Drinking History
Treatment
Withdrawal
Stabalization
Case Management
Service Delivery

Comprehensive Service Delivery

The delivery of comprehensive services to substance-using women and their families should continue postpartum. The greatest success is achieved by and for these women when a continuum of care is available to address their special needs as women, mothers, spouses, and heads of households. The following services are often needed:

1 Health Care Services

• Comprehensive, high-risk obstetrical care
• HIV antibody counselling and testing
• Routine checkups and immunizations for all children through a well-baby clinic, care by a paediatrician or other physician for specific health concerns as long as needed, and referral to early intervention programs
• Postpartum medical and dental checkups for the mother as long as needed
• Family planning, including contraceptive counselling and contraceptives
• Counselling for postpartum depression and for guilt about the effects of prenatal drug use on the infant, as needed
• Health care for other family members

2 Alcohol and Other Drug Treatment Services

• Medical withdrawal, as needed, in collaboration with prenatal care providers
• Ongoing alcohol and other drug treatment through a program of methadone maintenance, outpatient treatment, day treatment, or intensive outpatient care; or through intermediate or long-term residential care that provides services to a patient's children during the inpatient period
• Continuing support and relapse prevention with the clear understanding that relapse should not exclude women from treatment
• Group and individual counselling. focusing on such areas as acceptance, understanding, self-esteem, and issues of sexuality, parenting, and relapse prevention

3 Psychosocial Services

• Training in stress management and reduction; assertiveness; issues of sexism, racism, and class bias; and anger management
• Group, individual, and family counselling concerning sexual and physical abuse and their prevention
• Relationship and interpersonal skill building
• Personal care, issues of sexuality, and image enhancement
• Psychiatric and other mental health services, as needed by the woman, her children, and other family members

4 Parenting and Family Services

• Planning and counselling for reunification with the patient's other children
• Counselling for women who wish to breastfeed regarding the risks to the infant of maternal drug use and from possible transmission of HIV; training in breastfeeding procedures, as appropriate
• Education about child and adult nutritional needs, food purchasing and preparation, and weight management
• Education about and training in child growth and development patterns
• Training in and support for nonpunitive child-rearing practices
• Assistance with and counselling about maternal and child bonding; participation in parental support groups
• Counselling for couples or significant others in communication, money management, crisis management, and parenting
• Counselling and intervention concerning child abuse and neglect, as needed
• Education about family systems, including information about cultures, traditions, and heritage
• Family therapy, as needed