Parent-Child Assistance Program

The Parent‐Child Assistance Program (PCAP) is an award winning, evidence‐informed home visitation case‐management model for pregnant and parenting women with substance use disorders. PCAP goals are to help mothers build healthy families and prevent future births of children exposed prenatally to alcohol and drugs.

Washington State PCAP Director: Susan Stoner, Ph.D.

Our Background and Vision

In the mid‐1980’s when cocaine was at the height of popularity, researchers at the University of Washington Fetal Alcohol and Drug Unit received a federal grant to study the effects of prenatal cocaine exposure on infants and young children. The research protocol involved enrolling 500 high‐risk mothers who had used cocaine during pregnancy, interviewing them, and bringing their babies into a UW lab for periodic neuropsychological and other assessment.

Dr. Therese Grant, a member of the research team, believed that some of the most important lessons were those learned in conversations with the mothers. She heard stories of deeply ingrained family dysfunction that were “just the way it is” for the mothers. The women talked about how they wanted to be good moms, but they were instead giving their babies the same kind of upbringing they had experienced as children. They didn’t know any other way.

As the cocaine study ended, the research group decided the most compelling next direction for them would be to work with high‐risk mothers to help them address substance abuse, rebuild their lives, and prevent future births of children exposed prenatally to alcohol and drugs. Thus, with funding from the Substance Abuse and Mental Health Services Administration (SAMHSA), the PCAP model was developed and tested beginning in 1991.

Our data show clearly that most of the mothers we enroll in PCAP were themselves abused, neglected, and deprived children just a decade or two ago. Turning our backs on them because they are difficult to work with does not make their problems go away. It does ensure that these women will continue to experience a host of problems associated with intergenerational substance abuse, and continue to bear children who suffer in turn. PCAP undertook the challenge of finding a way to connect in a meaningful way with this population.

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