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NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Bookshelf ID: NBK64901PMID: 22514842

# Substance Abuse Treatment for Persons with Child Abuse and Neglect Issues

*Treatment Improvement Protocol (TIP) Series, No. 36*

Center for Substance Abuse Treatment.

Substance Abuse and Mental Health Services Administration (US)

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This TIP, *Substance Abuse Treatment for Persons With Child Abuse and Neglect     Issues*, examines treatment issues for both adult survivors of child abuse or neglect     and adults in treatment who may be abusing or neglecting their own children.

Chapters 1 through 3 focus primarily on adult survivors of child abuse and neglect. Chapter 1 defines child abuse and neglect,            provides rates of child abuse and neglect both in the general population and among those            in substance abuse treatment, and reviews the literature on links between childhood            abuse and subsequent substance abuse. Chapter 2            describes screening and assessment tools that can be used to determine whether a client            has a history of childhood abuse or neglect; Chapter                3 presents guidelines on treating clients with histories of child abuse or            neglect and referring them to mental health care treatment when necessary. Chapter 4 discusses the personal issues            counselors may encounter (e.g., countertransference) when working with clients with            histories of abuse or neglect and offers suggestions for addressing them. In Chapters 5            and 6, the focus shifts to adults in treatment who may be abusing or neglecting their            own children. Chapter 5 shows how alcohol and            drug counselors can identify whether their clients are at risk of or are currently            abusing or neglecting their children. It discusses what alcohol and drug counselors can            do to break the cycle of child abuse and neglect, including how to work with child            protective service agencies within the child welfare system. Chapter 6 is an overview of the legal issues that counselors            should be aware of as mandated reporters. The TIP concludes with an overview in Chapter 7 of continuing and emerging trends, such            as fast-track adoption and welfare reform, that counselors will need to follow in the            coming years.

## Contents

                    - Expand All
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                  -      What Is a TIP?
                  -      Editorial Advisory Board
                  -      Consensus Panel
                  -      Foreword
                  -     Executive Summary and Recommendations 
                  -  Chapter 1—Working With Child Abuse and Neglect Issues                     -      Substance Abuse and Child Abuse and Neglect
                    -      Implications for Treatment of Clients With Child Abuse     Histories
                    -      Incidence of Child Abuse and Neglect 
                    -      Incidence of Child Abuse and Neglect Histories Among     Adults
                    -      Defining Abuse and Neglect
                  -  Chapter 2—Screening and Assessing Adults For Childhood Abuse and Neglect                     -      Challenges to Accurate Screening and Assessment 
                    -      Screening for a History of Child Abuse or Neglect
                    -      Formal Assessment for a History of Child Abuse Or     Neglect
                    -      Special Considerations and Recommendations
                  -  Chapter 3—Comprehensive Treatment for Adult Survivors of Child Abuse and Neglect                     -      Treatment Issues
                    -      Treatment Techniques
                  -  Chapter 4—Therapeutic Issues for Counselors                     -      Transference, Countertransference, and Secondary     Traumatization
                    -      Establishing the Treatment Frame and Special     Issues
                    -      Responsibility of the Agency To Support the     Counselor
                  -  Chapter 5—Breaking the Cycle: The Substance-Dependent Client as Parent/Caregiver                     -      Who Abuses and Why
                    -      Role of the Counselor
                    -      Clues That the Client May Be Endangering Children
                    -      Incorporating Treatment Strategies for Child     Abusers
                    -      Organizational Roles and The Need for     Collaboration
                  -  Chapter 6—Legal Responsibilities and Recourse                     -      Mandated Reporting
                    -      State Laws Regarding Child Abuse and Neglect
                    -      CPS Agency Investigation and Potential Outcomes
                  -  Chapter 7—Emerging and Continuing Issues                     -      The Impact of New Legislation on Parents in     Treatment
                    -      Emerging Issues
                    -      Continuing Trends
                  - Appendix A --Bibliography
                  - Appendix B --Protecting Clients' Privacy
                  -     Appendix C --Implications of Recent Federal Legislation for    Clients in Treatment
                  - Appendix D—Obtaining Screening and Assessment Tools
                  - Appendix E --Resources Related to Childhood Trauma Among Adults
                  -     Appendix F --Resource Panelists
                  -     Appendix G—Field Reviewers

                    - Expand All
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This publication is part of the Substance Abuse Prevention and Treatment Block Grant technical assistance program. This publication was written under contract number 270-95-0013 with The CDM Group, Inc.     (CDM). Sandra Clunies, MS, ICADC, served as the CSAT government project officer. Rose M Urban, LCSW, JD, CCAS, served as the CDM TIPs project director. Other CDM TIPs     personnel included Raquel Ingraham, MS, project manager; Jonathan Max Gilbert, MA, managing     editor; Cara Smith, production editor; Kurt S Olsson, former editor/writer; Paul Seaman,     former acting editor; Y-Lang Nguyen, former production editor; and MaryLou Leonard, former     project manager. Special thanks go to consulting writers Tracy Simpson, PhD, and Christine     Courtois, PhD, for their considerable contributions to this document.

The opinions expressed herein are the views of the Consensus Panel members and do not reflect     the official position of CSAT, SAMHSA, or the U.S. Department of Health and Human Services     (DHHS). No official support or endorsement of CSAT, SAMHSA, or DHHS for these opinions or for     particular instruments or software that may be described in this document is intended or should     be inferred. The guidelines proffered in this document should not be considered as substitutes     for individualized client care and treatment decisions.

Copyright Notice: This publication is in the public domain. For more information, see the Bookshelf Copyright Notice.

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### Other titles in these collections

                -  SAMHSA/CSAT Treatment Improvement Protocols 
                -  Health Services/Technology Assessment Text                            (HSTAT) 

### Related citations in PubMed

                  -  Substance Abuse Treatment for Persons with HIV/AIDS  [ 2000]  Substance Abuse Treatment for Persons with HIV/AIDS*Center for Substance Abuse Treatment.**2000* 
                  -  Psychiatric profile and sociodemographic characteristics of adults who report physically abusing or neglecting children.  [Am J Psychiatry. 1996]  Psychiatric profile and sociodemographic characteristics of adults who report physically abusing or neglecting children.*Egami Y, Ford DE, Greenfield SF, Crum RM.**Am J Psychiatry. 1996 Jul; 153(7):921-8.* 
                  -  Brief Interventions and Brief Therapies for Substance Abuse  [ 1999]  Brief Interventions and Brief Therapies for Substance Abuse*Center for Substance Abuse Treatment.**1999* 
                  -  Review Coexisting child neglect and drug abuse in young mothers: specific recommendations for treatment based on a review of the outcome literature.  [Behav Modif. 2004]  Review Coexisting child neglect and drug abuse in young mothers: specific recommendations for treatment based on a review of the outcome literature.*Donohue B.**Behav Modif. 2004 Mar; 28(2):206-33.* 
                  -  Review Individual and group-based parenting programmes for the treatment of physical child abuse and neglect.  [Cochrane Database Syst Rev. 2006]  Review Individual and group-based parenting programmes for the treatment of physical child abuse and neglect.*Barlow J, Johnston I, Kendrick D, Polnay L, Stewart-Brown S.**Cochrane Database Syst Rev. 2006 Jul 19; (3):CD005463. Epub 2006 Jul 19.* 
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