Implementation of a family-centered treatment program for substance-abusing women and their children: barriers and resolutions.

Recent federal health financing and health care delivery programs have increased access to alcohol and other drug abuse treatment programs for low-income women, and have provided intervention and prevention services for their children and families. The Village South Families in Transition (FIT) in Miami, Florida, implemented a residential treatment program for women and their children that aims to decrease alcohol and other drug use, reduce reliance on social and health welfare systems, improve functioning in specific life-skill and vocational areas, improve parenting techniques and maternal/child relations, and provide intervention and prevention services for the clients' children in a safe and supportive environment. Program implementation required resolutions to numerous barriers, including securing a facility for women and children; recruiting, hiring and training of staff; establishing and maintaining community linkages; treatment considerations; balancing treatment versus evaluation/research; and critical decisions faced by treatment staff as they modify client-centered programs to incorporate gender-specific and family-centered programs.

Marathon: a life-and-death experience.

Therapists have a great need for techniques capable of provoking change in their clients. Generally, people resist change and need incentives to accomplish it. The tools to effect change are few. Therefore, the value of the theme Marathon experience is that it can be both innovative and piercing. Many clients need to have the drama of their own lives connected to a meaningful plot. The theme Marathon experience can do this. It exerts an influence on the emotional, cognitive and behavioral aspects of the participants and connects their past to the present and future, allowing them to see clearly the futility of a life of chemical dependence.