This K23 Mentored Patient-Oriented Research Career Development Award application is being submitted to the National Institute on Drug Abuse. The candidate, Dr. Lisa Saldana, is a clinical psychologist who has focused her training and career on developing research and clinical skills in the area of child maltreatment. She has specific interest in developing interventions for child neglect. Maternal substance abuse is one of the primary drivers for child neglect. The goals of this proposal would enhance Dr. Saldana's training to extend her knowledge to the treatment of maternal substance abuse. The nine goals to be accomplished throughout this K23 award that will assist Dr. Saldana in achieving her long-term career goals include: 1) attain skills to conduct randomized clinical trials for the study of treatments of maternal substance abuse within child welfare populations;2) gain understanding of current substance abuse service delivery within the child welfare system and the needs for serving this population from a system perspective;3) gain expertise in evidence-based practices for adult substance abuse;4) gain expertise in conducting clinical research with neglectful populations;5) adapt treatment manuals and quality assurance systems to target families presenting with co-occurring substance use disorders and neglectful parenting behaviors;6) develop a training protocol.;7) conduct a pilot test of an integrated treatment for substance abusing neglectful populations;8) write an R21 grant;and 9) write an R01 grant. The Research Plan proposes Stage 1 Research integrating Reinforcement Based Therapy for the treatment of substance abuse, with a framework for conceptualizing neglectful parenting, within the Multisystemic Therapy model of treatment delivery. Dr. Saldana will conduct a feasibility study (n - 5) during the treatment development stage, followed by a small randomized pilot (n = 24) to examine the efficacy of the Integrated Treatment for Substance Abuse and Neglect compared to treatment as usual, with a population of substance abusing neglectful mothers referred through the Department of Social Services. Dr. Saldana will conduct her training and research activities under the guidance of an expert mentoring team including Drs. Scott Henggeler, Hendree Jones, and Patricia Chamberlain. She will receive consulting from Drs. John Landsverk, Bradley Donohue, and Kristina Jackson for issues related to services research, consideration of ethnic factors in therapy delivery, and longitudinal statistical analyses respectively. Given that the cost of child maltreatment is $258 million per day, with over $24 billion a year being spent on parental substance abuse treatment, the goals of the current application might address an extremely costly public health problem. As child neglect is the most prevalent and costly form of maltreatment, development of evidence-based practice for co-occurring substance abuse and child neglect is critical.
