Struggle for custody: The salience of trauma among African American women navigating substance abuse treatment and child protection

Substance abuse among mothers has led to increases in the number of children involved with the child welfare system. Between 33% and 80% of all child abuse and neglect cases involve substance abuse. About 80% of families who become involved with the child welfare system resulting from substance abuse lose permanent custody of their children, with African American families having the worst outcomes. The vast majority of child welfare research focuses on children and the effects abuse and neglect has had on them. There is still a dearth of studies that privilege the mothers' voices or look at the problem of maternal substance abuse from their perspective. This study explores the factors that contribute to whether African American mothers retained, regained, or permanently lost custody of their children.;Using a multiple embedded Case Study design, interviews were conducted with 26 African American mothers receiving inpatient substance abuse treatment, 24 of the mothers' substance abuse treatment counselors, 16 of the mothers' parenting professionals, and six of the mothers' child welfare agency caseworkers. A total of 46 (26 mothers and 20 professionals) in-depth semi-structured interviews were conducted, along with 14 months of observation of the program site. Transcripts of the interviews were analyzed using pattern analysis to examine individual cases, and build a conceptual explanation that accounted for both the interview and observational data. This study used a number of methods to ensure rigor, including testing rival or alternative explanations.;Data analyses suggested that there were factors at the individual, relational, and professional levels that influenced the outcome of mothers' child protection cases. Individual level findings revealed that most of the women had extensive histories of trauma (e.g. childhood sexual abuse, neglect, physical abuse, domestic violence and rape) and the ways women coped with and the extent to which they were able to work through their trauma histories was a determining factor in whether they completed treatment, remained abstinent, and regained custody of their children. Relational level findings suggested that the type of family support and the women's relationships with professionals also contributed to the outcome. The professional level findings revealed that the ways in which the professionals (substance abuse treatment, child welfare caseworkers and parenting professionals) coped with and managed their difficult, stressful jobs also affected the reunification process.;There has been a great deal of research conducted about the extensive histories of trauma prevalent among substance-abusing women. This knowledge, however, has not translated into effective practice in child welfare and has resulted in fragmented services within substance abuse treatment with this population. The findings of this study support the creation of trauma-informed systems and services that include increasing awareness among social service professionals regarding the prevalence of trauma among substance abusing, African American women as well as understanding the ways their histories of trauma may interfere with the treatment and reunification process.