Characterizing Multisystem Barriers to Women's Residential SUD Treatment: A Multisite Qualitative Analysis in Los...

Area of Science:

• Social Sciences
• Public Health
• Psychology

Background:

• Residential substance use disorder (SUD) treatment programs face challenges integrating with problem-solving court (PSC) and child welfare (CW) systems.
• Divergent system values and communication barriers between staff can negatively impact treatment efficacy for women.

Purpose of the Study:

• To explore SUD treatment providers' perspectives on how differing values and communication barriers affect women's residential SUD treatment.
• To identify specific challenges arising from the intersection of SUD treatment, PSC, and CW systems.

Main Methods:

• Qualitative semistructured interviews were conducted with 18 SUD treatment clinicians and six directors from four women's residential SUD treatment programs.
• Thematic analysis was used to identify salient themes across the collected data.

Main Results:

• Six main themes emerged, highlighting adverse effects of differing values and communication barriers across SUD, PSC, and CW systems.
• Key issues include unaddressed trauma, negative perceptions of mothers with SUD, the Adoption and Safe Families Act (ASFA) timeline, inadequate inter-system communication, and competing priorities.
• These barriers negatively impact treatment coordination, patient stress, treatment disengagement, motivation, retention, and planning.

Conclusions:

• Significant barriers exist for women dually involved with CW and PSC systems in SUD treatment.
• Aligning system values, improving communication, policy changes, and cross-system training are crucial.
• Reevaluating the ASFA timeline is essential to accommodate long-term SUD treatment needs for mothers.