The core components of an early intervention treatment approach as perceived by substance misusing pregnant women

Literature on substance abuse and pregnancy indicates that something different needs to be done to help substance-misusing pregnant women. Most existing treatment models are reactive, addressing what should to be done after a child is born prenatally exposed to drugs or alcohol. Many pregnant women are motivated and want support for their addictions during pregnancy, but are reluctant to disclose their drug abuse due to multiple barriers, such as fear of child apprehension. Therefore, they deny their substance misuse, and the fetus continues to be at risk. In this study, I interviewed 10 women who had used either alcohol or illicit drugs while pregnant. Women were asked what aspects of intervention they identified as fostering treatment engagement? Findings indicated that many substance-misusing pregnant women deal with a number of struggles most of their life aside from their drug and alcohol use. Many of the women interviewed had experienced abuse, generations of substance misuse, lack of stability/relationships, and feelings of insecurity and invisibility, and their substance misuse served a coping function. Results indicated that treatment engagement by substance misusing women was facilitated by a collaborative relationship with their social worker. Results also demonstrated that children become motivators for positive change. Treatment, therefore, should include children as opposed to removing them. When their child was apprehended, many women fell deeper into their drug and alcohol misuse. Residential treatment programming that addressed both the women's pre and post birth practical (i.e. housing) and mental health needs (i.e. their histories of abuse), and had professional supportive counselling as well as peer/mentorship groups, was considered ideal for treatment engagement.Arts, Faculty ofSocial Work, School ofGraduat