Effects of Ecologically‐Based Family Therapy with substance‐using, prostituting mothers

Abstract

Studies report that high rates of prostituting women seek substance use treatment, and that most of these women have children in their care. However, compared to non-prostituting women, they show poorer treatment outcomes. Effective intervention for this population is needed, and the current study is the first to test family therapy with mothers seeking substance use treatment, who also reported prostitution. Sixty-eight treatment-seeking women with children in their care were randomly assigned to receive twelve sessions of Ecologically-Based Family Therapy or twelve sessions of individual treatment. Results showed that women who received family therapy reported greater reductions in substance use and depressive symptoms as well as greater improvements in their mother-child interactions. Findings underscore the importance of offering family therapy as a treatment option when prostituting women with children seek substance use treatment. Practitioner points• It has proved difficult to meet the unique needs of prostituting women, and this article offers practical assistance to practitioners serving this population • Ecologically-Based Family Therapy (EBFT) shows promise, having some superior outcomes compared to an individual therapy with prostituting mothers • Substance use treatment facilities should strongly consider including EBFT for these women and their children as an adjunct to treatment

Supporting pregnant and parenting women who use alcohol during pregnancy: A scoping review of trauma-informed approaches

“… 51 , 66 , 67 , 76 In programs that offered outreach/outpatient supports that worked around women’s needs by meeting in the evenings, on weekends, and/or at home offered a layer of safety for women. 56 , 63 , 64 , 75 , 81…”

Familial Influences on Treatment and Substance Use Among Mothers Engaged in Prostitution

“…Prior research has shown that substance use treatment can be improved by considering the family context in which individuals are embedded (Gruber & Fleetwood, 2004; Horigian et al, 2015; Rowe, 2012). One previous study found that among women engaged in street‐level prostitution, those assigned to an family systems theory informed intervention reported greater reductions in substance use and mental health issues, as well as greater improvements to mother–child relationships, compared with women assigned to an individually based, non–family systems intervention (Murnan et al, 2017). Family systems theory informed interventions have the potential to assist women in identifying and engaging supportive family members in an effort to promote women's sobriety and achievement of treatment goals.…”

“…Once in treatment, women commonly receive detoxification and other medically assisted treatments, as well as traditional 21‐ or 28‐day treatment, outpatient counseling, and 12‐step programming (Nuttbrock et al, 2004). Only two studies have tested individual‐based interventions targeting substance use with women engaged in street‐level prostitution (Burnette et al, 2009; Yahne et al, 2002), and one tested a family systems intervention (Murnan et al, 2017). Findings show that this population of women can be engaged in and benefit from substance use treatment.…”

“…Family therapy and family systems theory informed interventions are not commonly received by this population. A secondary analysis conducted from a larger clinical trial evaluating the effects of an ecologically based family therapy (EBFT) incorporating a family systems approach as an adjunct to women's substance use treatment was conducted with women reporting street‐level prostitution (Murnan et al, 2017). Findings indicated that women engaged in street‐level prostitution benefit from participation in a family systems theory informed intervention with their child.…”

“…Findings indicated that women engaged in street‐level prostitution benefit from participation in a family systems theory informed intervention with their child. Specifically, Murnan et al (2017) found that women assigned to the family systems informed EBFT reported greater reductions in substance use and depressive symptoms, as well as greater improvements in mother–child interactions, compared with those assigned to an individually delivered health intervention.…”