Title: La Bodega de la Familia: Reaching Out to the Forgotten Victims of Substance Abuse.
Series: Bulletin
Author: Carol Shapiro
Published: Bureau of Justice Assistance
Subject: Drug abuse
17 pages
36,000 bytes

------------------------------

Figures, charts, forms, and tables are not included in this ASCII plain-text
file. To view this document in its entirety, download the Adobe Acrobat
graphic file available from this Web site or order a print copy from BJA at
800-688-4252.

------------------------------

U.S. Department of Justice
Office of Justice Programs
Bureau of Justice Assistance

Bureau of Justice Assistance Bulletin
Nancy E. Gist, Director

La Bodega de la Familia: Reaching Out to the Forgotten Victims of
Substance Abuse

by Carol Shapiro, Project Director, La Bodega de la Familia

------------------------------

Drug abuse hurts many people, not just the addict. It hurts the grandmother
whose grandchild steals from her. It hurts the wife whose husband beats
her when he gets high. It hurts the child whose addicted parents can't care
for him. It hurts the intravenous drug user's infant, born addicted to drugs
or infected with HIV. It victimizes every relative, friend, and neighbor who
watches helplessly as a person he or she cares about relapses.

Unfortunately, most drug addiction programs focus exclusively on the user,
overlooking these hidden victims of drug abuse. In 1996, New York City
Mayor Rudolph Giuliani publicly supported the opening of La Bodega de la
Familia ("the family grocery"), a drug crisis center in Manhattan's Lower
East Side, which includes addicts' families in the drug treatment process.
The center, operated for the city by the Vera Institute of Justice, is
demonstrating that a supportive family is a drug user's best hope for
recovery.

------------------------------

Recent Criminal Justice Responses to Substance Abuse

Socioeconomic status determines the drug treatment options available to a
family seeking help for one of its members. For middle- and upper-income
Americans, substance abuse treatment is available through private
insurance and the health-care system. For low-income families, however,
substance abuse treatment primarily follows a drug user's arrest and often
ignores the needs of the drug user's family.

Nearly 25 percent of New York State prison inmates have committed no
other crime aside from possessing or selling drugs. African-Americans and
Latinos have felt the brunt of this criminal justice-driven response to drug
problems. The disproportionate increases (12.3 percent a year on average
for Latinos and 9.4 percent a year for African-Americans, compared with
7.6 percent for whites) in State prison populations largely reflect
sentencing patterns for nonviolent drug offenses.

Recently, the criminal justice system has started to place drug offenders
into drug treatment instead of traditional incarceration. Drug-use patterns
and criminal activity attributable to the influx of crack in the late 1980s
spawned a proliferation of alternative responses to substance abuse within
the criminal justice system. Through these alternatives, many more
low-income drug users began receiving treatment. These responses
included residential and outpatient treatment as an alternative to
incarceration, treatment for incarcerated offenders, and drug and
community courts.

Although drug and community courts try to provide some social services to
the families of offenders, the components of the criminal justice system
largely ignore the important role families play in helping a substance abuser
recover. John Goldkamp, in a 1994 article, argues "The attempt to
integrate disparate elements [of criminal justice and drug treatment] has
meant joining two perspectives accustomed to different methods and
sometimes competing aims regarding drug-involvement and its reduction"
(Goldkamp, 1994).

Focusing solely on the needs of individuals leaves the families of drug
offenders-the people who can make the most difference in changing an
offender's behavior-with little support and misses a rare opportunity to
interrupt the multigenerational cycle of drug use and criminal behavior.
Families of drug offenders, especially in low-income neighborhoods,
desperately need the support of the criminal justice system. Their
victimization can be severe, including financial ruin, physical abuse, and
emotional trauma.

------------------------------

La Bodega's Unique Approach: Family Case Management

La Bodega uses family case management (FCM) in its counseling activities.
This approach focuses on the entire family, not only on the substance
abuser involved with the criminal justice system. Case managers help
friends and families support their loved ones in outpatient treatment and
attend to related familial problems and concerns.

They engage family members in the FCM process by developing an action
plan. This plan proposes solutions that capitalize on family members'
strengths and identifies specific actions that can help a substance abuser
under criminal justice supervision remain in treatment. On average, La
Bodega maintains a caseload of 45 families, with approximately 4 members
per family.

