Residential substance use disorder (SUD) treatment programs are challenged by the differing values of the problem-solving court (PSC) and child welfare (CW) systems, along with communication barriers between staff. This study aimed to understand, from the viewpoints of SUD treatment providers, how divergent values and communication barriers adversely affect women’s residential SUD treatment. We conducted qualitative semistructured interviews with 18 SUD treatment clinicians and six directors from four women’s residential SUD treatment programs. Using a thematic analysis framework, we identified salient themes across specified codes. Analysis revealed six main themes, suggesting differing values and communication barriers across the SUD, PSC, and CW systems adversely affect the provision of SUD treatment. For differing values, three main themes emerged: (a) unaddressed trauma and fear of mental health treatment seeking; (b) perceptions of mothers with a SUD; and (c) the Adoption and Safe Families Act (ASFA) timeline as a barrier to SUD treatment provision. For communication barriers, three themes emerged: (a) inadequate communication and responsiveness with PSC and CW systems adversely affect treatment coordination, induce patient stress, and treatment disengagement; (b) lack of PSC and CW communication regarding child visitation planning adversely affects treatment motivation and retention; and (c) competing ASFA, PSC, and CW priorities and inadequate cross-system communication adversely affect treatment planning. Treatment providers face significant barriers in providing effective treatment to women simultaneously involved in the CW and PSC systems. Aligning values and addressing communication barriers, changes in policy, and enhanced cross-system training are crucial. Additionally, it is essential to reevaluate the ASFA timeline to align with the long-term treatment needs of mothers with a SUD. Further research should explore the viewpoints of patients, CW, and PSC staff to gain deeper insights into these SUD treatment barriers.

住宅药物使用障碍 (SUD) 治疗计划受到问题解决法院 (PSC) 和儿童福利 (CW) 系统不同价值观以及工作人员之间沟通障碍的挑战。本研究旨在从 SUD 治疗提供者的角度了解不同的价值观和沟通障碍如何对女性住院 SUD 治疗产生不利影响。我们对 18 名 SUD 治疗临床医生和来自 4 个女性住院 SUD 治疗项目的 6 名主任进行了定性半结构化访谈。使用主题分析框架，我们确定了特定代码中的显着主题。分析揭示了六个主题，表明 SUD、PSC 和 CW 系统之间的不同价值观和沟通障碍对 SUD 治疗的提供产生不利影响。针对不同的价值观，出现了三个主要主题：(a) 未解决的创伤和对寻求心理健康治疗的恐惧； (b) 具有 SUD 的母亲的看法； (c) 《收养和安全家庭法》(ASFA) 时间表是提供 SUD 治疗的障碍。对于沟通障碍，出现了三个主题：(a) 与 PSC 和 CW 系统的沟通和响应不足会对治疗协调产生不利影响，引起患者压力和治疗脱离； (b) PSC 和 CW 缺乏关于儿童探视计划的沟通会对治疗动机和保留产生不利影响； (c) ASFA、PSC 和 CW 优先事项相互竞争以及跨系统沟通不足会对治疗计划产生不利影响。治疗提供者在向同时参与 CW 和 PSC 系统的妇女提供有效治疗方面面临重大障碍。调整价值观、解决沟通障碍、改变政策以及加强跨系统培训至关重要。此外，必须重新评估 ASFA 时间表，以符合 SUD 母亲的长期治疗需求。进一步的研究应探讨患者、CW 和 PSC 工作人员的观点，以更深入地了解这些 SUD 治疗障碍。