Mental Health Treatment Strategies That Work. Building FASD State Systems Meeting San Francisco, CA May 10, 2006 Therese Grant, Ph.D. University of Washington Fetal Alcohol and Drug Unit Parent-Child Assistance Program (PCAP) 180 Nickerson, Suite #309
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Building FASD State Systems Meeting
San Francisco, CA
May 10, 2006
Therese Grant, Ph.D.
University of Washington Fetal Alcohol and Drug Unit
Parent-Child Assistance Program (PCAP)
180 Nickerson, Suite #309
Seattle, Washington 98109 (206)543-7155
Premji et al., (2004) reviewed the literature on FASD interventions with youth:
10 studies found; of 7 reviewed …
“One-size doesn’t fit all”
- Each individual has a different neuropsychological profile (depending on timing and dosage of prenatal alcohol exposure).
- Variability is the hallmark of FASD (within individuals AND between individuals).
The primary disability of FASD is permanent brain damage, manifest as neuropsychological deficits and neurobehavioral problems.
Treat primary mental health problems (e.g., depression, anxiety disorder) with interventions adapted to the individual’s neuropsychological and health profile.
Distress caused when a person with FASD does not receive appropriate support to address their neurobehavioral deficits, leading to chronic failure, loss, frustration, victimization (“secondary” mental health problems).
Provide sustained, comprehensive, multi-systemic and developmentally appropriate support to the individual with FASD.
PCAP: An intensive, 3-year advocacy/case management intervention serving high-risk alcohol and/or drug abusing mothers.
Double Jeopardy: One-year project funded by the March of Dimes to assist women in PCAP with FASD and develop a community service training model
Grant, T., Huggins, J., Connor, P., & Streissguth, A. (2005)
Grant, T., Huggins, J., Connor, P., Pedersen, J., Whitney, N., & Streissguth, A. (2004)
Average age = 22 Years (Range = 14-36)
Mostly white (60%), unmarried (85%), and poorly educated (45%)
Troubled life history profile
• Family history drug/alcohol abuse (100%)
• Sexual abuse (79%)
• Physical abuse (84%)
• Unstable and disrupted care giving (100%)
High levels of psychiatric distress and behavioral problems
Poor quality of life relative to other at-risk populations
"I thought I was weird. I thought I didn't belong here. And then when I talked to (PCAP advocate), it was like wow! You know what I’m talking about!”
- A PCAP Client with FASD
16/19 were receiving medical &/or mental health care
14/19 were abstinent from both drugs and alcohol
(11 maintained abstinence; 3 newly in recovery)
5/19 were still using drugs/alcohol but 3 of these 5 were using reliable birth control methods
(2 tubal ligations, 1 Depo Provera).
14/19 were using contraception regularly
(Depo = 7; Tubal = 3; IUD = 2; OCPs = 2);
16/19 obtained stable housing