Integrated programs for women with substance use issues and their children: a qualitative meta-synthesis of processes and outcomes

Abstract

BackgroundThere is a need for services that effectively and comprehensively address the complex needs of women with substance use issues and their children. A growing body of literature supports the relevance of integrated treatment programs that offer a wide range of services in centralized settings. Quantitative studies suggest that these programs are associated with positive outcomes. A qualitative meta-synthesis was conducted to provide insight into the processes that contribute to recovery in integrated programs and women's perceptions of benefits for themselves and their children.MethodsA comprehensive search of published and unpublished literature to August 2009 was carried out for narrative reports of women's experiences and perceptions of integrated treatment programs. Eligibility for inclusion in the meta-synthesis was determined using defined criteria. Quality assessment was then conducted. Qualitative data and interpretations were extracted from studies of adequate quality, and were synthesized using a systematic and iterative process to create themes and overarching concepts.ResultsA total of 15 documents were included in the meta-synthesis. Women experienced a number of psychosocial processes during treatment that played a role in their recovery and contributed to favourable outcomes. These included: development of a sense of self; development of personal agency; giving and receiving of social support; engagement with program staff; self-disclosure of challenges, feelings, and past experiences; recognizing patterns of destructive behaviour; and goal setting. A final process, the motivating presence of children, sustained women in their recovery journeys. Perceived outcomes included benefits for maternal and child well-being, and enhanced parenting capacity.ConclusionA number of distinct but interconnected processes emerged as being important to women's addiction recovery. Women experienced individual growth and transformative learning that led to a higher quality of life and improved interactions with their children. The findings support the need for programs to adopt practices that focus on improving maternal health and social functioning in an environment characterized by empowerment, safety, and connections. Women's relationships with their children require particular attention as positive parenting practices and family relationships can alter predispositions toward substance use later in life, thereby impacting favourably on the cycle of addiction and dysfunctional parenting.

Personal networks of women in residential and outpatient substance abuse treatment

“…Falkin and Strauss (2003) found that one in five women in their study reported that their children had helped them to stop substance use. A meta synthesis of existing research on women with substance use disorders and parenting (Sword et al, 2009) reported that children often exert a motivating presence and a sense of security and comfort, along with a sense of urgency to work on recovery issues.…”

Perceived Neighborhood Safety, Recovery Capital, and Successful Outcomes Among Mothers 10 years After Substance Abuse Treatment

“…Being pregnant at treatment entry increased the odds of success. For some women pregnancy may signify a change in social role responsibilities that promotes drug use cessation and sustained recovery (Massey et al., 2012; Sword et al, 2009; Mitchell et al, 2008; Massey et al, 2011). For others, potential involvement with the social service and child welfare systems, along with child custody concerns, can exert enormous pressures on pregnant women to quit using drugs (Cloud and Granfield, 2008).…”

Outcomes of the Main dans la main initiative on substance-abusing expectant and new mothers in the perinatal period

“…La documentation tant clinique que scientifique souligne l'importance des attitudes professionnelles positives à l'égard des futures et nouvelles mères ainsi que des actions visant le renforcement du pouvoir d'agir pour lever les obstacles auxquels se heurte ce groupe de femmes, comme la peur de ne pas être à la hauteur de leur nouveau rôle de mères et la faible estime de soi 24,34 . Parmi les attitudes des intervenantes jugées aidantes par les participantes de la présente étude, retenons en particulier la reconnaissance de leurs forces, l'encouragement, l'absence de jugement porté sur leur situation, le respect ainsi que l'écoute à l'égard de ce qu'elles souhaitent pour elles et leur enfant.…”

“…Parmi les manifestations de ce type de changements, retenons en particulier un rapprochement avec leur famille, des rapports plus positifs avec les intervenants sociaux et une plus grande utilisation des ressources d'aide. Les recherches soulignent que les interventions qui ont le plus de succès auprès de ce groupe de population sont celles qui adoptent une approche globale pour répondre aux besoins complexes et diversifiés de ces femmes 31,34,36 . Cela est d'autant plus important que les contacts précoces et réguliers avec les services augmentent les gains et aident à diminuer les risques de séquelles pour les enfants 39 .…”