The Mothers and Toddlers Program, an attachment-based parenting intervention for substance using women: Post-treatment results from a randomized clinical pilot

Abstract

This is a report of post-treatment findings from a completed randomized pilot study testing the preliminary efficacy of The Mothers and Toddlers Program (MTP), a 12 week attachment-based individual parenting therapy for mothers enrolled in substance abuse treatment and caring for children ages birth to 36 months. Forty-seven mothers were randomized to MTP versus the Parent Education Program (PE) -a comparison intervention providing individual case management and child guidance brochures. At post-treatment, MTP mothers demonstrated better reflective functioning in the Parent Development Interview, representational coherence and sensitivity, and caregiving behavior than PE mothers. Partial support was also found for proposed mechanisms of change in the MTP model. Together, preliminary findings suggest that attachment-based interventions may be more effective than traditional parent training for enhancing relationships between substance using women and their young children.

The efficacy of case management with persons who have substance abuse problems: A three-level meta-analysis of outcomes.

“…al., 2010; Suchman et al, 2010). We retained the authors' labels of a comparison as standard of care or active intervention, although the differences between the two were not always obvious.…”

Promoting Protective Factors and Strengthening Resilience

“…MTP is an attachment-based parenting intervention designed to enhance parent-child relationships by improving maternal refl ective functioning and the quality of the mother's mental representations of the child (e.g., being fl exible and balanced as opposed to infl exible and distorted). Researchers at Yale University School of Medicine recently reported the results of a pilot study involving 47 mothers who were enrolled in substance abuse treatment and caring for a child aged birth to 3 years (Suchman et al 2010(Suchman et al , 2011. Mothers were randomly assigned to participate in 12 weekly sessions of MTP or a comparison parenting education intervention.…”

The state of evidence-based parenting interventions for parents who are substance-involved

“…In a pilot study examining MTP in a small sample of 14 substance-involved mothers of toddlers who ranged in age from 12 to 36 mo, preliminary pre-postcomparisons indicated that MTP was effective in increasing mothers' reflective functioning, sensitivity to child cues, and responses to child distress (12). These mechanisms of change also improved mothers' depressive symptoms, abstinence from drugs, and responsive caregiving to their children's cues as well as their children's clarity of cues immediately posttreatment and at 6-wk follow-up in a sample of 47 substanceinvolved mothers of young children (i.e., ranging in age from birth to 36 mo) who were randomized to MTP or a parent education program (13,70).…”

“…This program can serve as an adjunct to individual substance abuse treatment and was developed to improve caregiving behavior by intervening at the level of maternal reflective functioning and representation quality (69). Within regard to reflective functioning, this intervention addresses mothers' ability to identify and downregulate their own distressing emotions as well as their ability to recognize and empathize with their children's emotions and needs (13,70). In a pilot study examining MTP in a small sample of 14 substance-involved mothers of toddlers who ranged in age from 12 to 36 mo, preliminary pre-postcomparisons indicated that MTP was effective in increasing mothers' reflective functioning, sensitivity to child cues, and responses to child distress (12).…”