Parental substance use and home visiting programs: Implementation considerations for relationship‐based treatment

Abstract

Home visiting programs can provide critical support to mothers in recovery from substance use disorders (SUDs) and young children prenatally exposed to substances. However, families impacted by maternal SUDs may not benefit from traditional child‐focused developmental home visiting services as much as families not impacted by SUDs, suggesting the need to adjust service provision for this population. Given the need to implement tailored services within home visiting programs for families impacted by SUDs, we sought to investigate the implementation barriers and facilitators to inform future integration of a relationship‐based parenting intervention developed specifically for parents with SUDs (Mothering from the Inside Out) into home visiting programs. We conducted nine interviews and five focus groups with a racially diverse sample (N = 38) of parents and providers delivering services for families affected by SUDs in the USA. Qualitative content analysis yielded three most prominent themes related to separate implementation domains and their associated barriers and facilitators: (1) engagement, (2) training, and (3) sustainability. We concluded that the home visiting setting may mitigate the logistical barriers to access for families affected by SUDs, whereas relationship‐based services may mitigate the emotional barriers that parents with SUDs experience when referred to home visiting programs.

Mothering from the Inside Out: Results of a community‐based randomized efficacy trial testing a mentalization‐based parenting intervention for mothers with addictions

“…Similar to previous qualitative work investigating the adaptation and implementation of MIO into home visiting settings, an overarching paradigm shift toward a relational framework may be necessary in the substance use treatment system as well in order to support the effective implementation of this intervention (Peacock‐Chambers et al., 2022). Of course, this initial shift will likely require significant training and support at multiple levels, and the sustainment of such changes will likely require time, funding, staffing, and flexibility (Lowell et al., 2023).…”

Bringing a mentalizing framework to understanding mothers with addiction: The groundbreaking work of Nancy E. Suchman

“…To determine whether training home visitors in the MIO model would be feasible, Lowell, Suchman et al. (2023) conducted extensive interviews and focus groups with both providers and families. While many providers noted their own lack of preparation in working with adult mental health issues, attachment, trauma, or mentalizing, they nevertheless recognized the tremendous value such an approach was likely to have.…”

Navigating the Crossroads: An Examination of Family Dynamics Amidst Fathers’ Recovery from Substance Abuse

“…Various factors impact people's decision to seek assistance, which might include support from loved ones, anxiety, fatigue, self-disgust, spiritual interventions, and reaching an all-time low (Wilson & Rhee, 2022). Additionally, demonstrating the ability to quit and avoiding severe health consequences linked with addiction are significant motivators behind seeking treatment (Lowell et al, 2023;Witkiewitz et al, 2022). The severity of addiction also influences the decision to pursue help.…”