A Combined Psychotherapy Intervention to Support Child-parent Attachment for Mothers Affected by Substance Use Disorder With Young Children
Background
Parental substance use disorder (SUD) increases risk for child maltreatment and child welfare system involvement. Parents with SUD have challenges forming healthy attachments with their children and have diminished capacity for reflective functioning, a vital component of attachment and child development. A novel dyadic psychotherapy model combining Mothering from the Inside Out and Child-Parent Psychotherapy (MIO-CPP) aims to strengthen parental reflective functioning as a foundation for improving child-parent attachment.
Objective
This study describes the implementation of the MIO-CPP model, including constructs of feasibility, acceptability and appropriateness, and examines the perceived impact of MIO-CPP from the perspective of mothers and clinicians.
Participants and setting
Mothers and their children < 6 years of age from residential and outpatient SUD treatment centers participated in weekly psychotherapy sessions over 9–12 months (N = 63).
Methods
Participants completed questionnaires about child and parent wellbeing and parenting attitudes. Semi-structured qualitative interviews asked participants about experiences in therapy and perceived impact. Clinician case summaries documented therapy participation and clinical case summaries.
Results
At enrollment, 83% of mothers indicated low levels of reflective functioning. Participants from residential vs. outpatient treatment were enrolled for longer (7.3 vs. 6.7 months) and had more dyadic sessions (5.8 vs. 2.6). Mothers frequently needed support when discussing personal safety. Participants endorsed high levels of acceptability of MIO-CPP and described improved perceptions of themselves as parents, as well as expanded understanding of parenting responsibility to include supporting children’s emotional needs.
Conclusions
This study provides evidence to support feasibility, acceptability, and appropriateness of MIO-CPP for mothers in SUD recovery. Future research should assess efficacy of MIO-CPP for this population.