Grant: Travel Awards - Institute Community Support

Interventions for maternal substance abuse are becoming increasingly integrated in nature (including prenatal, parenting, or child-related services). However, intervention is often limited to basic information regarding parenting and child behavior management. Children are rarely included in service and the mother-child relationship is seldom seen as a critical target of treatment. Breaking the Cycle (BTC) is a children's (aged 0 to 6) mental health agency in downtown Toronto that aims to improve child outcomes through intervention for maternal substance abuse that aims at fostering the mother-child relationship. The goal of this study was to compare the relative efficacy of this novel approach to standard, integrated treatment. Participants were 65 mothers from BTC and 25 comparison mothers. Three maternal outcome domains were assessed including: addiction severity (ASI; DTCQ), relationship capacity (PSS; AAS), and mental health (CES-D; BAI). Both groups showed significant improvement on measures of addiction severity, but only BTC mothers made significant gains on measures of relationship capacity and mental health (ds = small to moderate). One-year follow-up data were available for 45 children of BTC mothers. Improvements in maternal relationship capacity and mental health significantly predicted improvements in total parenting stress on the Parent Stress Index, total child behavioral difficulties on the Child Behavior Checklist, and working memory on the Behavior Rating Inventory of Executive Function (all ps < .05). These findings suggest that relationship-focused intervention supports mothers with substance abuse issues to make broad changes across multiple domains of functioning, including changes in their mental health and relationship capacity. Findings also indicate that improvements in maternal functioning are associated with better child behavioral outcomes.