The program was implemented in three IDHW regions of the state: Region I, northern Idaho; Region III, southwestern Idaho; and Region IV, south central Idaho. At the heart of the pro- gram was locating three Substance Abuse Liaisons (SALs), who are certified Substance Abuse Counselors in the Child and Family Services (CFS) offices in each of these regions. SALs pro- vided substance abuse assessments, direct referral to treatment providers, and pre-treatment services until entry into treatment. Goals of the program were to
engage parents waiting for treatment,
increase motivation for treatment entry,
improve treatment retention/completion, and
decrease out-of-home placement and child protection re-referrals for abuse or neglect
of children during the intervention. MI strategies (Miller & Rollnick, 2002) were used to assess parents’ Stage of Change and support them through individual and group meetings while waiting for treatment.
Specifically, when CPS social workers had reason to believe DOA abuse was a problem in a CPS-referred family, they could refer parents to SALs for a substance abuse assessment and direct referral to treatment if needed.
However, parents may not have received an assessment or accessed treatment immediately for several reasons: there may have been a waiting list for the particular type of treatment; they may not have perceived the need for treatment right away; or they had other situations that prevented immediate access to treatment (e.g., child care needs, jail time). In such events, SALs utilized an MI approach to assist parents in finding intrinsic reasons that motivated them to assess their alcohol or drug use, enter treatment, or wait for treatment until it was available.
SALs offered individual meetings or weekly support group meetings for parents who did not enter treatment immediately. Childcare and transportation were available for parents to attend meetings. In each meeting, parents reviewed their motivation for change using the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) motivational assessment instrument and developed written weekly goals for themselves, their children, and their families. Parents could attend the project until they were ready to enter treatment or until a treatment slot became available. Typically, SALs met with parents three to four times. The open-ended format meant parents could attend only one meeting or as many as needed.
SALs also provided case coordination services with the treatment facility for parents who entered treatment. This included providing a drug/alcohol assessment to the statewide sub- stance abuse treatment provider, BPA, for approval (BPA serves as the state’s gatekeeper for substance abuse treatment funding), and facilitating treatment entry to local providers (i.e., introducing parents to staff and describing program elements and expectations).
Idaho Pre-Treatment Program