CPS June 2010
Regardless of the nature of treatment, caseworkers need to make appropriate referrals when drug use is present. See Appendix 1960: Treatment Options for Substance Abuse.
All treatment must meet the individual needs of each client. In selecting the treatment option, the caseworker considers:
• the type of substance use,
• progression of that use,
• prior attempts at treatment,
• drug use experience, and
• client's motivation for treatment.
Clients respond differently to treatment. Treatment begins with abstinence; that is, refraining from alcohol or drugs that endanger a child's safety and continues with a drug-free lifestyle. The longer the client is in treatment, the better the outcome for abstinence and a drug-free lifestyle, and the greater the chance that protective measures remain in place for the child's safety.
CPS June 2010
If a service provider or screening substance abuse counselor does not recommend treatment for a client, and the caseworker is convinced (based on drug tests, or on information from collateral sources or the case record), that the client is in need of substance abuse services, the caseworker may consider:
• providing the client with substance abuse pamphlets and other educational materials about substance abuse;
• submitting the client to random drug tests; and
• referring the client to programs, such as Alcohol Anonymous or Narcotics Anonymous.
The caseworker may also appeal a denial. For more information about appealing a denial, see the regional substance abuse specialist. The CPS appeal process involving the OSAR can be found in Form 2062 DFPS Release of Confidential Information to DSHS/Substance Abuse Services.
1963 When Treatment Is Unavailable, Resources Are Scarce, Waiting Lists Are Long, or the Distance Is Too Far to Travel
CPS June 2010
A lack of resources and other logistical circumstances may prevent a client from getting certain substance abuse services; however, the caseworker must not assume that there are no services that may be provided.
In such circumstances, while the caseworker cannot provide treatment, the caseworker:
• considers the options for intervention that areavailable to the client;
• works with the client to incorporate the options into an agreed-upon service plan; and
• obtains approval of the plan from the supervisor.
Developing the Substance Abuse Service Plan
In lieu of other resources, the caseworker may advise the client to take the following actions as part of the client's substance abuse service plan:
• Join a community support group for people in recovery (for example, Alcoholic Anonymous or Narcotics Anonymous).
• Obtain a medical assessment by a health clinic or physician (for example to determine whether substance abuse has harmed the client's health, or to see whether there is medication that can help the client remain abstinent).
• Pass random drug tests conducted by the caseworker.
• Develop a relapse safety plan (see 1966 Developing a Safety Plan in Case a Client Relapses).
• Include protective measures in the client's relapse safety plan. (See 1940 Establishing Protective Measures When a Child Is Threatened by Substance Abuse.)
• Read educational materials and handouts on substance abuse and recovery. (The following Web sites contain handouts and publications on substance abuse that the caseworker may share with clients.):
• Identify the triggers and actions needed to change past behaviors. (The following Web sites contain information on relapse prevention that the caseworker may share with clients):
• Self-report the days abstinent and the days monitored by a sober or abstinent family member.
• Obtain services at a mental heath clinic, if applicable.
• Self-report when recovery is threatened.
• Avoid the people, places, and things that can jeopardize abstinence and recovery (avoid situations, friends, family members, and locations that encouraged drug use in the past).
• Accept, at the insistence of the caseworker, that abstinence is the only acceptable behavior if the client is to be allowed to care for or be in the presence of his or her children; and that the client's drug use has placed or places the children in danger.
CPS June 2010
The goal of the Prevention and Early Intervention Program (PEI) is to preclude the involvement of CPS while providing services to families thereby preventing or removing conditions that could lead to child abuse and neglect.
PEI services are delivered to the client by local contractors throughout the state. When a caseworker believes that a family could benefit from services that would prevent or stop child abuse and neglect and the CPS case has been closed, a referral to PEI may be appropriate.
For the locations of PEI programs by county, see the DFPS intranet page on Prevention and Early Intervention.
CPS June 2010
Recovery is a long process and, under the clauses of the Federal Adoption and Safe Families Act (P.L.105-89), CPS's involvement with a family is time limited; therefore a client's caseworker and treatment providers must communicate frequently and remain cognizant of the time limits.
Indicators of progress that the caseworker can rely on in weighing the next step in the CPS case are whether the parent:
• attends and stays engaged in a substance abuse treatment program.
• participates in community recovery support groups, following the guidelines of 12-step programs, such as Alcoholics Anonymous and Narcotics Anonymous, and obtaining a sponsor, if applicable.
• achieves a period of abstinence.
• complies with the CPS service plan.
• complies with the CPS safety plan, if there is one.
• has developed a relapse safety plan. See 1966 Developing a Safety Plan in Case a Client Relapses.
• is achieving parenting goals.
• has established a pattern of negative results from drug tests .
• visits his or her children consistently and displays increased parental responsibility (if applicable).
• has changed past substance-abusing behaviors and has developed a network of sober, abstinent family members and friends.
• parent is employed (if applicable).
• has no new reports of criminal activity.
• has no new substantiated allegations of abuse and neglect that are related to substance abuse.
• takes prescribed psychotropic medications correctly (if applicable).
The key components of effective substance treatment in the CPS context are as follows:
• Maintaining abstinence
• Remaining involved in treatment or aftercare
• Acquiring and demonstrating parenting skills, including bonding with the children (for applicable parents).
• Mitigating the problems that led to the abuse and neglect that was caused by substance abuse.
• Developing a relapse safety plan.
CPS June 2010
Relapse is the return to the pattern of substance abuse or addiction, as well as the process during which indicators appear before the client's resumption of substance use.
In the relapse safety plan the client spells out the steps he or she plans to take to ensure the safety of the children when relapse becomes an issue; for example, the client might state in the relapse safety plan that:
• he or she will place the children with CPS-approved family members or friends when experiencing a relapse; and
• the children will remain with the family members or friends until the client returns to abstinence and is once again engaged in treatment or aftercare services.
Any court orders supersede any actions stipulated by the client involving a voluntary caregiver in the relapse safety plan.