Controlled Evaluation of Family Behavior Therapy with Mothers Who Have Been Identified to Abuse Drugs and Neglect Their Children

This presentation focuses on testing an intervention strategy intended to reduce family risk factors in a high-risk, selected population, namely families where there is parental substance abuse. Objective: Approximately 50% of Child Protective Service (CPS) referrals abuse drugs; yet, existing intervention studies in this population have been limited to case examinations. A family-based behavioral therapy was evaluated in mothers referred from CPS. Method: 72 mothers evidencing drug abuse or dependence and child neglect were randomly assigned to a family behavior therapy (FBT) or treatment as usual (TAU). Participants were assessed at baseline, 6- month-, and 10-month post-randomization. Results: As hypothesized, intent-to-treat repeated measures analyses revealed mothers referred for child neglect not specific to their children being exposed to illicit drugs demonstrated better outcomes in child maltreatment potential from baseline to 6-month and 10-month post-randomization when assigned to FBT, as compared with TAU mothers and FBT mothers who were referred due to child drug exposure. Similar results occurred for hard drug use, but not marijuana use, from baseline to 6-month post-randomization. The effect size for hard drug use in TAU mothers referred due to child drug exposure was relatively high at 10-month post-randomization. Specific to secondary outcomes, mothers in FBT, relative to TAU, increased time employed from baseline to 6-month and 10-month post-randomization. Mothers in FBT, compared to TAU, also decreased HIV risk from baseline to 6-month post-randomization, although these results were not maintained at 10-month post-randomization. There were no differences in outcome between FBT and TAU for number of days children were in CPS custody and alcohol intoxication, although FBT mothers demonstrated marginal decreases in incarceration from baseline to 6-month post-randomization relative to TAU mothers. Conclusions: Family-based behavioral intervention programs offer promise for reducing family risk factors in mothers who have been reported to CPS for concurrent child neglect of their children and substance abuse. Recommendations are offered in light of the study results.