START Bulldozes Barriers to Recovery for Pregnant and Parenting Persons with Substance Use
Unique Approach from The Center for Great Expectations Continues with Remote Platforms

“There is a difference between foundation and platform,” stated Carolyn Flynn, director of one of The Center for Great Expectations’ programs, START, which serves pregnant and newly parenting New Jerseyans. Ms. Flynn, a clinician, specializing in child-parent psychotherapy, made this intriguing statement during a recent virtual presentation to an array of the region’s leading prenatal, primary and behavioral health care providers.

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The Center—or CGE—is a pioneer in the provision of infant mental health interventions in New Jersey and, since 2012, has offered substance use treatment, focusing on the impact of substance use on the relationship between parent and child. “And, all client-focused services are free and guided by CGE’s distinctive Trauma C.A.R.E.© model: In the era of Covid-19, our platform has shifted from in-person to telehealth, while our foundation is relationship-based therapy, and this has not changed,” Ms. Flynn went on to say.

Through its 22 years, the core of CGE’s mission has been to provide “a safe place, a safe presence, and a safe path.” This mission is more important now than ever before, as people in recovery or managing a mental health diagnosis must surmount additional challenges created by the pandemic. Across six programs, The Center for Great Expectations provides client-centered, evidence-based, transformational mental health and substance use disorder treatment. And, unsurprisingly, in response to this moment in history, the agency has—quite nimbly—increased access to mental health and recovery services.

While unique in New Jersey, CGE’s START program is part of a nationwide movement to strengthen early relational health between parent and child. The therapeutic relationship between client and clinician provides the template for a safe and secure relationship, expanding the parent’s capacity for attunement and responsiveness; thus transforming intergenerational patterns of substance use and allowing a pattern of attuned, responsive relationships to emerge. Doulas support this process during pregnancy with an individualized birth plan, birth education, access to prenatal care, and physical and emotional support during labor at the hospital. Doula services continue for 18 months and include postpartum care, including access to social determinants of health such as transportation, education, affordable housing and employment. Previously, START had served only individuals with opioid use disorder. But, in this new era of treatment and with the endorsement of the State of New Jersey, the team now offers its teletherapy, teledoulas and virtual peer recovery coaching to pregnant and postpartum persons who strive to overcome use of any harmful substance. START’s innovative approach, in tandem with imaginative pivoting in the Covid era, ensure that clients continue to receive exceptional care.

Out of two offices, in Newark and in Bridgewater, Ms. Flynn—a strong advocate for changing childbirth practices to become more family-centered and trauma-attuned—is joined by a gifted and multi-faceted staff from backgrounds and experiences as diverse as the communities they serve. In addition to doulas, the team includes licensed clinicians, peer recovery coaches, and an on-staff APN for initiation and maintenance of pharmacotherapy. Toxicology screening and therapeutic groups round out this holistic model of treatment.

During her talk, Ms. Flynn told listeners that, while utilizing telehealth, providers needed to become mindful of ways to become intentional about transmitting this relationship-based approach to client care. This (relational) foundation is what has enabled The Center for Great Expectations to continue to provide effective therapy to clients during this time. For example, she said that “creating a shared experience in the moment such as breathing together or sharing a guided meditation helps client and clinician transcend the space between them in a moment of shared experience,” and that “creating new rituals and routines in telehealth sessions is another way of creating a sense of safety and trust in the session.”

Agencies like CGE, with a foundation of client-centered, relationship-based philosophies have found that the most important aspect of therapy is being with clients—and knowing that how we are with clients is as important with what we do. Ms. Flynn stated that it has been demonstrated over these two months that, with intentionality, many of the gaps created by telehealth can be overcome, with many unintended benefits. She concluded, saying, “We know times of extraordinary stress provide opportunities for transformation and we stand ready to assist clients in elevating themselves and creating an intentional life filled with joy and connection.”

To schedule your START consultation, call (732) 247-7003 x 422. Text (732) 434-8577 or email Carolyn Flynn at Please also visit START.

About CGE: The Center for Great Expectations provides an uncompromised continuum of care across prevention and treatment of substance use and mental health disorders. Programs include: Prevention Services of The CTARI Institute; Residential Treatment Centers for women and adolescents; Katy’s Place, child development center; Roots to Recovery, an outpatient center; and Permanent Supportive Housing; START program, a comprehensive, relationally-based in-home treatment program for pregnant or parenting women and their infants who have experienced trauma and substance use. CGE’s organizational Trauma C.A.R.E.© model provides a safe environment for each client and the creation of client-centered treatment, informed by evidence-based approaches, including early relational health, for the best possible outcomes for both parent and child to break the intergenerational cycle of trauma, substance use, abuse and homelessness.