Maternal mental health and integrated programs for mothers with substance abuse issues.

Niccols, Alison; Milligan, Karen; Sword, Wendy; Thabane, Lehana; Henderson, Joanna; Smith, Ainsley; Liu, Jennifer; Jack, Susan M.

doi:10.1037/a0020139

Cited by 34 publications

(35 citation statements)

References 51 publications

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“…The findings of this systematic review are consistent with those reported in previous reviews of substance abuse treatment for women [20,21], meta-analyses of integrated programs showing their positive impact on maternal mental health and birth outcomes [42,43], qualitative studies in which women stated that integrated programs helped them gain insight into intergenerational influences on parenting, how to strengthen emotional bonds with children, and use positive discipline techniques [44], studies of parent interventions with parents (mothers and fathers) in methadone maintenance treatment [27,28], mothers in drug court [29], and other at-risk populations [16]. Results from this systematic review are important given the risks for poor outcomes in children of women with substance abuse issues [45].…”

Section: Discussionsupporting

confidence: 90%

Integrated programs for mothers with substance abuse issues: A systematic review of studies reporting on parenting outcomes

Milligan²,

et al. 2012

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BackgroundIntegrated treatment programs (those that include on-site pregnancy-, parenting-, or child-related services with addiction services) were developed to break the intergenerational cycle of addiction, dysfunctional parenting, and poor outcomes for mothers and children, yet there has been no systematic review of studies of parenting outcomes.ObjectivesAs part of larger systematic review to examine the effectiveness of integrated programs for mothers with substance abuse issues, we performed a systematic review of studies published from 1990 to 2011 with data on parenting outcomes.MethodsLiterature search strategies included online bibliographic database searches, checking printed sources, and requests to researchers. Studies were included if all participants were mothers with substance abuse problems at baseline, the treatment program included at least one specific substance use treatment and at least one parenting or child service, and there were quantitative data on parenting outcomes. We summarized data on parenting skills and capacity outcomes.ResultsThere were 24 cohort studies, 3 quasi-experimental studies, and 4 randomized trials. In the three randomized trials comparing integrated programs to addiction treatment-as-usual (N = 419), most improvements in parenting skills favored integrated programs and most effect sizes indicated that this advantage was small, ds = -0.02 to 0.94. Results for child protection services involvement did not differ by group. In the three studies that examined factors associated with treatment effects, parenting improvements were associated with attachment-based parenting interventions, children residing in the treatment facility, and improvements in maternal mental health.ConclusionsThis is the first systematic review of studies evaluating the effectiveness of integrated programs on parenting. The limited available evidence supports integrated programs, as findings suggest that they are associated with improvements in parenting skills. However, more research is required comparing integrated programs to addiction treatment-as-usual. This review highlights the need for improved methodology, study quality, and reporting to improve our understanding of how best to meet the parenting needs of women with substance abuse issues.

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Section: Discussionsupporting

confidence: 90%

Integrated programs for mothers with substance abuse issues: A systematic review of studies reporting on parenting outcomes

Milligan²,

et al. 2012

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“…Furthermore, the strong effects of fathers’ depressive symptoms and potential for child maltreatment risk among fathers with SUD clearly warrants the importance of integrated and comprehensive programs that address substance abuse, mental health, and parenting. Although these programs are often available for mothers (e.g., Milligan et al 2010, 2011; Niccols et al, 2010, 2012) and have important benefits for women (e.g., Sword et al, 2009; Sword et al, 2013), with rare exceptions (see McMahon, 2013; see Stover et al, 2012, for a discussion), few such programs have been developed for fathers.…”

Section: Discussionmentioning

confidence: 99%

Modeling risk for child abuse and harsh parenting in families with depressed and substance-abusing parents

Kelley

Lawrence

Milletich

et al. 2015

Child Abuse & Neglect

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Children with substance abusing parents are at considerable risk for child maltreatment. The current study applied an actor-partner interdependence model to examine how father only (n = 52) and dual couple (n = 33) substance use disorder, as well as their depressive symptomology influenced parents’ own (actor effects) and the partner's (partner effects) overreactivity in disciplinary interactions with their children, as well as their risk for child maltreatment. Parents completed the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977), the overreactivity subscale from the Parenting Scale (Arnold, O'Leary, Wolff, & Acker, 1993), and the Brief Child Abuse Potential Inventory (Ondersma, Chaffin, Mullins, & LeBreton, 2005). Results of multigroup structural equation models revealed that a parent's own report of depressive symptoms predicted their risk for child maltreatment in both father SUD and dual SUD couples. Similarly, a parent's report of their own depressive symptoms predicted their overreactivity in disciplinary encounters both in father SUD and dual SUD couples. In all models, partners’ depressive symptoms did not predict their partner's risk for child maltreatment or overreactivity. Findings underscore the importance of a parent's own levels of depressive symptoms in their risk for child maltreatment and for engaging in overreactivity during disciplinary episodes.

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“…Shwartz et al (2000) used in-depth interviews with a sample of program directors, case managers, and clients. The authors concluded that the women considered case management a valuable enhancement to substance abuse treatment Niccols et al (2010) conducted a meta-analysis of integrated programs published between 1990 and 2007 with outcome data on maternal mental health. There was no statistically significant heterogeneity among the studies.…”

Section: Program Planningmentioning

confidence: 97%

The treatment views and recommendations of substance abusing women: A meta-synthesis

Hines

2012

Qualitative Social Work

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The purpose of this review is to synthesize qualitative data describing the substance abuse treatment views and recommendations of addicted mothers. The meta-synthesis approach is a systematic comparison of qualitative studies all asking the same or similar questions and seeks to result in a theory that cuts across all of the studies. Keyword searches of online databases Academic Search Premiere, PubMed, and Google Scholar were conducted using the keywords: perinatal substance abuse, women and substance abuse, parenting and substance abuse to locate qualitative studies. The author also searched references of qualitative studies to access additional articles. Studies were included if they were qualitative, included excerpts from participants who discussed issues about perinatal substance abuse treatment views and recommendations and were published between 1992 and 2010. There were 30 studies reviewed. Evidence suggests that social marketing of substance abuse services that emphasize comprehensive services provided by caring non-judgmental staff is central to motivating women to enter treatment. Positive client and staff interactions are significant to retaining women in treatment. Culturally competent staff can motivate women who are considering treatment. Gender specific substance abuse services are recommended.

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Maternal mental health and integrated programs for mothers with substance abuse issues.

Cited by 34 publications

References 51 publications

Integrated programs for mothers with substance abuse issues: A systematic review of studies reporting on parenting outcomes

Integrated programs for mothers with substance abuse issues: A systematic review of studies reporting on parenting outcomes

Modeling risk for child abuse and harsh parenting in families with depressed and substance-abusing parents

The treatment views and recommendations of substance abusing women: A meta-synthesis

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