The influence of maternal substance abuse upon the placement of children in out-of-home care increased significantly in the 1980s and 1990s, affecting motherchild visiting in numerous ways. Content analysis of interview data from 15 mothers with histories of illegal drug use and child custody loss provides insight into five major factors that can promote or inhibit visiting: (1) mother's drug use and health status, (2) effects of visits on the child, (3) transportation, (4) scheduling/ visit settings, and (5) support of others.
Over the last two decades, parental substance abuse has become an increasingly significant factor in the placement of children in out-of-home care. For example, the prevalence of alleged substance abuse in one or both parents for cases investigated by child protective services in Washington state rose from roughly 30% to 40% between 1994 and 1997 (Marshall & English, 1999). An examination of records of 749 children in San Francisco placed into care in 1991 through 1992 revealed that 30% of parents had documented substance abuse histories (Takayama, Wolfe, & Coulter, 1998). When neglect was the reason for placement, the incidence of parental substance abuse rose to 51%. The Child Welfare League of America reported that 37% of referrals to public child welfare agencies in 10 states were related to problems associated with parental drug or alcohol use (Curtis & McCullough, 1993).
Studies that have focused on mothers with substance use histories have reported similar or even higher percentages of child custody loss than for parental substance use in general (Neuspiel, Zingman, Templeton, DiStabile, & Drucker, 1993; Raskin, 1992; Streissguth, Grant, Ernst, Phipps, & Gendler, 1994). Nair and colleagues (1997) found a 43.4% incidence when 152 mothers with histories of substance abuse were followed during their child's first 18 months. Kearney, Murphy, and Rosenbaum (1994) noted in their grounded theory study that 69% of the 68 mothers who were active cocaine users reported losing temporary or permanent custody of their children.
The Adoption Assistance and Child Welfare Act of 1980 (PL. 96-272) strongly encourages visiting between children and their parents who have temporarily lost child custody. Visits serve numerous purposes: they maintain family relationships, help families cope with changing relationships, empower and inform parents, enhance children's well-being, help families confront reality, provide a time and place to practice new behaviors, promote accurate assessment, and provide a transition to home (Hess & Proch, 1993). Yet for a variety of reasons, visits do not always occur at the frequency suggested by court mandates, case plans, or agency protocols.
For example, in a five-year longitudinal study of children in New York City entering out-of-home care for the first time in 1966 (N = 624), Fanshel and Shinn (1978) collected data about parental visiting patterns over four time periods. These researchers noted a direct inverse relationship between the length of time the child was in out-of-home care and the number of parental visits. As the length of time in care increased, parental visits decreased. Furthermore, children who had the maximum number of visits permitted or frequent irregular parental visits during the first year were twice as likely to be discharged from care as those children who had fewer or no parental visits in the first year. Although the study cited reasons such as parental mental or physical illness, child neglect or abuse, and family problems as contributing to placement in care, the use of drugs or alcohol by parents was not explicitly examined. Fanshel and Shinn (1978, p. 85) "viewed parental visiting as highly important for the welfare of the children." Later studies have supported the inverse relationship between parental visiting and length of stay in out-of-home care (Mech, 1985; White, Albers, & Bitonti, 1996). …