Toddler Osiah Lawing climbed onto his mother’s lap as she talked about addiction, recovery and the future she is trying to build for him.
Felicity Kavanagh hugged her son tightly and kissed his forehead. For years, she struggled with alcohol, meth and fentanyl addiction, homelessness and, finally, an arrest and jail time that changed her life.
Until June, Felicity and Osiah were living at Via Avanta, a residential rehabilitation program for women in Los Angeles that encourages mothers to bring their children with them to treatment.
For Kavanagh, being able to bring her toddler is the reason she agreed to go to rehab in the first place in February.
“There’s not many rehabs that allow your kids to come, and I think that’s what stops a lot of women going to rehab,” said Kavanagh, 26. “He’s the reason I’m here. I only have one chance left.”
Nearly 19 million children — about one in four in the United States — live with at least one parent who has a substance use disorder, research shows. Yet many treatment programs do not allow the children to accompany their parent while they receive care.
For more than three decades, a different model has been embraced at Via Avanta, housed in an unassuming, low-slung building behind chain link fences on a busy street off the freeway in the San Fernando Valley. Inside the former convalescent home, remodeled to create dorm-style living, up to 40 clients can live at a time. Two to three women share a room with a private bathroom. Their children live with them and sleep in cribs or toddler beds within reach of their mothers.
The program is built on the belief that recovery and parenting should happen together, not separately, said Elan Javanfard, senior director of whole person care for Didi Hirsch Mental Health Services, which operates the Via Avanta residential program.
“When you keep a mother and child together in treatment, you’re not just preserving the relationship they have with each other, you’re improving the clinical outcome for both people,” said Javanfard.
For decades, most addiction treatment programs have required mothers to choose between leaving their children and recovery, and as a result many opt to forgo much-needed care to keep their families together. Programs that bridge the gap, like Via Avanta, are built specifically around motherhood, because keeping families together may be one of the most effective ways to help moms recover while giving their children the stability they need.
This approach makes sense for moms and kids, who need to be together through the challenges of recovery and fortify their bond to have a better chance of success.
A 2019 study found mothers stay in treatment longer when their children remain with them and when programs include parenting and child-focused services, and that treating addiction within the context of the family, rather than as an individual problem, may improve recovery.
Those findings mirror what staff say they have witnessed for decades, and former residents and current participants at Via Avanta echo their sentiments.
“Children are part of the person, the family unit is part of the person,” Javanfard said. “If we don’t treat the entire family, then the entire family won’t thrive.”
Via Avanta’s community living space is a reflection of its philosophy of treating the entire family. Shared bedrooms adorned with solid wooden furniture and cribs or toddler beds are on a circular hallway that surrounds shared living areas. There is an outdoor playground for the children, and inside a playroom with a piano offers comfy couches, as well as toys and kids’ books for moms to play and read with their children. There’s a communal kitchen, where all the women take shifts, the children’s brightly decorated classroom, where the participants watch each other’s children, and vision boards in their dorm-style bedrooms that help them center on recovery and family.
Four decades ago, Maria Inez Chacon, then 20 years old, addicted to heroin and pregnant, realized she needed help. Two previous short-term treatment programs were not enough. She felt she needed something more stable and wanted a place where she could have her baby.
She found Via Avanta and entered treatment.
“I knew I couldn’t go back to where I was,” she said. “I don’t know what I would have done if there wasn’t a long-term program for mothers.”
Her daughter, Christina Ortiz, now 41, was born while she was living there and celebrated her first birthday with the other children and their mothers who were in the program.
Chacon remained in the program for 18 months.
“Christina saved my life,” Chacon said. “I would have never realized I had a problem if I didn’t try to stop doing drugs and getting clean for the baby.”
The baby girl who spent her first year at Via Avanta eventually earned advanced degrees in psychology. She now works at Didi Hirsch Mental Health Services in suicide prevention and trauma-focused mental health services. Didi Hirsch oversees Via Avanta.
Looking back, Ortiz sees her mother’s decision through both personal and professional lenses.
