Many women seek treatment for substance abuse problems during their child-bearing years. Evaluations of interventions for these women need to take into account other problems that women may have when they enter treatment. The effectiveness of residential treatment for women, some of whom reported a history of abuse and psychological problems, is reported here. Data were collected on 101 women in two residential treatment programs. Both programs were federally funded, model demonstration programs designed to serve perinatal women and children under the age of three. Both facilities provided short-term residential treatment and their primary goals included reducing substance abuse and developing parenting skills. Parenting skills were addressed through the modeling of appropriate practices and through parenting classes in which the women and children were joint participants. As predicted, many women reported early abuse and symptoms of psychological distress. Women who reported severe psychological problems were less likely to graduate from the programs. Those who did graduate showed a reduction in the severity of their alcohol, drug, legal, family, and psychological problems. It is argued that interventions need to be developed and tested to meet the needs of women with both psychological and substance abuse disorders. Nine tables provide statistical data. (RJM)