Perinatal substance abuse treatment. Findings from focus groups with clients and providers.

Thirty-three focus groups were conducted with pregnant women in substance abuse treatment and their providers in order to identify factors in women's lives that facilitate and hamper their treatment process and successful program components to address the needs of this high-risk population. The focus groups were conducted as part of a larger evaluation of demonstrations funded by the Health Care Financing Administration. From the 88 women in the focus groups we received a picture of their troubled lives and the events that led to their participation in the programs. The women had difficult childhoods, and currently had weak support networks and difficult relationships with male partners, many of whom were substance abusers. Most had children, which complicated getting into and staying in treatment. However, fear of losing custody of children was a major motivator for treatment. Important components of successful programs included: (a) the development of interorganizational linkages between various governmental agencies, especially child protection systems, prenatal care providers, and substance abuse treatment agencies and providers; (b) outreach and systems for identifying pregnant substance abusers through provider education and routine screening; and (c) intensive case management, necessary to link women to the many services they needed in order to obtain treatment, such as child care, transportation, and housing.