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Project Description

Tennessee New Beginnings for Women and Children, also referred to as New Beginnings, began as a partnership between Child and Family Tennessee, a nonprofit agency, and the Knox County and East Tennessee Regions of Tennessee’s Department of Children’s Services (DCS) in 16 East Tennessee counties. The program impacts the lives of pregnant women and mothers of small children who abuse substances, helping them to access and receive gender-specific model treatment services that contribute to their success as mothers and success in life. The program provides comprehensive treatment services to mothers affected by substance use, particularly methamphetamine, and their children. New Beginnings emphasizes a family-centered approach and thus, children are permitted to stay with their mothers on the residential treatment campus until the mother completes her treatment. Objectives included:

  • Providing evidenced-based substance abuse treatment for addicted mothers
  • Providing family-centered services including wraparound and development services for children
  • Building regional capacity through our East Tennessee Regional Partnership
  • Conducting a rigorous match comparison evaluation study

Target Population

New Beginnings targeted:

  • Mothers (pregnant or parenting a child age 0-3) who abused methamphetamine or other substances and who may be dually diagnosed with a mental health disorder

Major Project Goals

  • Protecting children from harm or neglect;
  • Improving coordination and integration of knowledge on children affected by methamphetamine or other substances.

Key Major Program Services

Case Management

  • Intensive Case Management

Parenting/Family Strengthening

  • Manualized/Evidence-Based Parenting Program – Nurturing Parenting

Mental Health and Trauma Services for Adults

  • Mental Health Services and Psychiatric Care
  • Trauma-Informed Services
  • Trauma-Specific Services – Healing the Trauma of Abuse, Beyond Trauma

Substance Abuse Treatment for Adults

  • Residential/Inpatient – Specialized for Parents with Children
  • Intensive Outpatient – Matrix Model

Children’s Services

  • Developmental Services
  • Trauma Services for Children and Youth

Specialized Outreach, Engagement and Retention

  • Cognitive Behavioral Therapy Strategies – Motivational Interviewing/Motivational Enhancement Therapy
  • Co-location of Staff

Partner Agencies and Organizations

The New Beginnings Project includes the following partners:

Child Welfare

  • Department of Children’s Services – Knox and East Tennessee Regions University of Tennessee Medical Center, Prenatal Services
  • Fort Sanders Regional Medical Center, Prenatal Services
  • East Tennessee Children’s Hospital

Substance Abuse/Mental Health

  • Child and Family Tennessee – Lead Agency


  • Anderson County Juvenile Court
  • Knox County Drug Court
  • Knox County Juvenile Court
  • Monroe County Sessions Court
  • Scott County Drug Court

Health Services

  • Knox County Health Department


  • Knox County Community Action Committee
  • Knox Community Development Corporation


  • Heart of Knoxville Career Center
  • Other Community and Child and Family Services
  • Compassion Coalition
  • TennCorp Community Services, Inc.


  • Metro Drug Commission
  • Blount County Sheriff’s Department

Performance Indicators


Reunification: Upon entering New Beginnings, 59 mothers (27.0 percent) reported that their children currently live with them. Upon discharge from the program, 8 mothers (4.0 percent) reported regaining physical custody of their children while involved with the program and 3 (1.0 percent) regained legal custody.

Substance Exposed Newborns: Twenty-seven mothers (12.0 percent) were pregnant at the time of intake to New Beginnings and 3 (1.0 percent) had given birth in the month prior to intake. After intake, 13 women (6.0 percent) gave birth while enrolled at New Beginnings and 11 (5.0 percent) were pregnant at the time of discharge from the program. Among those children born after program intake, none were reported to have been born with substance exposure due to maternal substance use prior to program intake.

Adult Well-Being

Mental Health Status: The provision of mental health care and prevention services was a critical part of the New Beginnings program. At termination, 118 mothers (54.0 percent) had received mental health counseling and 36 (17.0 percent) had received services to help manage their psychotropic medication.

Parental Stress: Scores on the Parenting Stress Inventory (PSI) indicate a general decrease in parenting stress in the six months following the baseline interview. This is especially evident for the total scale score and, to a lesser extent, the parent distress subscale.

Depression: Mothers involved with New Beginnings experienced a significant decline in depression as measured by the Center for Epidemiological Studies-Depression (CES-D) scale. Scores declined from above 25 at baseline to 10-12 at the time of the 6-month follow-up assessment.

Sustainability Status

  • New Beginnings was sustained in its entirety. The continuing components include the East Tennessee Regional Partnership group along with treatment in a supportive living environment in Knox County, TN, and intensive outpatient (IOP) treatment in Blount and Campbell counties. In addition to sustaining the existing components, Child and Family Tennessee added intensive outpatient treatment in Knox County, as well as in-home services in the three DCS regions in East Tennessee to the New Beginnings umbrella of services.
  • Sustainability for these program components was achieved through a mixture of funding including the Regional Partnership Grant for 2012-2017, continued local and State funding and increased insurance billing.

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Project Details

  • Lead Agency:
    Child and Family Tennessee
  • Geographic Area and Congressional District Served:
    Knox County and East Tennessee; Congressional District 2
  • Federal Grant:
    $1 million/5 years (2007-2012)
  • Evaluation Design and Comparison Group Type:
    Quasi-experimental, Same-Time, Matched Population-Level
  • Proposed Number Served (5 years):
    Children: 398
    Adults: 250
    Families: 250
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