Integrated programs for mothers with substance abuse issues: A systematic review of studies reporting on parenting outcomes

Harm Reduction Journal

Ainsley Smith⁵  Joanna Henderson¹  Lehana Thabane³  Wendy Sword⁶  Karen Milligan⁴  Alison Niccols² 

[1] Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada;Department of Psychiatry and Behavioural Neurosciences, McMaster University, 280 Holbrook Building, McMaster Children's Hospital-Chedoke Site, Hamilton, Ontario, Box 2000 L9N 3Z5, Canada;Department of Clinical Epidemiology and Biostatistics, McMaster University, St. Joseph's Healthcare, 50 Charlton Avenue., 3rd Floor, Room H325, Hamilton, Ontario L8N 4A6, Canada;Integra, 25 Imperial Street, Toronto, Ontario M5P 1B9, Canada;Department of Psychiatry and Behavioural Neurosciences, McMaster University, 284 Holbrook Building, McMaster Children's Hospital-Chedoke Site, Hamilton, Ontario, Box 2000 L9N 3Z5, Canada;School of Nursing, McMaster University, 1200 Main Street West, Room 3N25G, Hamilton, Ontario L8N 3Z5, Canada

关键词: Integrated programs;    Parenting;    Substance use;    Mothers;    Women;   

Others  :  810030
DOI  :  10.1186/1477-7517-9-14

 received in 2011-07-29, accepted in 2012-03-19,  发布年份 2012

【 摘 要 】

Background

Integrated treatment programs (those that include on-site pregnancy-, parenting-, or child-related services with addiction services) were developed to break the intergenerational cycle of addiction, dysfunctional parenting, and poor outcomes for mothers and children, yet there has been no systematic review of studies of parenting outcomes.

Objectives

As part of larger systematic review to examine the effectiveness of integrated programs for mothers with substance abuse issues, we performed a systematic review of studies published from 1990 to 2011 with data on parenting outcomes.

Methods

Literature search strategies included online bibliographic database searches, checking printed sources, and requests to researchers. Studies were included if all participants were mothers with substance abuse problems at baseline, the treatment program included at least one specific substance use treatment and at least one parenting or child service, and there were quantitative data on parenting outcomes. We summarized data on parenting skills and capacity outcomes.

Results

There were 24 cohort studies, 3 quasi-experimental studies, and 4 randomized trials. In the three randomized trials comparing integrated programs to addiction treatment-as-usual (N = 419), most improvements in parenting skills favored integrated programs and most effect sizes indicated that this advantage was small, ds = -0.02 to 0.94. Results for child protection services involvement did not differ by group. In the three studies that examined factors associated with treatment effects, parenting improvements were associated with attachment-based parenting interventions, children residing in the treatment facility, and improvements in maternal mental health.

Conclusions

This is the first systematic review of studies evaluating the effectiveness of integrated programs on parenting. The limited available evidence supports integrated programs, as findings suggest that they are associated with improvements in parenting skills. However, more research is required comparing integrated programs to addiction treatment-as-usual. This review highlights the need for improved methodology, study quality, and reporting to improve our understanding of how best to meet the parenting needs of women with substance abuse issues.

【 授权许可】

   
2012 Niccols et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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