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. It’s well known that young children of parents with substance use disorders are at substantially increased risk for biological, psychological and emotional problems. As they grow older, these children may experience anxiety, depression, poor school performance and their own substance use disorders.

Philadelphia has one of the most serious problems in overuse and abuse of opioids and heroin in the nation. Unfortunately, there are significant barriers to mothers successfully enrolling and completing programs to address the family impact of parental substance use disorder. In addition to systems-level barriers around the 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, many caregivers struggle bonding with their children and providing adequate care-taking.

This challenge is particularly acute for the critical parenting skill of reflective functioning, or understanding emotions both in oneself and in others. In an effort to support parents with substance use disorders, several recent interventions have demonstrated that mothers with substance use disorder can acquire reflective parenting skills while in substance use treatment. This in turn decreases their likelihood for relapse after treatment, as well as the risk of having their children placed in foster care.


In collaboration with the Health Federation of Philadelphia, our project, known as the Young Child and Parent Project, seeks to improve child and parent well-being, permanency and safety by integrating two evidence-based therapeutic models (Mothering from the Inside Out and Child Parent Psychotherapy) to increase parental-child attachment and reflective functioning, as well as parents’ receptivity and engagement with treatment and therapeutic services. This new therapeutic model is delivered to mothers enrolled in substance use treatment programs in Philadelphia and Bucks Counties. Through a mixed-methods study of the implementation of this model, we will assess parental/caregiver depression, substance use disorder treatment recovery rates and involvement of young children in the child welfare system. We will conduct a randomized trial to compare the outcomes of our integrated therapeutic model with standard dyadic therapy. We also seek to understand the cross-system collaboration and communication needed to ensure that treatment services are meeting the needs of mothers.

Next Steps

This is five-year project, with integration of the two evidence-based models scheduled for year two. Following implementation, we will work with the Health Federation of Philadelphia on evaluating 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 September 2020.

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]. 

More projects from Implementation and Evaluation View More Projects