1. Family – Centered Treatment Women with Substance Use and Co-Occurring Mental Health Disorders who are Pregnant, Postpartum and/or Parenting and their Children A Case Study Francine Feinberg, Psy.D., LCSW, Meta House, Inc.

2. Meet Paula Homeless Substance use disorder – alcohol, cocaine, heroin Constantly feels anxious, cries easily, has difficulty concentrating Sexual abuse hx. starting age 15 Diabetes & Hypertension Probation TANF Unemployed no HS diploma

3. Paula’s Vision To live my life as a good mother to my children

4. Meet Paula’s Children One daughter in kinship care (18 mos) Two sons children with her (ages 2 & 3) Daughter 18 Months Old Lived with grandmother since birth Withdrawn Limited speech Mother describes as frozen Mother most troubled by lack of interaction

5. Paula’s Children 2 year old Cerebral palsy Poor vision Unable to walk Fearful Nightmares Difficulty adjusting to new situations & people Bites Difficult to calm Mother most troubled by inability to walk

6. Paula’s Children 3 Year Old Speech disorder – phonological Tantrums Bites Fights Refuses to eat Mother most troubled by speech

7. AODA Tx Mental Health Tx Case Management Coordination of Services Child Welfare Housing Medical Care Dental Care RN Medical Services & Education Trauma Treatment Literacy Voc. Soft Skills Paula Transportation Counseling Relapse Prevention for Women Depression and Substance Use Post-Acute Withdrawal 12 Steps for Women The Substance Exposed Child Self-Identity Relationships Sexuality Spirituality Family Dynamics Anger Management Drug Screening Mental Health TANF Criminal Justice Job Training Meta House Core Services

8. Case Management Child Welfare Head Start Daily help with children Nurturing Program Nurturing Lab Parenting- trauma informed Education: Substance exposed child Alcohol & Drug Abuse – Family Dynamics Child-Play Therapy Family Therapy Father Parenting Ed. Paula’s Mother Children’s Father All Children Meta House Core Services: Paula’s Family Services

9. Case Management coordination of Services Child Welfare Head Start Psychosocial & Developmental Assessments Play Therapy Mental Health Therapy Referrals Art Therapy Family Therapy Physical Therapy Speech Therapy Medical Care Transportation Dental Services Easter Seals Birth to Three Meta House Core Services: Children’s Services

10. Child Welfare Stipulations for Reunification Stay in touch and cooperate with worker, meet with worker weekly to check progress Have a safe, suitable and stable home Have regular successful visits with your child Call child regularly Complete a psych evaluation Complete programs recommended by evaluation Resolve all criminal charges and cooperate with probation officer Complete: –AODA program – have negative urine tests –Parenting program –Nurturing program –Anger Management Have successful extended visits Drug testing

11. Rules of Community Supervision Complete AODA program and sign consent to release information to your agent Get a mental health evaluation and follow-through on recommendations Provide urine for analysis Meet with officer weekly Attend anger management classes Obtain employment Pay restitution, fines and supervision and court fees Obtain safe housing Drug Testing

12. TANF Employment Plan Basic Education/GEDHrs/wk: 10 Employment SearchHrs/wk: 15 Ongoing Dr. apptsHrs/wk: 5 Report to worker weekly Drug testing

13. SINGLE COORDINATED CARE PLAN (SCCP) Consumer Name: Paula Lead Facilitator: Carole M. Date of Initial SCCP: 9/20/05 Dates of SCCP Revisions: 10/18/05, 11/22/05, 12/20/05 Consumer Vision To live my life as a good mother to my children Functional Strengths of Consumers and Team Members 1. Great mother 7. Good work ethic 2. Hard worker 8. Realistic 3. Sensitive 9. Honest 4. Open-minded 5. Learns well 6. Willingness 1. Strong advocates 2. Resources 3. Concern 4. Knowledge of community resources

14. 1. Consumer Need: Reunite my family Strategies to Meet Needs: Increase my visitation with my daughter – Saturdays & Weds. MH will supervise visits – 2 mos. have weekend visitation Follow CW plan – Get parenting & Nurturing program –Attend program at MH Attend Nurturing Lab at Meta House Get psych eval. – Child Welfare will arrange and fund including transportation Follow TANF plan Get housing arranged before discharge Updates: (Progress and accomplishments – use dates where applicable)

15. 1. Consumer Need: Get the help my children need Strategies to Meet Needs: Attend child-centered play therapy at Meta House with my daughter and sons Take my son to Easter Seals regularly to get physical therapy. MH to coordinate and transport 3. Get my son evaluated for speech disorder 4. Start my sons in Head Start program Updates: (Progress and accomplishments – use dates where applicable)

16. 2. Consumer Need: Become financially self-sufficient Strategies to Meet Needs: TANF will re-classify to W2-T -Basic Education/GED Hrs/wk: 10 and AODA treatment Hrs/wk: 30 for at least 2 mos. Attend MH Literacy Center and MH residential treatment program. MH funding. Set up budget/save $ - MH before 10/18/04 Obtain employment – TANF and MH after discharge 4. Obtain GED – Attend Meta House literacy, transportation TANF – take test in Jan or Feb 5. Obtain a protective payee – referral to Community Advocates – 10/04 Meet with TANF worker at least monthly Updates: (Progress and accomplishments – use dates where applicable)

17. 2. Consumer Need: Resolve my legal issues Strategies to Meet Needs: Pay all fines – Set up payment plan with PO Pay $50.00/mo. Supervision and court fees MH-CM with Community Advocates Pay restitution $200.00 MH-CM with Community Advocates Send budget to PO Follow Stipulations Updates:

18. Today Lives in Meta Housing with all three children Got G.E.D. Currently in Culinary School Member of Sacred Authority No longer on Probation Peer Mentor Speech improved in older son – eating, improved behavior Younger son ambulatory with a walker- less fearful Daughter animated and with appropriate attachment to mother

19. Picture of a family

20. Meta House