A controlled evaluation of family behavior therapy in concurrent child neglect and drug abuse.
OBJECTIVE
Approximately 50% of child protective service (CPS) referrals abuse drugs; yet, existing treatment studies in this population have been limited to case examinations. Therefore, a family-based behavioral therapy was evaluated in mothers referred from CPS for child neglect and drug abuse utilizing a controlled experimental design.


METHODS
Seventy-two mothers evidencing drug abuse or dependence and child neglect were randomly assigned to family behavior therapy (FBT) or treatment as usual (TAU). Participants were assessed at baseline, 6 months, and 10 months postrandomization.


RESULTS
As hypothesized, intent-to-treat repeated measures analyses revealed mothers referred for child neglect not due to their children being exposed to illicit drugs demonstrated better outcomes in child maltreatment potential from baseline to 6- and 10-month postrandomization assessments 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 from baseline to 6 and 10 months postrandomization. However, TAU mothers referred due to child drug exposure were also found to decrease their hard drug use more than TAU mothers of non-drug-exposed children and FBT mothers of drug-exposed children at 6 and 10 months postrandomization. Although effect sizes for mothers assigned to FBT were slightly larger for marijuana use than TAU (medium vs. large), these differences were not statistically significant. Specific to secondary outcomes, mothers in FBT, relative to TAU, increased time employed from baseline to 6 and 10 months postrandomization. Mothers in FBT, compared to TAU, also decreased HIV risk from baseline to 6 months postrandomization. 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 (p = .058) in incarceration from baseline to 6 months postrandomization relative to TAU mothers.


CONCLUSIONS
Family-based behavioral treatment programs offer promise in mothers who have been reported to CPS for concurrent substance abuse and child neglect of their children. However, continued intervention development in this population is very much needed.
Department of Psychology, University of Nevada, Las Vegas.
Brad
B
Donohue
Center for Psychological Services, Nova Southeastern University.
Nathan H
NH
Azrin
Department of Psychology, University of Nevada, Las Vegas.
Kelsey
K
Bradshaw
Center for Psychological Services, Nova Southeastern University.
Vincent B
VB
Van Hasselt
Department of Psychology, University of Nevada, Las Vegas.
Chad L
CL
Cross
Department of Psychology, University of Nevada, Las Vegas.
Jessica
J
Urgelles
Department of Psychology, University of Nevada, Las Vegas.
Valerie
V
Romero
Department of Psychology, University of Nevada, Las Vegas.
Heather H
HH
Hill
Department of Psychology, University of Nevada, Las Vegas.
Daniel N
DN
Allen
D000328:Adult; D001521:Behavior Therapy; D002648:Child; D002649:Child Abuse; D002675:Child, Preschool; D005196:Family Therapy; D005260:Female; D006801:Humans; D008297:Male; D009035:Mothers; D011329:Prisoners / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome