Every day, millions of parents in recovery from substance use disorders show that healing is possible and that families can thrive. Recovery improves relationships, prevents child removal, reunites families, and strengthens communities. Yet too many families still face barriers to substance use disorder treatment and recovery support. Estimates from 2023 show that one in four U.S. children — almost 19 million children — live with at least one parent or primary caregiver who has a substance use disorder(Opens link in new tab).
Children of parents with substance use disorders face higher risks of emotional, behavioral, and physical health problems, as well as family instability and poorer social and academic outcomes, due to disrupted relationships and reduced parental monitoring. These risks increase the likelihood of child maltreatment and involvement with the child welfare system. In 2023, parental alcohol or drug use was cited as a condition associated with removal for about 39% of children entering out-of-home care.
Traditional residential treatment programs for substance use disorders often focus only on the parent’s recovery and require separation from children. While this model can provide intensive counseling and clinical care, it also can weaken the parent–child bond and create barriers for families involved with the child welfare system that seek reunification. This is additionally problematic because primary motivators for parents to engage and succeed in treatment are reuniting with children and preserving their family. Residential substance use disorder treatment programs that recognize the importance of family and the parent-child connection are more likely to result in successful treatment, sustained recovery, and positive child welfare outcomes.
What family-based residential treatment looks like
Research on family-based residential treatment programs suggests that participating families are less likely to experience foster care placements and more likely to remain safely together. Evaluations of pregnant and parenting women’s substance use disorder treatment found that comprehensive residential treatment:
- Alleviated women’s substance abuse problems
- Improved birth outcomes
- Helped mothers increase parenting capacity
- Improved collaboration between child welfare agencies and family courts on reunification and custody planning
In family-based residential treatment, parents and children live together in a safe, structured, and supervised environment — or maintain frequent connections and family time when full co-residency is not feasible. Services often include:
- Comprehensive substance use disorder treatment, including individual and group therapy
- Parenting education and parent–child therapy
- Early education, developmentally appropriate services, and early intervention for children
- Integrated health care and mental health services
- Vocational training
- Childcare and respite services
- Safe and sober housing
- Onsite childcare
- Visits between parents and children fit around treatment schedules
This family-centered approach to substance use disorder treatment helps parents build recovery skills while providing children opportunities to grow emotionally, strengthen relationships with their parents, and receive the assessments and developmental and emotional therapeutic services they need. Residential treatment programs for parents and their children that have been built around such a family-centered environment offer lessons on how substance use disorder treatment not only can help the parent recovering from the addictive disease, but also the entire family.
A family-centered approach to treatment recognizes that parents or primary caregivers are part of a family system. As all individuals are unique, so are the families within which they exist. Treatment plans are tailored to each individual and their family. Important considerations for family-based residential treatment are comprehensive assessments that provide essential information on the developmental status of children, parental capacity, and social support networks, thereby helping determine the course of family-centered care.