Mothering From the Inside Out: Results of a second randomized clinical trial testing a mentalization-based intervention for mothers in addiction treatment

Abstract

Mothers with histories of alcohol and drug addiction have shown greater difficulty parenting young children than mothers with no history of substance misuse. This study was the second randomized clinical trial testing the efficacy of Mothering from the Inside Out (MIO), a 12-week mentalization-based individual therapy designed to address psychological deficits commonly associated with chronic substance use that also interfere with the capacity to parent young children. Eighty-seven mothers caring for a child between 11 and 60 months of age were randomly assigned to receive 12 sessions of MIO versus 12 sessions of Parent Education (PE)—a psychoeducation active control comparison. Maternal reflective functioning, representations of caregiving, mother-child interaction quality, and child attachment were evaluated at baseline and post-treatment and 3-month follow up. Mother-child interaction quality was assessed again at 12-month follow up. In comparison with PE mothers, MIO mothers demonstrated a higher capacity for reflective functioning and representational coherence at post-treatment and 3-month follow up. At 12-month follow up, compared to PE cohorts, MIO mothers demonstrated greater sensitivity, their children showed greater involvement, and MIO dyads showed greater reciprocity. As addiction severity increased, MIO also appeared to serve as a protective factor for maternal reflective functioning, quality of mother-child interactions, and child attachment status. Results demonstrate the promise of mentalization-based interventions provided concomitant with addiction treatment for mothers and their young children.

Mothering from the Inside Out: results of a pilot study testing a mentalization-based therapy for mothers enrolled in mental health services

“…Interested mothers who were enrolled in outpatient services themselves or who had a biological child enrolled in outpatient services at the treatment center were eligible for treatment if they were caring for a child between birth and 84 months of age. All mothers who consented received 12 sessions of a manualized mentalization-based intervention called Mothering from the Inside Out (MIO) that was originally designed for mothers enrolled in treatment for drug addiction (see Suchman et al, 2013, in press). Enrolled mothers and their families continued to receive treatment as usual at the clinic throughout their enrollment in the study.…”

“…The study included a 2-week baseline assessment, 12-week intervention and 2-week post-treatment assessment. Treatment fidelity was measured using a scale developed for the randomized trial involving substance using mothers (Suchman et al, in press). Treatment attendance and alliance served as measures of feasibility and acceptability, respectively.…”

“…We previously reported findings from two randomized, controlled trial with mothers enrolled in substance abuse treatment and caring for young children (ages birth to five; see Suchman et al, 2010, 2011, in press). In both trials, at the end of 12 sessions, in comparison with mothers who received an active psychoeducational comparison intervention, those who received MIO demonstrated higher levels of RF and these differences were sustained at follow up.…”

“…To date, however, there have been no reported efforts to pilot such interventions with parents who struggle with mental illness. The aim of this study was to examine the preliminary feasibility, acceptability and efficacy of Mothering from the Inside Out (MIO ), a 12-session mentalization-based therapy (MBT) that was initially designed for and demonstrated efficacy in two randomized clinical trials with mothers enrolled in treatment for substance abuse (Suchman et al, 2010, in press; Suchman, DeCoste, McMahon, Rounsaville, & Mayes, 2011). …”

Concealed and Unconcealed Motives for Joining the Parent-Teacher Association: Mapping Sentence and Smallest Space Analysis

“…However, given that there is no single comprehensive definition of parental involvement at school, clarity should be attained in order to reach a consensus among researchers (Fisher and Friedman, 2009). …”