Play Therapy for Young Children and Mothers in Substance Use Disorder Programs

The opioid epidemic currently impacting children and families in Philadelphia and its surrounding areas is an important topic that has often dominated local and even national news. While opioids are the main focus today, substance use disorders in general have a detrimental effect on communities, families and—most concerning to me—children. Young children of parents with substance use disorders are at an increased risk of maltreatment and child welfare involvement. These children have a greater risk for developing substance use disorders of their own. They may also develop mental, emotional, social and physical problems. For example, children may display poor behavioral and academic performance in school as a result of these social-emotional impacts.

If a parent, particularly a mother, has a history of trauma and other problems combined with a substance use disorder, appropriate parenting and bonding with their young children becomes a struggle. We know that if a mother is withdrawn, less responsive and less engaging with her child due to her own trauma and substance use, this will have negative influence on the proper development of the child. Therefore, it is imperative to intercept the effects that parental substance use can cause to young children.

To do so here in Philadelphia, PolicyLab is partnering with the Health Federation of Philadelphia to evaluate a new intervention, The Young Child and Parent Program (YCPP), for mothers who are either pregnant or have children under age five. Through a play-therapy approach, YCPP aims to improve the well-being, permanency and safety outcomes for young children affected by maternal substance abuse and at risk of out-of-home placement.

We will be testing two types of evidence-based, therapies, Mothering from the Inside Out (MIO) and Child Parent Psychotherapy (CPP). MIO will consist of a therapist meeting with the mother alone for several weeks. During this time, the mother will work on understanding her parenting capabilities and her child’s behavioral responses. CPP will consist of a therapist meeting with the mother and child together for up to one year with the goal of improving their bond through facilitated play activities. These activities may include interactive play with games and toys. Among 170 mother-child pairs, we will provide MIO and CPP combined to some families and CPP alone to other families and compare the effects on both groups. I am particularly excited to learn the outcomes of incorporating MIO, including whether it contributes to an even more enjoyable and effective experience for the pair. However, through both of these interventions, we expect that YCPP will improve well-being for parents/caregivers, the child and the family as a whole.

YCPP provides a unique approach to therapy that I believe will be appealing to parents. In many other therapy programs, it is common to have separate therapy sessions for the mother and child. The duration of those other programs are often short, lasting only a few weeks or months. YCPP provides therapy with the mother and child together. The sessions will be in the form of interactive play therapy between the pair and can continue for up to one year. The Health Federation of Philadelphia is currently only able to provide CPP to a very limited number of families. There are no other programs in this area providing therapy to mothers and their children under 18 months, together. YCPP would begin to address some of the service gaps by aiming to make these therapies available to more children and families in the future.

YCPP offers a safe, positive and healthy environment for families to interact. Not only can this intervention improve reflective functioning and the bond between mother and child, it creates fun memories for families to always reflect and cherish. I can recall my own childhood, interacting and playing with my mother. Those are simple but significant events that children may always treasure.