Our research program grew from a collaboration between practitioners and university professors. This partnership has been invaluable in designing a transdisciplinary research program to address a pressing social issue in rural America. It also allows us to bring to the fore those perspectives of practitioners that are too often ignored by researchers. In this chapter, we depart from a traditional academic presentation to provide a glimpse of rural Midwestern storytelling. Linda Kingery, a masters level social worker and child welfare professional with over 20 years of experience in rural area substance misuse, provides a first-person account of child welfare practice in contemporary rural Illinois. Her discussion illustrates some general principles of a child abuse/neglect investigation in rural Illinois, as well as a description of a case involving parental methamphetamine misuse. My early years of work in child welfare seemed to be business as usual. Most of the families who were involved in child abuse/neglect investigations at that time were dealing with alcohol misuse and sometimes marijuana misuse. There was no mention of methamphetamine. Sometime in 2003, it became painfully apparent throughout the child welfare Read more [...]

To initiate a child abuse/neglect investigation, the child welfare worker is mandated by law to see the children named in the report, or make a good faith attempt to do so, within 24 hours of receiving the hotline report. Workers sometimes see children at school, but often a visit to the home is how this first contact with children occurs. The law requires that a visit to the home occur at some point in the investigation. Entering someone’s home to discuss allegations of child abuse/neglect can be frightening to everyone. One need only think for a moment of what it would feel like to have a state official question your parenting abilities to begin to understand the defensive posture that many parents quickly assume. This defensive posture increases the potential for violence. It is common to be called to a residence that is located 20 to 30 minutes from the nearest town, and the investigator may then find that cell phone service is unavailable. Law enforcement assistance is available upon request, but it is difficult to predict when such assistance will be necessary It is not feasible for workers to request law enforcement personnel to accompany them on every investigation. If every report came in with details Read more [...]

Following the initiation of a child abuse/neglect investigation, in which the child’s safety is paramount and decisions are made quickly without all available evidence, the process of gathering more complete information begins. Experience tells us that there are almost always underlying issues in cases of child abuse/neglect. Few parents set out to hurt their children. The effects of poverty, mental illness, domestic violence, and/or substance misuse are common in cases of child maltreatment, but these issues are not necessarily identifiable in the early stages of an investigation. Illinois child welfare rules and procedures require that each family be screened for such issues, but it is not reasonable to expect that families will be immediately forthcoming in regards to such personal information. It almost goes without saying that a person involved in the manufacture and use of an illegal drug as stigmatized as methamphetamine will not sit down with a state worker and readily admit to the problem. It is often after a family has agreed to open a follow-up case, when a caseworker has been assigned to meet with the family monthly, that the underlying issues actually come to light and needed services are put into place. Just Read more [...]

I remember a time when I was sitting at my desk, overwhelmed with paperwork and pushing to meet deadlines. My supervisor appeared at my doorway with two sheets of paper in her hand. All investigators know that when the boss appears with paper in her hand, there is a new report. In the field of child welfare, a new report may mean going to a home that is alleged to have pet feces on the floor, interviewing a small child who has been sexually abused by her stepfather, or, in some rare instances, investigating the death of a child. One thing for certain is that a new report requires a prompt response. On this occasion, I looked to the door and asked, “You got somethin’ for me?” With an unmistakable urgency in her voice, my supervisor said, “There’s been a meth bust in your county. The parents have already been arrested, and the police have taken custody of two young boys, ages 12 and 9.” Paperwork and deadlines were suddenly the last thing on my mind as I began to ready myself to leave the office and get on the road. I quickly grabbed a “protective custody” packet, which contains the documents needed to allow an investigator to obtain the necessary health exam and other required services for the children after they Read more [...]

Effective methamphetamine treatment involves successfully helping addicted individuals make key changes in their lives. These changes include staying away from other people who use meth, developing close friendships with sober people, sleeping and eating well, being able to handle difficult situations without using, and being able to feel good without using while changing some of their automatic expectations and beliefs about methamphetamine. All of these changes are needed to accomplish the final goal of abstaining from methamphetamine altogether and living a sober lifestyle. Obviously, this is easier said than done, and helping individuals make these changes requires many people working together. As has been noted, the chances that just one person or one agency would be able to help someone who is addicted to methamphetamine make these changes are very slim. However, many people and agencies working together are much more likely to be successful. Stages Of Change And Readiness For Change Accountability The first ingredient of therapeutic structure is accountability. Accountability refers to the addicted individuals’ being held responsible for their actions. It also refers to the need to focus on what individuals Read more [...]

