Knowledge of the epidemiology of substance use and associated problems demonstrates that a sizeable minority of pregnant women are using substances, and following delivery the majority revert to higher levels of misuse which is to the detriment of themselves and their babies. There is a rapidly accumulating range of effective interventions for substance misuse. Pregnancy can be a turning point for the delivery of such treatments as women attend obstetric services. This is an opportune moment for detection and treatment, if generalists have the skills to manage less severe problems and referral to specialists is possible. It is important to be able to determine when a patient requires specialist referral for the health and safety of the patient, their baby and the family and for the integration of provision by professionals involved in their care. This symposium will outline the basis of expert assessment and judgement regarding appropriate psychological treatment interventions for this group of young women within the framework of comprehensive service models.