Intervention for Homeless, Substance Abusing Mothers: Findings from a Non-randomized Pilot

Overview

Journal Behav Med

Specialties Psychiatry
Social Sciences

Date 2012 Jun 9

PMID 22676629

Citations 10

Authors

Natasha Slesnick

Gizem Erdem

Affiliations

Soon will be listed here.

Abstract

Little empirically-based information is available regarding how best to intervene with substance-abusing homeless mothers. This study pilot-tested a comprehensive intervention with 15 homeless women and their 2- to 6-year-old children, recruited from a local family shelter. All participants were offered integrated intervention with three major components. The first component was housing which included 3 months of rental and utility assistance, and these services were not contingent upon women's abstinence from drugs or alcohol. The second and third components included 6 months of case management services and an evidence-based substance abuse treatment (Community Reinforcement Approach; CRA). Analysis revealed that women showed reductions in substance use (F(2,22) = 3.63; p < .05), homelessness (F(2,24) = 25.31; p < .001), and mental health problems (F(2,20) = 8.5; p < .01). Further, women reported reduced internalizing (F(2,22) = 4.08; p < .05) and externalizing problems (F(2,24) = 7.7; p = .01) among their children. The findings suggest that the intervention is a promising approach to meet the multiple needs of this vulnerable population. These positive outcomes support the need for future research to replicate the findings with a larger sample using a randomized design.

Citing Articles

Housing stability, employment, and survival behaviors among young mothers experiencing homelessness: A randomized controlled trial of a housing intervention.

Zhang J, Slesnick N, Famelia R, Feng X Soc Sci Med. 2024; 366:117658.

PMID: 39740634 PMC: 11842152. DOI: 10.1016/j.socscimed.2024.117658.

Interventions to improve the mental health of women experiencing homelessness: A systematic review of the literature.

Anderson J, Trevella C, Burn A PLoS One. 2024; 19(4):e0297865.

PMID: 38568910 PMC: 10990227. DOI: 10.1371/journal.pone.0297865.

Exploring the effect of case management in homelessness per components: A systematic review of effectiveness and implementation, with meta-analysis and thematic synthesis.

Weightman A, Kelson M, Thomas I, Mann M, Searchfield L, Willis S Campbell Syst Rev. 2023; 19(2):e1329.

PMID: 37206622 PMC: 10189499. DOI: 10.1002/cl2.1329.

A comprehensive review of prioritised interventions to improve the health and wellbeing of persons with lived experience of homelessness.

Moledina A, Magwood O, Agbata E, Hung J, Saad A, Thavorn K Campbell Syst Rev. 2023; 17(2):e1154.

PMID: 37131928 PMC: 8356292. DOI: 10.1002/cl2.1154.

Non-pharmacologic interventions to improve depression and anxiety among pregnant and parenting women who use substances: An integrative literature review.

Darlington C, Compton P, Teitelman A, Alexander K Drug Alcohol Depend Rep. 2023; 2:100017.

PMID: 36845894 PMC: 9949346. DOI: 10.1016/j.dadr.2021.100017.

References

Nelson G, Hall G, Forchuk C . Current and preferred housing of psychiatric consumers/survivors. Can J Commun Ment Health. 2004; 22(1):5-19. DOI: 10.7870/cjcmh-2003-0001. View

Vostanis P, GRATTAN E, Cumella S, Winchester C . Psychosocial functioning of homeless children. J Am Acad Child Adolesc Psychiatry. 1997; 36(7):881-9. DOI: 10.1097/00004583-199707000-00009. View

Bassuk E, Melnick S, Browne A . Responding to the needs of low-income and homeless women who are survivors of family violence. J Am Med Womens Assoc (1972). 1998; 53(2):57-64. View

. 2005 APA Gold Award: Providing housing first and recovery services for homeless adults with severe mental illness. Psychiatr Serv. 2005; 56(10):1303-5. DOI: 10.1176/appi.ps.56.10.1303. View

Buckner J, Bassuk E . Mental disorders and service utilization among youths from homeless and low-income housed families. J Am Acad Child Adolesc Psychiatry. 1997; 36(7):890-900. DOI: 10.1097/00004583-199707000-00010. View

Jones H, Wong C, Tuten M, Stitzer M . Reinforcement-based therapy: 12-month evaluation of an outpatient drug-free treatment for heroin abusers. Drug Alcohol Depend. 2005; 79(2):119-28. DOI: 10.1016/j.drugalcdep.2005.01.006. View

Stahler G, Shipley Jr T, Kirby K, Godboldte C, Kerwin M, Shandler I . Development and initial demonstration of a community-based intervention for homeless, cocaine-using, African-American Women. J Subst Abuse Treat. 2005; 28(2):171-9. DOI: 10.1016/j.jsat.2004.12.003. View

Ware Jr J, Sherbourne C . The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992; 30(6):473-83. View

Lennox R, Dennis M, Scott C, Funk R . Combining psychometric and biometric measures of substance use. Drug Alcohol Depend. 2005; 83(2):95-103. PMC: 5933842. DOI: 10.1016/j.drugalcdep.2005.10.016. View

10.

Sacks S, Sacks J, McKendrick K, Pearson F, Banks S, Harle M . Outcomes from a therapeutic community for homeless addicted mothers and their children. Adm Policy Ment Health. 2004; 31(4):313-38. DOI: 10.1023/b:apih.0000028895.78151.88. View

11.

Webb E . Children and the inverse care law. BMJ. 1998; 316(7144):1588-91. PMC: 1113202. DOI: 10.1136/bmj.316.7144.1588. View

12.

Simpson D, Joe G, Broome K . A national 5-year follow-up of treatment outcomes for cocaine dependence. Arch Gen Psychiatry. 2002; 59(6):538-44. DOI: 10.1001/archpsyc.59.6.538. View

13.

Tsemberis S, Gulcur L, Nakae M . Housing First, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. Am J Public Health. 2004; 94(4):651-6. PMC: 1448313. DOI: 10.2105/ajph.94.4.651. View

14.

Lorant V, Deliege D, Eaton W, Robert A, Philippot P, Ansseau M . Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol. 2003; 157(2):98-112. DOI: 10.1093/aje/kwf182. View

15.

Stahler G . Social interventions for homeless substance abusers: evaluating treatment outcomes. J Addict Dis. 1995; 14(4):xv-xxvi. DOI: 10.1300/j069v14n04_a. View

16.

Tischler V, Karim K, Rustall S, Gregory P, Vostanis P . A family support service for homeless children and parents: users' perspectives and characteristics. Health Soc Care Community. 2004; 12(4):327-35. DOI: 10.1111/j.1365-2524.2004.00502.x. View

17.

Dobscha S, Delucchi K, Young M . Adherence with referrals for outpatient follow-up from a VA psychiatric emergency room. Community Ment Health J. 1999; 35(5):451-8. DOI: 10.1023/a:1018786512676. View

18.

Smith P, Earp J, Devellis R . Measuring battering: development of the Women's Experience with Battering (WEB) Scale. Womens Health. 1995; 1(4):273-88. View

19.

Slesnick N, Kang M, Bonomi A, Prestopnik J . Six- and twelve-month outcomes among homeless youth accessing therapy and case management services through an urban drop-in center. Health Serv Res. 2008; 43(1 Pt 1):211-29. PMC: 2323142. DOI: 10.1111/j.1475-6773.2007.00755.x. View

20.

Smith J, MEYERS R, Delaney H . The community reinforcement approach with homeless alcohol-dependent individuals. J Consult Clin Psychol. 1998; 66(3):541-8. DOI: 10.1037//0022-006x.66.3.541. View