Principles for Practice with Substance-Abusing Pregnant Women: A Framework Based on the Five Social Work Intervention Roles (Health Care‪)‬

Traditionally, substance abuse treatment programs are designed for men and are not readily available to women, particularly pregnant women (Blume, 1998; Finkelstein, 1994). Although more programs became available to substance-abusing pregnant women (SAPW) in the 1990s through federal funding policies, many do not provide pregnancy-specific treatment (Breitbart, Chavkin, & Wise, 1994). Cohen (2000) stated that although women-specific substance abuse treatment programs increased 53 percent during the past decade, some "do not facilitate them in a way that is supportive and positive for women" (p. 91). Using the five social work intervention roles (that is, teacher, broker, clinician, mediator, and advocate) (Compton & Galaway, 1994) as a framework and integrating relevant literature, I discuss components essential to a comprehensive pregnancy-specific treatment practice. [Compton and Galaway originally used the term "enabler." I changed "enabler" to "clinician" to avoid an association with "enabling" substance-abusing behavior, which has a negative connotation in the substance abuse treatment field.] Issues and elements related to substance abuse during pregnancy, although not exhaustive, are identified, and a systematic approach for working with SAPW is presented. The Role of Teacher