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Approximately half of mothers receiving substance use treatment are involved with childcare proceedings. This review aims to determine whether integrated treatment programmes for mothers with substance use problems are effective in preventing out-of-home placement (temporally/permanent) and influencing other maternal factors such as patterns of substance use, treatment completion and parenting behaviours. Six trials were identified—two randomised controlled trials and four non-randomised controlled studies. The pooled sample of participants was 1717. The results showed that mothers who participated in integrated treatment programmes were significantly less likely to have the children removed from their care (Odds Ratio (OR)?=?0.40, 95% CI?=?0.27, 0.61), more likely to complete substance use treatment (OR?=?3.01, 95% CI?=?1.79, 5.06), and more likely to reduce their alcohol consumption (Standardised Mean Difference (SMD)?=??0.40, 95% Cl?=??0.78, ?0.01) and drug use (SMD?=??0.30, 95% CI?=??0.53, ?0.07). However, non-significant reductions were observed for parent–child conflict (SMD?=??0.35, 95% CI?=??0.72, 0.03) and child abuse risk (SMD?=??0.03, 95% CI?=??0.36, 0.31). While the findings from this review suggest that mothers involved in integrated treatment programmes could potentially be less likely to experience out-of-home child placements and more likely to improve substance use treatment outcomes, little evidence exists for the effectiveness of these interventions. Further research, particularly high-quality RCTs, is required to demonstrate and persuade health and public policy on the far-reaching value of the integrated approaches.
相似文献This article presents a qualitative case study that explores how faculty and administrators at one community college conceptualized and experienced academic community within their institution and how that conceptualization helped shape the part-time faculty work environment. Using a combined framework of academic community and care ethics, this study utilizes data from 55 interviews with full-time and part-time faculty and administrative leaders from a large community college. Findings from this study indicate that defining membership, a sense of belonging, and shared mission and goals are key components to their understanding of academic community. From these three components, the study found that when participants included adjunct faculty as members of their academic community, they also reported a sense of responsibility or obligation to supporting them.
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