Treatment Availability. The premise of the PTP was that substance abuse treatment would be accessible to parents who were assessed as needing treatment. Thus the program necessarily depended on larger systems (i.e., BPA) to provide and fund treatment for parents who did not have insurance or Medicaid, or could not pay for the treatment themselves. Unfortunately dur- ing the implementation, funding for treatment was not as available as it had been in the past. This created major challenges for SALs as the model called for them to provide services and support for only three to four weeks and not months. In addition, the availability of treatment resources, particularly in rural areas where transportation was an issue, remained a recurrent problem.
Summary of Project Start-up Challenges and Successful Strategies
Although there were initial problems affecting the start-up of the PTP, some of which within the control of the program and others not, problems that were in control of the project were overcome.
1.To meet the challenges of the research design, a new outside evaluator was selected, adjustment to earlier and new data collection instruments were agreed upon, and data collection started in October 2003.
Qualified SALs were eventually hired for each of the three regions, although there continued to be service gaps because of difficulties finding qualified replacements.
In spite of challenges to the more traditional confrontational stance of substance abuse treatment providers, SALs were able to use the additional training to infuse MI techniques, and began to experience success with this model.
After several months of flux, the grant named Project Manager assumed the Project Directorship and remained constant in this position throughout the project.
Relationships that were previously almost non-existent solidified as substance abuse treatment providers and child welfare workers began to depend on SALs to help parents with very serious problems negotiate the two systems.
The availability and funding of substance abuse treatment continued to be problematic, as detailed in the next section.
PROGRAM IMPLEMENTATION PROCESS
Participants and their Characteristics. The typical client referred to the PTP was female, white, 27 years of age, unemployed, and economically poor. She had an 11th grade and two young children, and used methamphetamines. Further details are addressed in the Process Evaluation section.
Initial Referral Description Family engagement varied slightly by region, but in general it began formally by CPS social workers referring families through the written referral or informally by workers seeing SALs in the building and saying something like, “Just took a baby from the hospital…mom will be calling you.” In Region I, the CPS social worker had to make a formal referral for it to be acted on; in Region III, the SAL would go to the referring worker and get the written referral.
Idaho Pre-Treatment Program