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Young Child and Parent Project: Improving the Well-being and Safety of Families with Parental Substance Abuse

Statement of Problem

The widespread, ongoing opioid and heroin epidemic in the United States has garnered a lot of necessary attention regarding the impact substance use disorders have on families. In the U.S., about 1 in 8 children, totaling nearly 9 million, most under the age of 5, live in homes with at least one parent who has a substance use disorder. It’s well known that young children of parents with substance use disorders are at substantially increased risk for psychological and emotional problems. As they grow older, these children may experience anxiety, depression, poor school performance and their own substance use disorders.

Families in Philadelphia and the surrounding communities have felt the effects of the opioid epidemic for years. Unfortunately, there are significant barriers to mothers enrolling in and completing programs to address the family impact of parental substance use disorder. In addition to systems-level barriers to availability of mother-baby treatment options, insurance considerations, and other accessibility challenges, a mother’s own trauma and current substance use can significantly impact her engagement with therapeutic interventions. Without proper treatment for their substance use disorder, mothers may struggle to bond with their young children and thrive in their role as a caregiver.

This challenge is particularly acute for the critical parenting skill of reflective functioning, or a parent’s understanding of their own emotions and those of their child. Several recent interventions have found ways to support mothers with substance use disorder in acquiring reflective parenting skills while completing substance use treatment. This in turn decreases their chances for relapse after treatment, as well as the risk of having their children placed in foster care.


Next Steps

This is five-year project that will begin enrolling patients in 2023, with integration of the certified recovery specialists scheduled for 2025. Following implementation, we will work with the Health Federation of Philadelphia on our continued evaluation of the intervention to understand if we were able to increase mothers’ and children’s well-being, improve permanency of a child in their home and enhance the safety of children of parents with substance use disorders.

This project page was last updated in June 2023.

Suggested Citation

Children's Hospital of Philadelphia, PolicyLab. Young Child and Parent Project: Improving the Well-being and Safety of Families with Parental Substance Abuse [online]. Available at: [Accessed: plug in date accessed here]. 

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