Evidence linking alcohol and other drug abuse with child maltreatment, particularly neglect, is strong. But does substance abuse cause maltreatment? In a recent article in The Future of Children volume Preventing Child Maltreatment, authors Mark Testa and Brenda Smith found that co-occurring risk factors such as parental depression, social isolation, homelessness, or domestic violence may be more directly responsible than substance abuse itself for maltreatment. Interventions to prevent substance abuse–related maltreatment, say the authors, must attend to the underlying direct causes of both.
On November 19, an international coalition of NGOs used World Day for Prevention of Child Abuse to host events about and bring attention to a threat faced by children all over the world. While most child abuse and neglect prevention strategies focus on parents – by educating them on parenting methods or treating underlying risk factors such as alcohol abuse – this coalition instead addresses the wider culture. This strategy holds that a supportive community can lead parents to make better parenting choices and can help them overcome challenges, whereas negative societal influence can overwhelm even well-intentioned parents.
In the latest The Future of Children volume, Preventing Child Maltreatment, one article looked at the community’s role in preventing child abuse from taking place. The authors found that social environment affects norms about appropriate child-raising behaviors and the acceptability of parents seeking external support when encountering challenges. In addition, positive interactions between neighbors increase the likelihood that parents will feel responsible for and act to protect all children in the neighborhood, whereas isolating and unfriendly neighborhoods may increase parental stress and their tendencies to neglect or mistreat their children. Formal community services can improve parents’ mental health and parenting capabilities and provide temporary relief from parental responsibilities.
The article highlights some innovative community programs that are designed to change a community’s atmosphere and norms to reduce child maltreatment. For instance, Triple-P in South Carolina has offered community-level information campaigns and parenting advice sessions through existing institutions such as child care centers and preschools. The Durham Family Initiative in North Carolina expands the availability of community services and uses outreach workers to build relationships in at-risk communities, address neighborhood needs, and build human capital through leadership and mentoring programs. Both these and other programs have shown promising results in reducing child abuse and neglect cases — suggesting that well-informed, well-equipped, and socially cohesive neighborhoods aid child wellbeing.
These programs face major challenges, however; costs can be significant, and changing behavior and investing in social networks can be difficult. In addition, more work needs to focus on which communities are most in need of such programs and most likely to benefit from them. Of course, individual factors play a major role in child maltreatment cases, so a community approach alone cannot solve problems of child abuse and neglect. Still, building up a supportive community is an important step toward protecting children.
Research on whether prevention programs reduce drug abuse or help parents control substance use and improve their parenting has had mixed results, at best. The evidence raises questions generally about the effectiveness of substance abuse services in preventing child maltreatment. Such services, for example, raise only marginally the rates at which parents are reunified with children who have been placed in foster care. The primary reason for the mixed findings is that almost all the parents face not only substance abuse problems but the co-occurring issues as well. To prevent recurring maltreatment and promote reunification, programs must ensure client progress in all problem areas.
At some point in the intervention process, attention must turn to the child’s permanency needs and well-being. The best evidence to date suggests that substance-abusing parents pose no greater risk to their children than do parents of other children taken into child protective custody. It may be sensible to set a six-month timetable for parents to engage in treatment and allow twelve to eighteen months for them to show sufficient progress in all identified problem areas. After that, permanency plans should be expedited to place the child with a relative caregiver or in an adoptive home.
Investing in parental recovery from substance abuse and dependence should not substitute for a comprehensive approach that addresses the multiple social and economic risks to child well-being beyond the harms associated with parental substance abuse.
Drawn from “Prevention and Drug Treatment,” by Mark Testa and Brenda Smith.