FCM incorporates both prevention and treatment by including services that
address the needs of the substance abuser as well as those of the substance
abuser's family (Olsen, 1995). La Bodega's bilingual staff use a
comprehensive mix of services, including assessment, treatment planning,
referrals, monitoring, advocacy, counseling, and structural and instrumental
social support, to tend to the multiple needs of substance abusers and their
families (Rotham, 1991).

Traditionally a prototype of treatment with the chronically mentally ill,
FCM has emerged recently as an important approach to substance abuse
treatment (Rotham, 1991). Preliminary evaluations of FCM with
drug-involved arrestees show that it has a positive effect on a range of
outcomes, including reducing recidivism, increasing retention in treatment,
reducing HIV-related risk behaviors, and reducing employment problems
(Siegal et al., 1996).

Field Work and 24-Hour Support.

One element that distinguishes La Bodega's FCM from other treatment
programs is the program's field staff, who work with clinical staff to extend
services to participants' in their homes and in the community. Field
counselors provide 24-hour support for families dealing with drug-related
emergencies, which can include encounters with police, drug abuse
relapses, domestic violence situations, evictions, truancies, and health
crises. Field staff also follow up on referrals made to clients and serve as
their advocates in court or with enforcement agents such as probation and
parole officers, child welfare caseworkers, or public housing investigators.
As a general practice, field staff also follow up with family members the
day after a crisis intervention. When relapse symptoms such as missed
appointments, indications of drug use, and lapses in treatment attendance
are noted, parole and probation officers and La Bodega staff confer with
one another to determine the most appropriate response. In addition, at the
request of probation, parole, or police officers, field staff make home visits
to encourage families to continue their FCM participation. They also make
visits to families and individuals who are homebound because of illness or
age.

Walk-in Support and Prevention Services.

La Bodega offers a series of walk-in services that include workshops and
support groups, access to computers and the Internet, information about
health and housing services, referrals to primary and mental health care, job
training, and housing and employment information. Walk-in support gives
everyone residing in La Bodega's catchment area a way to learn about
FCM and deal with the substance abuse problems of a family member
without feeling threatened or stigmatized. Walk-in services are also used by
La Bodega's case managers to make sure families who no longer need the
intensive attention of FCM still receive ongoing assistance. For example,
La Bodega's Monday night group meeting is designed to provide a safe
forum for parents, guardians, and spouses of substance users to discuss
issues and concerns about addiction. Many participants are former FCM
clients whose loved ones are in treatment and no longer living in crisis.

------------------------------

Using the Natural Support System

Recent studies show that substance abusers supported by caring family and
friends are more successful than others in completing their outpatient
treatment (Currie, 1993). An individual's problems are more easily
understood and solved within the context of his or her interpersonal
relationships. At times, relationships with relatives and neighbors can
contribute to a user's addiction. However, in many instances, relatives and
neighbors can help a drug user during the treatment process. Latino
communities, such as those served by La Bodega, historically have
had strong support systems based partly on the extended family (Delgado
and Humm-Delgado, 1982).By providing counseling services that
strengthen these existing networks, La Bodega can help ensure successful
completion of a substance abuser's outpatient drug treatment program.

La Bodega's FCM approach provides an opportunity to improve treatment
and realize prevention goals. Through constant contact with both the
substance abuser and his or her family, La Bodega pro-actively works to
prevent the problems associated with a relapse or failure in treatment. The
center's case managers, for example, will notify parole officers when a
parolee relapses to divert a parole violation and will collaborate with the
officer to find an appropriate treatment option. Moreover, La Bodega
works to prevent the cycle of drug addiction and crime from being passed
down through generations by reducing the negative effects of a user's
incarceration on the rest of his or her family. The vast majority of La
Bodega's FCM families have a history of multigenerational substance abuse
(more than 80 percent) and many have been involved with the criminal
justice system (46 percent). By addressing the drug abuser's family's needs,
La Bodega hopes to break this cycle of abuse and crime.

------------------------------

Working in Partnership With Government

La Bodega's FCM approach is unique because it recognizes and responds
to a low-income family's need for help when maneuvering through the
criminal justice system and other complex public systems. Judges,
prosecutors, and parole and probation officers are more likely to allow a
substance abuser to complete a course of treatment in spite of problems
such as relapse, repeat offenses, or irregular attendance if a family member
is taking some responsibility for him or her(Galanter, 1993). La Bodega
provides a vehicle for law enforcement agencies to stop the cycle of relapse
and incarceration.

