In 1993, the Center for Substance Abuse Treatment published materials titled Pregnant, Substance-Using Women, (Treatment Improvement Protocol [TIP] series, No. 2). A consensus panel, chaired by Janet Mitchell, wrote these materials. Simultaneously, the Center for

Substance Abuse Treatment published Improving Treatment for Substance-Exposed Infants, (Treatment Improvement Protocol [TIP] series, No. 5). Stephen Kandall chaired the consensus panel producing these materials. The information, though excellent, did not offer an avenue for

providing training to professionals and care providers. Therefore, this manual was developed, utilizing information from Pregnant, Substance-Using Women, and Improving Treatment for Substance-Exposed Infants as the foundation for the training materials presented here.

In some content areas, it was necessary to provide supplemental information. Models of Case Management for Pregnant and Parenting Addicted Women and Their Families (1994), written by Marty Jessup and Laurie Soman, provides the body of information for Module Six. Substance Abuse Curriculum for Obstetricians and Gynecologists (1995), published by the March of Dimes Birth Defects Foundation, provides supplemental information for several of the teaching modules. It was decided that, after gaining permission from the authors, information adopted from these two supplemental publications would be quoted verbatim for the most part.

A Training Manual: TIPs on Assisting Service Providers to Appropriately Respond to the Needs of the Pregnant and Substance-using Woman and Her Alcohol/Drug-exposed Infant is written to provide training to all individuals and professionals addressing the special needs of the pregnant and substance-using woman as well as her alcohol or alcohol/drug exposed infant. Although the content is developed primarily for health care providers and other service providers, care givers should be encouraged to participate in the training as well. Those who will benefit from the information provided through this training include:

• Health care providers
• Chemical Dependency Treatment providers
• Social workers
• Criminal justice workers
• Educators
• Foster, birth parents, and adoptive parents of alcohol and/or drug-exposed children
• Clergy

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It is assumed that the trainer(s) will have ample knowledge of prenatal substance abuse, chemical dependency treatment, case management, provision of health care for the pregnant,

substance-using woman, and helpful interventions for the alcohol and/or drug affected infant prior to studying the teaching outlines presented in these training materials. Simply becoming familiar with the contents of the modules will NOT provide the necessary foundation for

adequate coverage of the information. The nature of the subject matter dictates a thorough, comprehensive scope of knowledge. It is recommended that this training be co-facilitated by a health care provider and a chemical dependency treatment provider whenever possible.

Varying teaching methods are mandated by the curriculum. A large portion of the information is conveyed via lecture. These portions of the workshop can be taught in a large group setting, utilizing interactive discussion as the materials are addressed. Additionally, the curriculum offers several opportunities for participants to take part in role play situations which allow practice of the skills taught in several of the modules. There are experiential exercises scattered throughout the curriculum as well, offering participants the opportunity to assess their personal beliefs and values, develop a case management plan, and test the baseline of their knowledge regarding the subject area covered in the module. It is recommended that the role play and experiential exercises be conducted in small groups. Thus, the trainer(s) needs a plethora of teaching techniques in his/her grab bag of skills.

It is also suggested that the trainer be familiar with using a camcorder. The camcorder can be used to videotape exemplary role plays/exercises that can then be critiqued by the large group. Taping provides an excellent learning tool for participants to make mistakes in a safe, controlled environment, to practice skills, and to receive helpful corrective feedback and support.

However, for this technique to be an asset to the training, it is essential that the trainer be able to skillfully operate the camcorder, and coordinate the feedback component of the experience, making certain that all communication is positively stated and productive.

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A Training Manual: TIPs on Assisting Service Providers to Appropriately Respond to the Needs of the Pregnant and Substance-using Woman and Her Alcohol/Drug-exposed Infant consists of seven teaching modules, developed to provide: 1) a comprehensive scope of information addressing the core issues involved; 2) support materials; and 3) experiential exercises to provide an opportunity to practice clinical skills.

It is essential that professionals and care providers be adequately trained to detect a client's substance abuse problem and the characteristics of a child exposed in utero to alcohol and/or drugs. It is equally important that professionals and care providers be knowledgeable about what constitutes appropriate intervention and treatment for the needs of the addicted pregnant woman and her alcohol or drug-exposed child. This training is orchestrated to provide a compendium of information addressing the special needs of these populations.

Each module represents a component of the overall scope of information. The modules fall in deliberate order, offering the trainer a range of information within the content addressed in each module. A teaching outline is provided to suggest a guide through the information.

Supplemental materials accompany several of the modules, and experiential exercises play a major role in assisting participant acquisition of fundamental intervention techniques. Overheads are provided for each module, incorporating the information presented in the teaching outline. Accompanying handouts reinforce the materials and guide participants through practice exercises.

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Recommended readings are listed at the end of each module description. The facilitator is encouraged to review the readings in preparation for teaching each session.

At the start of the training, participants will be given a copy of Pregnant, Substance-Using Women, (Treatment Improvement Protocol [TIP] series, No. 2), and Improving Treatment for Substance-Exposed Infants, (Treatment Improvement Protocol [TIP] series, No. 5). Additional reference materials are listed at the end of each chapter/section of TIPs No. 2 and No. 5, and can be researched by interested participants following the training.

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