Integrating responses to caregiver substance misuse, intimate partner violence and child maltreatment: Initiatives and policies that support families at risk for entering the child welfare system

Abstract

Complex trauma is a significant public health problem in the United States (U.S.), occurring in families with chronic and compounding exposures to traumatic stressors like substance misuse, intimate partner violence (IPV) and child maltreatment (Cook et al., 2017). Yet, few programs exist to treat their intersection, challenging our ability to respond effectively and restore positive trajectories for children and families. In this context, there is a need for innovative approaches to treat these intersecting phenomena. In this conceptual paper, we identify three innovative programs that offer integrative approaches to these intersecting challenges. We analyze common elements among these programs, offering a theoretical foundation for fundamental elements of transformative services. Finally, we consider how the Families First Prevention Act could be leveraged for states to adopt and implement these programs. The goal of this conceptual paper is to advance empirical and practical discussions regarding programmatic and policy options for more effectively responding to substance misuse, and IPV in families, and the associated traumas incurred by maltreated children and their caregivers. • Substance misuse, IPV, and child maltreatment, frequently co-occur. Yet, few programs exist to address their inter-related effects. • This conceptual paper reviews three exemplar integrative programs: Child Development Community Policing, Family-Based Recovery, and Child Parent-Psychotherapy. • We identify key and common elements of these integrative programs. Specifically, we find that: 1 warm handoffs, 2) removing barriers to access, 3) relationship-based practice, 4) a trauma-informed approach, 5) strong case management, 6) providing access to services when families are in crisis, and 7) breaking down silos are important components for integrated approaches. • The federal Family First Prevention Act (FFPSA) could be leveraged to fund innovative, integrative approaches to substance misuse, intimate partner violence, and child maltreatment. • Integrative programs are important for promoting resilience and restoring positive trajectories for children and families.