La Bodega partners with local government and community representatives
to identify appropriate treatment options that incorporate a drug abuser's
family in the recovery process. By keeping appropriate parolees out of
prison and in the community, La Bodega hopes to reduce the family
tensions caused by incarceration, increase parolees' chances for recovery by
helping them connect with their families, and help families to see parole
officers as an ally in the recovery process.

Administrators at La Bodega work closely with officials from the city's
police and probation departments and the State parole division to
encourage the use of family case management as an alternative to punitive
responses. At the local level, La Bodega staff have cultivated strong
relationships with precinct police, probation and parole field staff, social
workers and investigators from the city's child services department and
housing authority, school officials, and local health-care providers. These
relationships permit the quick referral of drug-abusing family members for
immediate services and allow La Bodega's field staff to track the substance
abuser's progress in treatment.

La Bodega's willingness to work with government agencies has increased
the confidence of the local criminal justice system that the center's
approach can improve the success rate of outpatient drug treatment. Parole
and police officers regularly refer individuals at risk of a parole violation to
La Bodega. La Bodega also advocates for the early release of drug
offenders with HIV and AIDS who would fare better in community
treatment.

Although many of La Bodega's families have experience with government
agencies, they are often ashamed of their loved ones' substance abuse and
criminal histories. The stigma they believe they will suffer often prevents
individuals from seeking assistance outside the family, particularly for
health-care and social services needs (Molina and Aguirre-Molina, 1994).
Although more than half of the center's families have a member in
mandated drug treatment, La Bodega remains a nonmandated, neutral
option for its government partners, which complements the statutory
requirements of parole and probation supervision. Family members and law
enforcement official shave come to rely on La Bodega. In one case, a field
representative introduced an Assistant District Attorney (ADA) to the
family of a parolee who had violated his parole stipulations by relapsing
repeatedly. His family was involved with La Bodega and was willing to
support him in outpatient drug treatment. The ADA and the parole officer
agreed to place the defendant in a short-term detoxification program on the
condition that outpatient treatment would follow along with continued
family support.

------------------------------

Keeping Recovery in the Neighborhood

In choosing a site to test this program, La Bodega planners sought a
community with strengths as well as needs-a neighborhood with institutions
and programs in place to address the myriad problems that arise for
substance abusers and their families and friends. The Loisaida, a
neighborhood in Manhattan's Lower East Side, is filled with
community-based organizations, settlement houses, and health-care
facilities and is a major consumer of criminal justice resources. The
neighborhood is permeated with tangible evidence of the harmful effects of
drug use on families-crime such as theft and domestic violence and
drug-related health problems such as low birth weight, babies born
addicted to drugs, and high rates of HIV infection and AIDS. The majority
of La Bodega's participants are Hispanic, an ethnic group disproportionally
represented in State prisons in relation to other ethnic groups (Bureau of
Justice Statistics, 1996).

Historically, communities such as the Loisaida have failed to fully use the
social services available within their neighborhoods and have a history of
resisting interventions from outside organizations. Engaging members of
minority communities can be facilitated by having a staff similar to La
Bodega's-ethnically diverse, culturally sensitive, and bilingual (Lecca,
Gutierrez, and Tijerina, 1996).

A shortcoming of some residential drug treatment programs is that they
take drug users out of their community and treat them away from the
environment that precipitated the drug-abusing behavior. La Bodega's
planners at the Vera Institute of Justice saw the importance of placing
La Bodega within the community it serves so that staff could draw upon the
resources of not only existing heath clinics, hospital detoxification facilities,
religious groups, settlement houses, and counseling services, but also local
residents. La Bodega received unanimous approval from the local
community board to place its drug crisis center in Loisaida.

Word of mouth in the Loisaida is integral to La Bodega's success. La
Bodega relies on its reputation within the community to promote
participation. The number of referrals to the center from neighborhood
residents is increasing. La Bodega also enlists the community in evaluating
its services. The Community Advisory Board, a guiding body comprising
local service providers, academics, government partners, and Bodega
participants, enables La Bodega to assess how well it complements existing
local services, how services can be modified to better meet the needs of
neighborhood residents, and how La Bodega can more effectively use
government systems and resources to serve the families of
substance-abusing offenders. The Community Advisory Board also plays
an important role in developing programs and workshops that empower
participants, teaching them to solve their own problems and lead by
example in their homes and in their communities.

