Award Date


Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Committee Member

Bradley Donohue

Second Committee Member

Danile N. Allen

Third Committee Member

Andrew Freeman

Fourth Committee Member

Liam Frink

Number of Pages



Introduction: The current study is a secondary analysis of one arm of a controlled trial evaluating the efficacy of FBT-CW for mothers identified for concurrent child neglect and substance abuse (see Donohue et al., 2014). FBT-CW is comprised of multiple cognitive behavioral intervention components targeting skill sets that are hypothesized to influence child neglect and/or substance abuse. The primary areas of focus for these interventions include: (a) management of antecedents to substance abuse and/or child neglect, (b) parenting skills training, (c) communication skills training, and (d) job getting and financial management skills. Purpose: The purpose of this study was to assist clinicians and clinical researchers in understanding the influence of implementation frequency, cognitive behavior therapy treatment preferences and therapeutic participation/engagement of the participants in this study, and the relationship of these factors with intervention outcomes to guide treatment development and dissemination efforts in this population. Method: Participants were 35 mothers identified by child welfare services for concurrent drug abuse and child neglect. Data was collected from treatment sessions and three assessments at baseline and 6- and 10-month post-baseline. Results: Repeated measure ANOVAs were conducted to determine (1) whether specific interventions components were implemented more frequently, (2) whether participants rated certain intervention components as more helpful and (3) whether therapists rated participants as more compliant during the implementation of certain intervention components as compared to others. Participants received the antecedent-based intervention most frequently, followed by the parenting skills interventions and communication and job/financial skills interventions were implemented at a similar frequency. No differences were found in helpfulness and participation/engagement ratings across the intervention components. Partial correlations revealed that participant helpfulness and participation ratings were not related to drug use outcomes, while controlling for baseline scores. However, participant helpfulness was related to child maltreatment outcomes at the 10-month post-baseline assessment, and therapist participation ratings were related to child maltreatment outcomes at both 6- and 10-month post-baseline assessments. Brinley Plots were utilized to determine whether the number of times specific cognitive behavioral intervention components were implemented was related to improvements from baseline to 6 months and baseline to 10 months assessments on drug use and child maltreatment potential measures. Overall, results revealed that participants identified for neglect not related to drug exposure in utero improved at a higher percentage than did participants identified for in utero drug exposure. In addition, receiving the cognitive behavioral interventions components more frequently also seemed to lead to greater percentages of participants improving in both drug use and child maltreatment outcomes following treatment. Discussion: This study provides support for the acceptability and utility of cognitive behavioral intervention components targeting antecedents to drug use and child neglect, parenting skills, communication skills and job/financial skills in mothers involved with child welfare.


Brinley plot; Child nelgect; Components; Drug use; Intervention; Treatment outcome


Clinical Psychology

File Format


File Size

848 KB

Degree Grantor

University of Nevada, Las Vegas




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