Perceptions of a Therapeutic Parenting Intervention for Mothers with Young Children in Substance Use Treatment

• In Event: 1-139 - Supporting Parents’ Caregiving Knowledge and Understanding: Incorporating Perspectives of Parents from Diverse Backgrounds

Integrative Statement

Introduction. Parenting young children while in treatment for substance use disorders (SUDs) is an extremely challenging prospect. Yet, pregnancy and parenting an infant is known to increase a woman’s motivation to minimize or stop substance misuse and to maintain sobriety. The stakes are high as many children who are substance-exposed are at increased risk for attachment and developmental difficulties, in-part due to parents’ co-occurring mental health disorders and transactional effects between the parent and child (Salo & Flykt, 2013). Additionally, child welfare involvement is high, and many children are removed from their mother’s care at least while investigations are conducted. Integrating therapeutic parenting interventions into substance use treatment programs provides the tools and structure for mothers in recovery to build on their strong desire to be a good parent (Suchman et al., 2017). Yet, little is known about mothers’ intervention experiences, particularly with regard to motivation for participation, acceptability, helpfulness and perceived change.

Method. As part of larger evaluation studies, 60 mothers were interviewed who participated in an evidence-informed dyadic attachment-based therapeutic parenting intervention with their young children while in family residential (n=40) or outpatient opioid treatment (n=20). Semi-structured interviews aimed to understand perceptions of their parenting processes, motivation for participation, and views of the intervention and associated changes. Sample questions included: (1) How would you describe yourself as a parent when you were using drugs?; (2) What are the most important things you felt you learned from working with your clinician?; and (3) Has your relationship with your child changed since participating in the intervention? If so, how? Interview transcripts were analyzed using line-by-line coding and grounded theory techniques. Codes that emerged were examined and subsequently collapsed into larger categories based on commonalities and frequency.

Participants were on average in their late 20s with children under 2 years of age (residential treatment: mean child age=21 months; outpatient opioid treatment: mean child age=18 months). At both types of substance use treatment programs participants were predominantly white with a larger group of non-white participants (Black, Hispanic and other) in residential programs. The vast majority of participants were never married. Heroin and other opioids were reported as the most frequently used substances. Mean number of therapeutic sessions ranged from 13 in residential to 15 in outpatient treatment.

Results. Findings showed that, despite differences between settings, three overarching themes were identified: (1) mothers strongly desired to be better parents by improving relationships with their children and cooperating with child welfare; (2) mothers viewed the intervention as supportive and positive, particularly the nonjudgmental clinician and its difference from substance use treatment; and (3) mothers perceived benefits to include improved understanding of themselves as parents, changes in their parenting approach and enhanced relationships with children.

Discussion. Practice implications to be discussed with audience participants include the feasibility, acceptability and importance of offering an attachment-based parenting intervention within substance use treatment given the high stakes and mothers’ perceived ability to address the parenting process while in substance use treatment.

Authors

• Ruth Paris, Boston University School of Social Work
  Presenting Author

• Jae Quinn, Boston University School of Social Work
  Non-Presenting Author