------------------------------

The Challenge for the Future

Whether measured by levels of attention or accomplishments, few
controversies have rivaled the recent debates over U.S. drug policy. The
criminal justice system is often at the center of these discussions.
Acknowledging that singularly punitive policies have been prohibitively
expensive and possibly ineffective, criminal justice researchers now search
for ways to bring drug users into treatment and break their connections to
drugs and crime.

La Bodega is a concept that could be replicated within other existing
government and neighborhood services. By researching the effects of FCM
on local families and by using a highly distinguished national advisory
board to test the efficacy of this new model, La Bodega is learning how
family-focused approaches to substance abuse can be implemented most
effectively around the country.

If we include addicts' families in the drug treatment process, everyone will
have a role: Judges could consider a treatment option such as FCM when
sentencing if there is adequate family support; probation and parole officers
could consider family-focused options before violating an offender for
failures in drug treatment; when appropriate, police officers could seek
family solutions instead of relying on arrests to manage family problems;
and health-care providers could be sensitive to the likelihood that the
substance abuse of one family member is a strong indicator that other
family members may be at risk for poor mental and physical health.

The intransigence of the drug and crime problems in this country, marked
by endless policy debates, suggests a need for many alternative solutions.
Conventional offender-focused programs are one approach. La Bodega's
family-centered approach represents an equally viable option-one that may
provide a more comprehensive response to the myriad destructive
consequences of this persistent problem.

------------------------------

Sources for Further Information

For more information on La Bodega de la Familia, contact:

Bureau of Justice Assistance Clearinghouse 
P.O. Box 6000
Rockville, MD20849-6000
1-800-688-4252
E-mail: askncjrs@ncjrs.org
World Wide Web: http://www.ncjrs.org

La Bodega de la Familia
272 East Third Street 
New York, NY10009
212-982-2335
World Wide Web: http://www.vera.org/bdf

------------------------------

References

Anthony, W.A., M. Cohen, B. Cohen, and M. Farkas. 1998. "Clinical Care
Update: The Chronically Mentally Ill: Case Management-More Than a
Response to a Dysfunctional System."Community Mental Health Journal
24 (3): 219-227.

Applebaum, R., and C. Austin. 1990. Long-Term Care Case Management:
Design and Evaluation. New York: Springer Publishing Company.

Azzi-Lessing, L., and L. Olsen. 1994. "Project Connect: What We've
Learned From Serving Substance Abuse Afflicted Families." Common
Ground 11 (3): 183-196.

Belenko, S., J. A. Fagan, and T. Dumanovsky. 1994. "The Effects of Legal
Sanctions on Recidivism in Special Drug Courts." The Justice System
Journal 17 (1): 53-81.

Bureau of Justice Assistance. 1995. Treatment Accountability for Safer
Communities. Fact Sheet. Washington, DC: Bureau of Justice Assistance.
FS000044. Available from the BJA Clearinghouse at 1-800-688-4252 and
electronically at http://www.ncjrs.org.

Bureau of Justice Statistics. 1996. Prisoners in 1996. Washington, DC:
U.S. Department of Justice.

Center for Substance Abuse Prevention. 1995. Practical Approaches in the
Treatment of Women Who Abuse Alcohol and Other Drugs. Washington,
DC: U.S. Department of Health and Human Services. NCJ 166451.
Available from the BJA Clearinghouse at 1-800-688-4252.

Currie, E. 1993. Drugs, the Cities, and the American Future. New York:
Farrar, Straus, and Giroux.

Delgado, M., and D. Humm-Delgado. 1982. Natural Support Systems:
Source of Strength in Hispanic Communities. Washington, DC: National
Association of Social Workers.

Effectiveness of Innovative Approaches in the Treatment of Drug Abuse.
1997. Westport, CT: Greenwood Press. Contributions in Criminology and
Penology, Issue paper 49. NCJ 163802.Available from the BJA
Clearinghouse at 1-800-688-4252.

Galanter, M. 1993. Network Therapy for Alcohol and Drug Abuse: A New
Approach in Practice. New York: Basic Books.

Goldkamp, J. 1994. "Miami's Treatment Drug Court for Felony
Defendants: Some Implications of Assessment Findings." The Prison
Journal 73 (2): 110-166.

Haack, M.R., ed. 1997. Drug-Dependent Mothers and Their Children.
New York: Springer Publishing Company.