These helping efforts require an organizing strategy since saying that people need to change their behavior is one thing, but helping them to do it is something entirely different. Strategies communities and families can use do rely on the addicted person’s having at least some investment in making the needed changes, even if the person’s investment is based on nothing more than staying out of trouble or out of jail, getting off of probation, or getting one’s children back. These are the important sanctions and rewards that are part of the accountability and structure needed for treatment to work. They help to create the right kind of environment for change, but change itself is a process. Other people cannot assume responsibility for the changes, any more than a gardener can assume the responsibility of making a plant grow. Enid had been trying for years to get her adult daughter Julie off of methamphetamine. She had expended almost all of her retirement savings paying for one failed inpatient treatment after another. Each time Julie would respond well while in treatment, her mother and others would become hopeful and excited, believing that she was finally ready to stop using methamphetamine and change her life. Read more [...]

The most obvious question regarding accountability is, “accountable to whom?” In some situations this is an easy question to answer, as the meth-using individuals’ actions may have brought them in contact with the legal system. They are then accountable to probation officers or judges regarding behaviors associated with their drug use. Their contact with a legal system is not always because of criminal behavior. For example, in some cases meth-using parents may come to the attention of child protection services because their drug use has negatively impacted their ability to adequately care for their children. They then are accountable to caseworkers or to the courts regarding their meth-using behaviors and the degree to which they are able comply with expectations to safely parent their child(ren). A number of people addicted to methamphetamine recognize that their use is a problem and seek help trying to stop it. They may come to this realization on their own, but more commonly it is because of other people. These other people can be family members, friends, romantic partners, church leaders, counselors, attorneys, or employers. These other people became aware of the individual’s drug use and other negative behaviors Read more [...]

Traditionally, treatment progress has been measured primarily by periods of verified abstinence or by time spent in treatment. While periods of verified abstaining from methamphetamine are a good but incomplete measure of treatment progress, time spent in treatment provides little information about how beneficial the experience may have been for the user. In spite of this, treatment continues to be measured in length of stay, and people addicted to methamphetamine are commonly mandated to go to treatment for a specific period of time. The risk of approaching treatment this way is that the focus can become more about some kind of a duration expectation, as opposed to actual change. Treatment is not like baking rolls in an oven where it is expected that if someone stays in treatment for a certain span of time, it will have the desired effect. More reasonable measures of treatment progress, like periods of verified abstinence, involve objective verification of changes in behavior that suggest that the person is changing and that treatment does appear to be working. Periods of verified stable sleep patterns can also be used as measures of treatment progress. It can safely be assumed that even if individuals addicted Read more [...]

Abstinence monitoring is perhaps the most important of the measures of treatment progress since, regardless of how users in recovery may be doing at all of the other behavioral benchmarks, if they continue to use the drug, treatment is obviously not working. Monitoring substance use by individuals in treatment also helps assure that they are not just trading dependency on one addictive substance for another. Periods of verified abstinence can also be and are often used as mile markers for sobriety. The longer the individuals addicted to methamphetamine are able to abstain from using all addictive substances; the more likely they are to continue in sober lifestyles. There are many ways to objectively monitor drug use. They all have one thing in common: they involve collecting some type of biological marker to determine whether or not there has been recent or past use of addictive substances. These markers can be trace indicators which provide evidence that there are drugs in the person’s system, currently, or there have been some time in the recent or distant past. They can also be measurable physical signs of recent use, including coordination tests, sleep disruption, pupil dilation, and ocular motor tests. These Read more [...]

Effective Community – Based Treatment for Methamphetamine Addiction Communities The topic of this book is treatment of methamphetamine addiction, and more specifically, what families and communities can do to be an important part of the treatment process. The obvious answer to how families and communities can help people addicted to methamphetamine would probably entail support. However, the concept of support simply for the sake of supporting is actually quite risky. When it comes to methamphetamine addiction, often users become quite adept at taking advantage of other people around them, especially those who unconditionally support them with no accountability. Deception and manipulation often become paramount, and the loved one or the concerned community member showing them support often has feelings of his or her being used and perhaps even preyed upon. Take the example of Janice: Janice was 29 and was a master at getting what she wanted out of other people, which was that they help her to get meth, to use it, to take on her responsibilities, or help her avoid the negative consequences because of her methamphetamine use. More than once, her parents had lied to the police about her whereabouts and her activities Read more [...]