Cross-training to work better together with women in Quebec who use substances: care providers' perceptions.

Some authors have called attention to the lack of service integration related to evaluation and treatment of parental substance abuse, an ongoing challenge for service providers. A cross-training project involving exchanges (immersion sessions) among clinical teams was established to improve the integration, effectiveness and coherence of interventions for pregnant women and mothers with problematic substance use, and to prevent negative impacts of substance abuse on parenting skills and on foetal and child development. The research goal was to understand, from the perspectives of care providers, how cross-training either fosters or fails to foster changes in the practices of care providers who work with young pregnant women and mothers whose use of psychotropic drugs puts them at risk of neglecting their children. The cross-training project was carried out between 2009 and 2013. During the last phase of the project, focus group data were collected from 14 different clinical teams (N = 121) from the fields of substance abuse, child protection, perinatality and early childhood. The responses of each focus group yielded data for thematic analysis, performed using a mixed coding approach that included predefined and emerging themes. Points of convergence and divergence were identified by comparing what was said in different groups and types of clinical settings. At the conclusion of the project, the care providers said they knew their clinical partners better, communicated more with each other and made more referrals to those partners, and were better able to express themselves clearly about the effects of psychotropic drug use on the foetus, the child and the parenting role. In conclusion, the project helped create a culture of co-operation and partnership that has direct effects on services for pregnant women and young mothers who use substances.