Kandall, S.R., and J. Petrillo. 1996. Substance and Shadow: Women and
Addiction in the United States. Cambridge, MA: Harvard University Press.

Lecca, P.J., J.A Gutierrez, and G. Tijerina. 1996. "A Model To Improve
the Utilization of Health and Social Services in Latino Communities."
Journal of Health and Social Policy 8 (2): 55-69.

Lipton, D.S. 1995. The Effectiveness of Treatment for Drug Abusers
Under Criminal Justice Supervision. Research Report. Washington, DC:
National Institute of Justice. NCJ 157642.Available from the BJA
Clearinghouse at 1-800-688-4252 and electronically at
http://www.ncjrs.org

Martin, S., H. Isenberg, and J.A. Inciardi. 1993. "Assertive Community
Treatment: Integrating Intensive Drug Treatment With Aggressive Case
Management for Hard-to-Reach Populations."In Innovative Approaches in
the Treatment of Drug Abuse. J.A. Inciardi, F.M. Tims, and B.W.Fletcher,
eds. Westport, CT: Greenwood Press.

McClellan, A.T., G. E. Woody, and D. Metzger. 1996. "Evaluating the
Effectiveness of Addiction Treatments: Reasonable Expectations,
Appropriate Comparisons." Milbank Quarterly 74 (1):51-85.

Molina, C.W., and M. Aguirre-Molina, eds. 1994. Latino Health in the
U.S.: A Growing Challenge. Washington, DC: American Public Health
Association.

Nash, J.M. 1997. "Addicted." Time 149 (18).

National Center on Addiction and Substance Abuse. 1998. Behind Bars:
Substance Abuse and America's Prisons. New York: Columbia University.

National Institute of Justice. 1994. Drug-Abusing Women Offenders:
Results of a National Survey. Washington, DC: U.S. Department of
Justice.

National Institute on Drug Abuse. 1994. Substance Abuse Among Women
and Parents. Washington, DC: U.S. Department of Health and Human
Services.

Neff, J.A., B. Holamon, and T.D. Schluter. 1995. "Spousal Violence
Among Anglos, Blacks, and Mexican Americans: The Role of
Demographic Variables, Psychosocial Predictors, and Alcohol
Consumption." Journal of Family Violence 10 (1): 1-21.

Office of Justice Programs. 1996. OJP Drugs and Crime Working Group:
A Report to the Assistant Attorney General. Washington, DC: U.S.
Department of Justice. NCJ 161131. Available from the BJA
Clearinghouse at 1-800-688-4252 and electronically at
http://www.ncjrs.org

Olsen, L.J. 1995. "Services for Substance Abuse-Affected Families: The
Project Connect Experience." Child and Adolescent Social Work Journal
12: 183-196.

Prendergast, M.L. 1995. "Toward a Drug Abuse Treatment System."
Journal of Drug Issues(Fall): 759-782. NCJ 163937. Available from the
BJA Clearinghouse at 1-800-688-4252.

Prendergast, M.L., M.D. Anglin, and J. Wellisch. 1995. "Up to Speed:
Treatment for Drug-Abusing Offenders Under Community Supervision."
Federal Probation 59 (4): 66-75. NCJ162828. Available from the BJA
Clearinghouse at 1-800-688-4252.

Rivera, F.P., B.A. Mueller, G. Somes, C.T. Mendoza, N.B. Rushford, and
A.L. Kellermann.1997. "Alcohol and Illicit Drug Abuse and the Risk of
Violent Death in the Home." Journal of the American Medical Association
278 (7): 569-575.

Rotham, J. 1991. "A Model of Case Management: Toward Empirically
Based Practice." Social Work 36 (6): 520-528.

Shwartz, M., G. Baker, K.P. Mulvey, and A. Plough. 1997. "Improving
Publicly Funded Substance Abuse Treatment: The Value of Case
Management." American Journal of Public Health 87: 1659-1664.

Siegal, H.A., J.H. Fisher, R.C. Rapp, C.A. Kelliher, J.H. Wagner, W.R.
O'Brien, and P.A. Cole.1996. "Enhancing Substance Abuse Treatment
With Case Management: Its Impact on Employment." Journal of Substance
Abuse Treatment 13 (2): 93-98.

Substance Abuse and Mental Health Services Administration. 1996.
Overview of the National Drug and Alcoholism Treatment Unit Survey:
1994 and 1980-1994. Washington, DC: U.S. Department of Health and
Human Services.

