fear of forced treatment or criminal prosecution; lack of treatment readiness; coexisting mental illness; guilt, denial and/or embarrassment regarding their substance use; and lack of transportation and/or child care.

Other systems-level issues often create barriers to care such as negative attitudes of health care providers towards pregnant women who use substances and the traditional separation of prenatal care and substance abuse treatment.

Further reading: Integrated Treatment Approaches for Pregnant and Parenting Women with Substance Use Issues

Cailleaux, M. and Dechief, L. I’ve found my voice”: Wraparound as a Promising Strength-based Team Process for High-risk Pregnant and Early Parenting Women. Surrey, BC: Atira Women’s Resource Society

Leslie, M., DeMarchi, G., Motz, M. (2007). Breaking the Cycle: An Essay in Three Voices. In Boyd, S.C. and Marcellus, L. (Eds). With Child: Substance Use During Pregnancy: A Woman-Centred Approach. Peterborough: Fernwood Publishing. pp. 91-104.

Poole, Nancy. (2000). Evaluation report of the Sheway Project for high-risk pregnant and parenting women. Vancouver: British Columbia Centre of Excellence for Women’s Health.

Racine, N., Motz, M., Leslie, M. and Pepler, D. (2009). Breaking the Cycle Pregnancy Outreach Program: Reaching out to improve the health and well-being of pregnant substance involved mothers. Journal of the Association for Research on Mothering, 11 (1): 279-290. (Free full-text here).

Sword, W., Jack, S., Niccols, A., Milligan, K., Henderson, J., and Thabane, L. (2009). Integrated programs for women with substance use issues and their children: a qualitative meta-synthesis of processes and outcomes. Harm Reduction Journal, 6:32. doi:10.1186/1477-7517-6-32. (Free full-text through PMC)

Sword, W., Niccols, A., and Fan, A. (2004). “New Choices” for women with addictions: perceptions of program participants. BMC Public Health, 4:10. PMCID: 420243. doi:  10.1186/1471-2458-4-10. (Free full-textthrough PMC)