“That first year is such a critical time,” Ortiz said. “There was not that separation that unfortunately some children go through.”
She believes the support her mother received created a healthier environment during a formative period of her childhood.
Research has also found that children benefit when treatment programs include parenting and child-focused services, with studies showing improvements in children’s emotional well-being.
For many years, the question around children and addiction care has been about whether children belong there. However, Via Avanta’s program points to what is lost when children are not allowed to accompany their mothers through recovery.
Via Avanta program coordinator Jennie Wyatt Coste has her own history at the center. Thirty-nine years ago, she entered the program with her 4-year-old daughter and stayed 13 months. She learned how to navigate recovery while raising a child.
She eventually became an employee and has now spent more than three decades helping other mothers do the same. She has seen women come and go, and sometimes women return for more support and treatment. It’s challenging to recover from substance abuse, and Via Avanta works to prepare women for life outside its walls.
The Via family includes women, with and without children, who help care for all of the children in the community. When a parent is in a session, a group meeting or working a kitchen shift they must get another participant to watch their child, said Coste.
“Moms get to learn how to be and get clean, but they also learn the stress of being a parent and getting clean,” Coste said.
Women in the program attend treatment, participate in counseling, care for their children, share responsibilities and learn how to manage the realities of daily life while sober. The goal is to prepare mothers for life after treatment rather than isolate them from it, Coste said.
“It does take a village,” Coste said.
For Kavanagh, community has become an essential part of recovery.
Kavanagh began using alcohol and drugs at age 13 and experienced domestic violence, homelessness and incarceration. She had already lost custody of an older son, who is 5 and lives with Kavanagh’s mother in North Carolina, and feared she was trapped in a cycle. When she was pregnant with Osiah and still using drugs she was arrested in North Carolina. She said a judge gave her a choice: Go to jail or go to rehab.
Her first stint in rehab was in North Carolina and it’s where she had her baby. Then she moved back to Southern California with her son to live with her grandmother and committed to Via Avanta.
Rather than distracting her from treatment, she says her son strengthened her resolve to succeed.
“I realized he’s a big part of my recovery,” she said. “He gets the sober me. He gets the real me.”
She now spends her days caring for Osiah while rebuilding her life.
“He’s my peace when there’s chaos going on,” she said.
Her grandmother, Victoria Smart, who has been in recovery for 32 years, is a rock for Kavanagh. Smart believes her granddaughter can break the generational cycle for her great-grandson Osiah despite how hard it can be.
“There’s nothing I want more for her than to get the life she can have in recovery and bring up her son the way she wants to,” Smart said. “It will be a beautiful life as a mother, a friend, as a daughter and as a partner, hopefully.”
Programs like Via Avanta remain uncommon despite evidence that family-centered treatment improves outcomes for mothers and children, Javanford said.
Residential programs that welcome children require added space, staffing, child care and funding, making them more expensive to operate than a traditional rehab. Other hurdles include licensing, safety rules for kids and the extra labor of caring for mom and her child. Advocates argue those challenges are worth it and should not outweigh the benefits of keeping families together. It seems that if the goal is long-term recovery, treatment should strengthen families while they are working on their goal.
Women in the program are typically funded through Medi-Cal, the state’s health care program for low-income residents. But there is limited funding for the children, because they are not the patient, and that remains a barrier to expanding the model across the industry, Javanfard said.
Didi Hirsch Mental Health Services raises funds annually to close the gap between what Medi-Cal pays for the program and what it costs to also host the children, Javanfard said.
Standing as evidence of the power of the program, Chacon, Coste and Kavanagh span decades but value the experience as life changing.
One was pregnant with a daughter who now spends her days helping families like her own. Another entered with a young child and was so deeply impacted she stayed on as a staff member. A third, still in the initial stages of recovery, hopes to break the cycle of addiction, so her toddler never goes through what she experienced in her life.
They prove that addiction recovery does not happen in isolation. For many mothers and their hopeful children, neither should addiction treatment.