Torres, S. 1996. "Should Corrections Treat or Punish Substance-Abusing
Criminals?" Federal Probation 60 (3): 18-23. NCJ 167473. Available from
the BJA Clearinghouse at 1-800-688-4252.

Weil, M., and J.M. Karls et al. 1985. Case Management in Human Service
Practice. San Francisco: Jossey-Bass.

------------------------------

Drug Addiction's Devastating Impact on Families

An estimated 13 million American children live with parents who have
reported using illicit drugs in the past year, and more than 6 million live
with parents who have reported using illicit drugs in the past month
(National Institute on Drug Abuse, 1994). When parents have serious
substance abuse problems, their children suffer the consequences of living in
unhealthy, chaotic environments. Parents who seriously abuse drugs
commonly are unable to fulfill major obligations at home and at work. And
some children are forced into foster care when a substance-abusing parent is
incarcerated. Numerous studies have shown that substance abuse is often a
critical factor in these harmful family situations.

o Alcohol abuse is the leading cause of family violence. More than 50
percent of spousal murders are drug- or alcohol-related, and parents with
substance abuse problems show much higher rates of abusive and
neglectful behavior toward their children than do other parents. One study
estimated that from 60 to 80 percent of children who are abused and
neglected live with substance-abusing families (National Institute of Justice,
1994).

o Drug abuse is one of the most common factors leading to a child's entry
into the welfare system. In 1994, caseworkers nationwide reported that
they knew of parental substance abuse in at least one-third of the families
they were serving (Haack, 1997).

o At least half of the 104,000 drug- and alcohol-involved female inmates in
the United States had minor-age children living with them before they
entered prison (National Center on Addiction and Substance Abuse, 1998).
Many of these women receive little or no help from the children's fathers,
lack supportive family and social networks, and have limited or no financial
resources.

o The number of women in drug treatment programs has more than
doubled in the past two decades (Substance Abuse and Mental Health
Services Administration, 1996).

------------------------------

La Bodega de la Familia at a Glance

o La Bodega de la Familia means "the family grocery." It opened in
October 1996, taking its name from a grocery store that had once occupied
the same storefront at C and Third Streets in an area of Manhattan's Lower
East Side called the Loisaida by its Hispanic residents.

o A violent confrontation between police and local drug dealers at the
former grocery store in1995 resulted in the death of one person and the
near-fatal shooting of police officer Keith Prunty, who was left paralyzed.
More than 30 businesses donated services and construction materials to
transform the site.

o La Bodega's annual budget of $850,000 is funded through a collaboration
between Federal and city government and the nonprofit sector. The center
is operated by the Vera Institute of Justice, an organization that has
worked since the mid-1960s to develop innovative solutions to crime and
drug addiction. It is funded by the city of New York, Office of the Mayor's
Criminal Justice Coordinator, and the Bureau of Justice Assistance.

o At any one time, La Bodega provides assistance to more than 45 families
(with an average of 4members per family) through its family case
management services. The center's client base is largely referred by police,
probation, and parole officers; Lower East Side residents; and
community-based organizations.

o In its first year, La Bodega enrolled more than 90 local families in family
case management. More than 350 individuals living in Manhattan's Lower
East Side have been successfully treated through the center's walk-in and
prevention services.

------------------------------

The Road to Recovery: One Family's Story

The Family: Sam, father, 26; Maria, mother, 32; David, son of Maria, 11;
Luis, son, 8; Monique, daughter, 7; Frances, mother of Maria, 50; Eleanor,
mother of Sam, 44; and Paul, brother of Sam, 21.

Before seeking help from La Bodega, Sam had been incarcerated for 18
months at a Shock Incarceration Unit for possessing and selling drugs. He
had a recent relapse after 8 months of sobriety; he was using drugs in
violation of his parole. His parole officer referred him to La Bodega for
family counseling, diverting an arrest for relapse. Sam was in need of drug
treatment, education, employment, health-care coverage, a primary care
physician, and family counseling. He was concerned and embarrassed about
the pain his addiction and incarceration had caused his family, particularly
his children.

