Substance abusing, mentally ill mothers have a multitude of medical, emotional, interpersonal, legal, educational, and vocational needs that impact their families. Because of these needs, such mothers are at risk for abusing and neglecting their children. In spite of their difficulties, however, these mothers are concerned about their parenting responsibilities, and this concern can provide incentive for them to seek and benefit from treatment. Virtually no existing programs simultaneously address substance abuse problems, mental illness, and child management issues among mothers. Those charged with the development of programs and services for such dually impaired mothers can adapt treatment strategies from related areas of mental health and substance abuse treatment. Promising treatment strategies could include social support services that enable women to help each other with daily-living tasks, alcohol-abuse and stress-management treatment strategies, and skills intervention that promotes healthful life management. Other topics discussed in this paper are program planning for innovative services and research strategies. 41 references