Ecostructural Family Therapy and Maternal Substance Use

This pilot study utilized phenomenological methodology to explore relational systems for ten mothers enrolled in family-centered substance use treatment. Participants described their experiences during motherhood and addiction. Analysis revealed themes that captured the interpersonal relationships of maternal substance use: (1) parent-child relationships in the context of maternal substance use disorders (SUDs), (2) interaction between romantic relationships and maternal substance use, and (3) intergenerational relationships among mothers and grandmothers. Mothers discussed these complicated and simultaneous roles and relationships that impacted their substance use and recovery within the context of family. Using ecostructural family therapy, we offer clinical recommendations with the aim of creating organizational change for families in recovery.

Maternal pre- and postnatal substance use and attachment in young children: A systematic review and meta-analysis

Maternal substance use has often been associated with insecure and disorganized child attachment. We evaluated this association with a meta-analysis of young children and, further, systematically reviewed mediating and moderating factors between maternal substance use and child attachment. We performed a systematic database search of quantitative English language studies on child attachment that included substance-using mothers and their children below 6 years of age. Eleven studies (N = 1,841) met the inclusion criteria and were included in the meta-analysis of attachment security and seven (N = 1,589) studies were included in the meta-analysis of attachment disorganization. We found that maternal substance use was negatively associated with secure attachment in children, but the effect size was small (r = −.10). The association with disorganized attachment was not significant (r = .15). Related to moderating and mediating factors (k = 6), we found evidence on the role of teratogenic and sociological factors on child attachment. Most importantly, the impact of cumulative risks was vital. However, literature was scarce, and studies varied in risk of bias, leaving many unanswered questions on other potential factors underlying the development of attachment in these high-risk children. We discuss the results considering clinical implications and future directions.

A Promising Approach in Home Visiting to Support Families Affected by Maternal Substance Use

Introduction Many factors influence women’s use of alcohol and other drugs while pregnant and postpartum. Substance use impacts the maternal-child relationship during the critical neonatal period. The first days and months of human development lay the foundation for health and well-being across the lifespan, making this period an important window of opportunity to interrupt the transmission of trauma and stress to the next generation. Pregnant and postpartum women with a history of substance use require specialized support services. Methods The Team for Infants Exposed to Substance abuse (TIES) Program provides a holistic, multi-disciplinary, community-based model to address the complex needs of families with young children affected by maternal substance use. Results A multi-year implementation study of the model yielded results that indicate the effectiveness of this home-based family support intervention. The model focuses on reducing maternal alcohol and other drug use, increasing positive parenting, promoting child and maternal health, and improving family income and family housing. A key component of the model is establishing a mutual, trusting relationship between the home visiting specialists and the family. Foundational to the TIES model is a family-centered, culturally competent, trauma-informed approach that includes formal interagency community partnerships Discussion This article describes elements of the model that lead to high retention and completion rates and family goal attainment for this unique population.

Changes in Maternal Substance Use During the COVID-19 Pandemic

Background: Maternal stress levels and mental health symptoms have significantly increased since the coronavirus (COVID-19) pandemic began. As a result, experts have become concerned about elevated substance use given well-known associations between negative emotions and increased substance use. Extant research has not examined substance use among mothers during the COVID-19 pandemic which is a critical next step given links between maternal substance use and adverse childhood outcomes. Methods: Data was collected April 14th to 28th, 2020 from 508 mothers (Mage = 34.8 years, SD = 5.1) with young children between the ages of 0 to 8 years old via the Parenting During the Pandemic study. To identify associations between self-reported changes in substance use, mothers completed self-reported questionnaires on their substance use, motivations for using substances, and their mental health. Results: Of participating mothers, 54.9% did not change their substance use, 39.2% increased their use, and 5.9% decreased their use. Findings indicate that mothers with an anxiety disorder or clinically relevant anxiety symptomatology were more likely to report increased substance use during the COVID-19 pandemic. Using substances to cope with anxiety, but not depression or boredom, was significantly elevated among mothers who self-reported increased substance use during the pandemic relative to those reporting no change to or a decrease in usage. Using substances to cope with anxiety was a risk factor for increasing substance use. Discussion: A large proportion of mothers have reported increasing their substance use since the onset of the COVID-19 pandemic. Our results highlight the crucial need to treat maternal anxiety and the importance of teaching mothers alternative coping strategies, other than using substances, to reduce the incidence of increased substance use among mothers and its negative sequelae.