Sam's family has struggled with substance abuse and criminal justice
problems for many years. Sam's mother, Eleanor, began drinking alcohol at
a young age and has had periods of heavy drinking over the past 25 years.
Eleanor's eldest son, Adam, was killed 9 years ago in a drug-related drive
by shooting. There is considerable conflict between Eleanor and her two
surviving sons. Her relationship with Sam is especially strained; she is
angry and disappointed about his substance abuse and incarcerations. Paul,
her youngest child, began using marijuana as an early teen. He was
convicted of assault with a deadly weapon in August 1997 and sentenced
to5 years in jail. Sam began using marijuana when he was 15 and heroin
when he was 17. Sam and Paul have been arrested numerous times for
possession of drugs, assault with a deadly weapon, robbery, and grand theft
auto. The majority of the convictions were drug related.

Since his release from prison, Sam has worked occasionally at a relative's
shop. He lives with his wife, Maria, her son, David, and their daughter,
Monique, in a New York City public housing apartment. Maria works
part-time as a sales representative and is the family's primary source of
income. Sam has no contact with his 8-year-old son from a previous
marriage, who lives with his mother. Maria's mother, Frances, who has
been diagnosed with cancer, is an important source of support for the
family. While Sam was incarcerated, she helped Maria when David began
getting into fights at school. Monique attends school regularly and has not
begun to act out against any member of her family.

Keeping the Family Intact

Rather than focus narrowly on Sam's addiction, La Bodega's counselors
sought to help the whole family by involving each member in two types of
family services-group sessions to address problems affecting the family as a
whole and individual sessions to address each person's needs. La Bodega
also supports the family's daily needs. For example, staff worked with
David's school principal to deal with David's persistent fighting in school.

Sam, Maria, David, and Monique began attending counseling sessions at
La Bodega as a group. Sam and Maria also participate in individual
sessions. Sam's case manager helped him enroll in a detoxification program.
The case manager had difficulty placing Sam in a program because he
lacked Medicaid coverage. After completing the detoxification program,
Sam began his parole-mandated outpatient drug treatment. La Bodega staff
held periodic conferences with his parole officer and drug treatment
counselors to discuss his progress and compliance with supervision.

The Family's Progress

Eleanor and Sam are working on reestablishing a relationship that is
positive and supportive. Eleanor has reduced her alcohol consumption but
still refuses to participate with La Bodega.

Sam experienced a relapse and contemplated suicide in November 1997.
Maria contacted the case manager, who intervened with his parole officer
to divert an arrest for parole violation. Given the existing support of Sam's
mother-in-law, wife, and children, his parole officer agreed not to violate
him. Sam is awaiting approval for Medicaid coverage, after which he will
transfer from his current outpatient drug treatment program to more
intensive outpatient treatment.

Maria and the children continue to attend sessions and discuss their feelings
about Sam's relapse, addiction, and incarceration. They also discuss
Frances' cancer treatment.

Goals for the Future

Sam

o Transfer to a new outpatient drug treatment program after Medicaid
approval.

o Find employment.

o Enroll in a GED program.

o Continue to attend family and individual counseling sessions.

o Contact his estranged son, Luis.

Maria

o Continue family and individual counseling.

o Establish support systems to deal with her mother's chronic illness.

o Participate in "Reflejos," La Bodega's family support group for nonusers.

David and Monique

o Continue family counseling sessions.

o Maintain good attendance and behavior in school.

o Participate in youth activities.

Eleanor

o Become involved in family and individual sessions at La Bodega.

Editor's note: The names of the members of the family discussed in this
case study were changed to protect their privacy.

------------------------------

The Bureau of Justice Assistance and La Bodega de la Familia would like
to acknowledge the contributions of the following individuals in the
researching, writing, editing, and graphic design of this publication: Amber
Douglas, Jesse Souweine, Catherine Stayton, and Doug Young of
LaBodega de la Familia; Chadwick Bash of the Bureau of Justice
Assistance; and Doug Roemer and Lisa Pearce of the Bureau of Justice
Assistance Clearinghouse.

------------------------------

This document was prepared by the Vera Institute of Justice, Inc., under
grant number95-DD-BX-0094, awarded by the Bureau of Justice
Assistance, Office of Justice Programs, U.S. Department of Justice. The
opinions, findings, and conclusions or recommendations expressed in this
document are those of the authors and do not necessarily represent the
official position or policies of the U.S. Department of Justice. The Bureau
of Justice Assistance is a component of the Office of Justice Programs,
which also includes the Bureau of Justice Statistics, the National Institute
of Justice, the Office of Juvenile Justice and Delinquency Prevention, and
the Office for Victims of Crime.
NCJ 170595
April 1998