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Advancing Family-Centered Care for Pregnant and Parenting Women

Pat Stilen, MSW
Sarah Knopf-Amelung, MA-R
Kate Mallula, MPH, LMSW

Mid-America ATTC

March 5, 2019

As former director of a women’s treatment program in Nebraska, Mid-America ATTC Co-Director Pat Stilen saw firsthand the importance of family in mothers’ recovery journeys. She also recognized that family-centered care was the exception rather than the standard of substance use disorder (SUD) care. It was with this perspective that she and her team at Mid-America ATTC led the ATTC Center of Excellence on Behavioral Health for Pregnant and Postpartum Women and Their Families (ATTC CoE-PPW) from October 2015 – September 2017. We collaborated with three other regional centers – Great Lakes, New England, and Southeast ATTCs – to advance family-centered care nationally.

After embarking on an environmental scan within our first few months of operation, we realized there was no existing curricula on the topic—let alone a common definition of family-centered care. In many ways, starting at square one and simply defining what family-centered care actually means is an accomplishment that guides our work to this day. Through a series of 10 site visits across the country, we saw the need to build a coherent practice framework for supporting mothers and children in identifying their supports—including fathers—and actively engaging these key family members in treatment and recovery services.

After site visits, reviewing the literature, and working with a subject matter expert panel, we defined family-centered care as: “Providing services for the whole family to make recovery possible; though the mother is the entry point, the family becomes the client.” This definition reflects the reality that SUDs during motherhood affect the whole family and require a comprehensive, compassionate, and family-centered response from systems of care.

...we defined family-centered care as: "Providing services for the whole family to make recovery possible; though the mother is the entry point, the family becomes the client."

To develop this practice framework, our team translated the latest research on women’s addiction treatment and SUD’S impact on parenting, child development, and family systems into evidence-based curriculum, products, and technical assistance. We launched a comprehensive web-based toolkit, developed a six-module in-service curriculum, produced a documentary and five topic-specific vignettes, led a six-month national Project ECHO, published an interview monograph, released a monthly newsletter with research updates, and developed 21 on-demand didactic presentations and an online course.

The transition from working with women in isolation from their families to seeing them as integral parts of larger family systems continues to guide our work at Mid-America ATTC. We still maintain our Tools for Treatment website, a centralized source of up-to-date research, resources, and trainings. In partnership with Mountain Plains ATTC, we host the Family-Centered Care Learning Collaborative, a combination of our in-service curriculum with individualized implementation coaching that runs through May 2019.

On a local level, we facilitate the Kansas City Perinatal Recovery Collaborative, which is working to develop, grow, and nurture a coordinated network of services and programs to support pregnant and parenting mothers as they navigate the dual journey of parenting and recovery in the bi-state metro area. The KC PRC Steering Committee convenes on a monthly basis and has garnered attention in local and national media, including a two-part series on Kansas City’s NPR affiliate (part one and part two), articles in the Kansas City Star and Associated Press, and segments on local news.

From local to national scales, the opportunity to begin this work has opened our eyes to the transformative presence of family in recovery. It is the providers who embody this inclusive spirit and the families who bravely navigate and shape their own recovery journeys that continue to inspire us to see new possibilities for more compassionate, holistic SUD services.

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The opinions expressed herein are the views of the authors and do not reflect the official position of the Department of Health and Human Services (DHHS), SAMHSA, CSAT or the ATTC Network. No official support or endorsement of DHHS, SAMHSA, or CSAT for the opinions of authors presented in this e-publication is intended or should be inferred.