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Service providers and FASD prevention advocates are well aware of the intersections of trauma, substance use, and mental health issues as first described by researchers like Lisa Najavits (Najavits, Weiss, & Shaw, 1997). Research from the Women and Co-occurring Disorders and Violence study substantiated what many understood intuitively – that women with substance use problems facing complex life issues are best served through multi-leveled, integrated service models that are trauma-informed, gender-specific, and holistic (Amaro, Chernoff, Brown, Arévalo, & Gatz, 2007; Brown & Melchior, 2008).
There is an upcoming opportunity to learn more about applying these approaches to FASD prevention and care in a webinar on April 18th at 9:00 am MST. The CSS Learning Series webinar as part of their FASD Learning Series will feature speakers Candice Sutterfield, Lakeland Centre for FASD, and Dr. Peter Choate, Assistant Professor of Social Work at Mount Royal University and clinical supervisor for the Alberta College of Registered Social Workers. They will address both a prevention and supports & services perspective. Sign up here: http://csslearningseries.ca/trauma-informed-fasd-prevention-and-care-registration-2/
Programs in Canada, like Breaking the Cycle and HerWay Home, currently offer integrated programs for/with pregnant and parenting women with substance use issues. Their program frameworks are trauma- and FASD-informed and they offer substance use treatment/support programming as well as needed social services and referrals at a single access point. Program evaluation findings show that relationship building is the key component benefiting women’s growth and supporting the mother-child relationship long-term. (See their evaluations here: Breaking the Cycle and HerWay Home).
In a very recent study undertaken in Ontario, findings from interviews with women participating in integrated programs, described qualities of a therapeutic relationship that helped women improve emotional regulation and executive functioning (Milligan, Usher, & Urbanoski, 2017). Therapeutic relationships that incorporate trust, care, positive regard and a non-punitive attitude can create a safe attachment from which women can apply effective problem solving in all areas of their lives.
Sign up for the webinar and see these earlier posts for more information:
The Mother-Child Study: Evaluating Treatments for Substance-Using Women, March 18, 2015
HerWay Home Program for Pregnant Women and New Mothers in Victoria, BC, February 12, 2013
REFERENCES
Amaro, H., Chernoff, M., Brown, V., Arévalo, S., & Gatz, M. (2007). Does integrated trauma-informed substance abuse treatment increase treatment retention? Journal of Community Psychology, 35(7), 845-862.
Brown, V. B., & Melchior, L. A. (2008). Women with co-occuring disorders (COD): Treatment settings and service needs. Journal of Psychoactive Drugs, SARC SUPPL 5, 365-385.
Milligan, K., Usher, A. M., & Urbanoski, K. A. (2017). Supporting pregnant and parenting women with substance-related problems by addressing emotion regulation and executive function needs. Addiction Research & Theory, 25(3), 251-261. doi:10.1080/16066359.2016.1259617
Najavits, L. M., Weiss, R. D., & Shaw, S. R. (1997). The link between substance abuse and posttraumatic stress disorder in women. A research review. The American Journal On Addictions / American Academy Of Psychiatrists In Alcoholism And Addictions, 6(4), 273-283.
For the last four years, HerWay Home in Victoria, BC, has been providing outreach, medical and social services to pregnant and parenting women with difficult lives in a one-stop supportive environment. On June 23 from 9:00-10:00 a.m. PST, there will be a free webinar to share the results of a first-phase evaluation of HerWay.
Deborah Rutman and Carol Hubberstey of Nota Bene Consulting, and Nancy Poole of BC Centre of Excellence for Women’s Health will discuss lessons learned and promising practices, and lead a discussion on working with pregnant and parenting women affected by substance use, violence and mental health issues. With its child-focused, women-centred and family focused approach, HerWay Home encourages positive parenting and healthy outcomes for children and women.
Click here for more information and register by June 20th at http://fluidsurveys.com/surveys/bccewh/herway-home-evaluation-webinar/
To learn more about HerWay home and similar programs, see these previous postings:
- Harm Reduction and Pregnancy: Community-Based Approaches to Prenatal Substance Use In Western Canada, February 26, 2015
- Herway Home Conference and Networking Day – September 29, 2014 – Registration Information, August 18, 2014
- New Maternal and Infant Health Interventions on the Canadian Best Practices Portal, August 1, 2013
- Herway Home Program for Pregnant Women and New Mothers In Victoria, BC, February 12, 2013
- Herway Home ‘One-Stop Access’ Program in Victoria Set to Open, May 20, 2012
- Alberta’s Pcap Women’s Quilt: “Creating A Bond . . . Building A Relationship”, April 22, 2016
- Evaluation of FASD Prevention Programs in Saskatchewan, November 3, 2014
- Supporting Pregnant and Parenting Women Who Use Substances: What Communities Are Doing To Help, October 1, 2012
- Women-Centred Approaches to FASD Prevention, October 13, 2010
This 16-page booklet provides a short introduction to harm reduction approaches during pregnancy.
Harm Reduction refers to policies, programs and practices that aim to reduce the negative health, social and economic consequences that may ensue from the use of legal and illegal psychoactive drugs, without necessarily reducing drug use.
Harm reduction can be an important approach to FASD prevention for women who struggle with addiction and related concerns and who are often at highest risk for having a child with FASD.
The booklet gives an overview of evidence-based harm reduction approaches during pregnancy and provides concrete examples from integrated maternity programs in Western Canada that work with women with substance use concerns.
Programs profiled include: Sheway in Vancouver, Maxxine Wright Place in Surrey, HerWay Home in Victoria, H.E.R. Pregnancy Program in Edmonton and Manito Ikwe Kagiikwe (The Mothering Project) in Winnipeg.
Other topics discussed include the role of housing, peer support, rooming-in, methadone and buprenorphine use during pregnancy, and outreach.
Download Harm Reduction and Pregnancy: Community-based Approaches to Prenatal Substance Use in Western Canada from the BC Centre of Excellence for Women’s Health website.
This 12-day telesummit started last Monday on September 9, International FASD Awareness Day.
There is a jam-packed program of amazing speakers, including Canada FASD Research Network members, Lenora Marcellus and Janet Christie.
22 speakers, 7 countries, two speakers a day….. Check out the intro video below or on the FASD 2013 Summit website. Interviews can be replayed for free within 48 hours and MP3s can be purchased at the end of the summit.
New program addresses maternal alcohol and drug use with a range of services under one roof
After six years of planning and research by a volunteer committee of 30 experts, community organizations, advocates and educators, the HerWay Home program began working with women and children on January 7, 2013.
Located in the James Bay Community Project, HerWay Home is a child-focused, women-centred, family-oriented drop-in and outreach program for pregnant women and new moms with substance use challenges and their children.
Women do not need a referral to access the program. The program expects to work with about 70 women in the first year and 100 to 150 in the second year. Currently, there are four staff members who support women accessing a range of services to meet their individual needs. Services include meals during drop-in hours, grocery store food vouchers, health care during and after pregnancy, alcohol, drug and mental-health support, and parenting support.
Read the press release (February 8, 2013) from the Children’s Health Foundation of Vancouver Island here. Check out the news coverage New Victoria program helps new moms with addictions (Cindy E. Harnett, Feb 7, 2013).
For more on HerWay Home, see earlier post: Herway Home ‘one-stop access’ program in Victoria set to open (May 20, 2012).
Learn more about the development of HerWay Home and similar programs across Canada in Supporting Pregnant and Parenting Women Who Use Substances: What Communities Are Doing to Help by members of the Canada FASD Research Network.
Specialized, Single-Access Perinatal Community Programs in Canada
Members of our Network Action Team on FASD prevention have recently developed a 12-page overview of community programs in Canada that support pregnant and early parenting women who use alcohol and other substances.
Since the 1990s, several communities in Canada have developed specialized programs to address barriers to accessing prenatal services that exist for many women who use substances. These barriers 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.
These programs have been developed with an awareness of how substance misuse is often intertwined with other issues such as homelessness, gender-based violence, involvement with the law, loss of cultural connectedness, and food insecurity.
This overview describes the development of four programs in Canada:
- Maxxine Wright Place Project for High Risk Pregnant and Early Parenting Women in Surrey, British Columbia
- H.E.R. (Healthy, Empowered, Resilient) Pregnancy Program (Streetworks Program) in Edmonton, Alberta
- HerWay Home in Victoria, British Columbia
- The Mothering Project in Winnipeg, Manitoba
The document describes how the programs started, how they evolved to meet the unique needs of each community, and describes the research evidence that shows why they work.
If you take a look at the Four-Part Model of FASD Prevention below (see Poole, 2008 here for more on this model), you’ll notice that these type of programs fall under levels 3 and 4.
“The third level of FASD prevention is about the provision of recovery and support services that are specialized, culturally specific and accessible for women with alcohol problems and related mental health concerns. These services are needed not only for pregnant women, but also before pregnancy and throughout the childbearing years.
The fourth level of FASD prevention is about supporting new mothers to maintain healthy changes they have been able to make during pregnancy. Postpartum support for mothers who were not able to make significant changes in their substance use during pregnancy is also vital. This will assist them to continue to improve their health and social support, as well as the health of their children. Early interventions for children who potentially have FASD are also important at this stage.”
You can download “Supporting Pregnant and Parenting Women Who Use Substances: What Communities are Doing to Help” from either the Canada FASD Research Network website here or the the BC Centre of Excellence for Women’s Health website here.
For more on this type of community program, see previous posts:
- Herway Home ‘one-stop access’ program in Victoria set to open (May 20, 2012)
- “New Choices” for pregnant and parenting women with addictions (January 9, 2012)
- Streetworks’ Supports for Homeless Pregnant Women project (September 15, 2011)
- Clinical Webcast on Breaking the Cycle Program: September 20, 2011 (August 2, 2011)
