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Relational Psychotherapy Mothers' Group: A randomized clinical trial for substance abusing mothers

Published online by Cambridge University Press:  22 January 2007

SUNIYA S. LUTHAR
Affiliation:
Teachers College, Columbia University
NANCY E. SUCHMAN
Affiliation:
Teachers College, Columbia University
MICHELLE ALTOMARE
Affiliation:
Teachers College, Columbia University

Abstract

The purpose of this study was to ascertain the effectiveness of the Relational Psychotherapy Mothers' Group (RPMG), a supportive parenting group intervention for substance abusing women. Sixty mothers receiving RPMG were compared to 67 women receiving recovery training (RT); both treatments supplemented treatment in the methadone clinics. At the end of the 6-month treatment period, RPMG mothers showed marginally significant improvement on child maltreatment (self-reported) and cocaine abuse based on urinalyses when compared with RT mothers; notably, children of RPMG mothers reported significantly greater improvement in emotional adjustment and depression than children of RT mothers. At 6 months follow-up, however, treatment gains were no longer apparent. Overall, the findings suggest that whereas supportive parenting interventions for substance abusing women do have some preventive potential, abrupt cessation of the therapeutic program could have deleterious consequences.Preparation of the manuscript was funded in part by grants from the National Institutes of Health (RO1-DA10726, RO1-DA11498, R01-DA14385, and K23DA14606), the William T. Grant Foundation, and the Spencer Foundation.

Type
Research Article
Copyright
© 2007 Cambridge University Press

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References

REFERENCES

Aikins, D. E., Hazlett-Stevens, H., & Craske, M. G. (2001). Issues of measurement and mechanism in meta-analyses: Comment on Westen and Morrison (2001). Journal of Consulting and Clinical Psychology, 69, 904907.CrossRefGoogle Scholar
Ammerman, R. T., Kolko, D. J., Kirisci, L., Blackson, T. C., & Dawes, M. A. (1999). Child abuse potential in parents with histories of substance use disorder. Child Abuse and Neglect, 23, 12251238.CrossRefGoogle Scholar
Amaro, H., & Hardy-Fanta, C. (1995). Gender relations in addiction and recovery. Journal of Psychoactive Drugs, 27, 325337.CrossRefGoogle Scholar
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck Depression Inventory: Second edition manual. San Antonio, TX: Psychological Corporation.
Beckwith, L., Rozga, A., & Sigman, M. (2002). Maternal sensitivity and attachment in atypical groups. Advances in Child Development and Behavior, 30, 231274.Google Scholar
Black, M. M., Nair, P., Kight, C., Wachtel, R., Roby, P., & Schuler, M. (1994). Parenting and early development among children of drug-abusing women: Effects of home intervention. Pediatrics, 94, 440448.Google Scholar
Brooks, J. S., & Tseng, L. J. (1995). Maternal drug use, personality, child-rearing practices, and toddlers' sadness. Psychological Reports, 76, 912914.CrossRefGoogle Scholar
Brunswick, A., Lewis, C., & Messeri, P. (1991). A life span perspective on drug use and affective distress in an African-American sample. Journal of Community Psychology, 19, 123135.3.0.CO;2-J>CrossRefGoogle Scholar
Brunswick, A. F., Messeri, P. A., & Titus, S. P. (1992). Predictive factors in adult substance abuse: A prospective study of African-American adults. Washington, DC: American Psychological Association.
Brunswick, A. F., & Titus, S. P. (1998). Heroin patterns and trajectories in an African American Cohort (1969–1990). In J. A. Inciardi & L. D. Harrison (Eds.), Heroin in the age of crack-cocaine: Vol. 6. Drugs, health, and social policy series (pp. 77108). Thousand Oaks, CA: Sage.
Camp, J. M., & Finkelstein, N. (1997). Parenting training for women in residential substance abuse treatment. Journal of Substance Abuse Treatment, 14, 311422.Google Scholar
Carey, K. B., Purnine, D. M., Maisto, S. A., & Carey, M. P. (1999). Assessing readiness to change substance abuse: A critical review of instruments. Clinical Psychology: Science and Practice, 6, 245266.CrossRefGoogle Scholar
Carroll, K. (1995). Methodological issues and problems in the assessment of substance use. Psychological Assessment, 7, 349358.CrossRefGoogle Scholar
Catalano, R. R., Gainey, R. R., Fleming, C. B., Haggerty, K. P., & Johnson, N. O. (1999). An experimental intervention with families of substance abusers: One-year follow-up of the focus on families project. Addiction, 94, 241254.CrossRefGoogle Scholar
Cicchetti, D., & Cohen, D. J. (1995). Perspectives on developmental psychopathology. In D. Cicchetti & D. J. Cohen, (Eds.), Developmental psychopathology: Vol. 1. Theory and methods. Wiley series on personality processes (pp. 320). Oxford: Wiley.
Dore, M. M., & Doris, J. M. (1998). Preventing child placement in substance abusing families: Research-informed practice. Child Welfare, 77, 407426.Google Scholar
Dunn, M. G., Tarter, R. E., Mezzich, A. C., Vanyukov, M., Kirisci, L., & Kirillova, G. (2002). Origins and consequences of child neglect in substance abuse families. Clinical Psychology Review, 2, 10631090.CrossRefGoogle Scholar
El-Bassel, N., Gilbert, L., Schilling, R., & Wada, T. (2000). Drug abuse and partner violence among women in methadone treatment. Journal of Family Violence, 15, 209228.CrossRefGoogle Scholar
Eliason, M. J., & Skinstad, A. H. (1995). Drug/alcohol addictions and mothering. Alcoholism Treatment Quarterly, 12, 8396.Google Scholar
Ernst, C. C., Grant, T. M., & Streissguth, A. P. (1999). Intervention with high-risk alcohol and drug-abusing mothers: II. Three-year findings from the Seattle Model of Paraprofessional Advocacy. Journal of Community Psychology, 27, 1938.Google Scholar
Gerard, A. B. (1994). Parent–Child Relationship Inventory (PCRI) manual. Tacoma, WA: Western Psychological Services.
Gibbons, R. D., Hedeker, D., Elkin, I., Waternaux, C., Craemer, H., Greenhouse, J., et al. (1993). Some conceptual and statistical issues in analysis of longitudinal psychiatric data. Archives of General Psychiatry, 50, 739750.CrossRefGoogle Scholar
Harmer, A. L. M., Sanderson, J., & Mertin, P. (1999). Influence of negative childhood experiences on psychological functioning, social support, and parenting for mothers recovering from addiction. Child Abuse and Neglect, 23, 421433.CrossRefGoogle Scholar
Harkness, K. L., Frank, E., Anderson, B., Houck, P. R., Luther, J., & Kupfer, D. J. (2002). Does interpersonal psychotherapy protect women from depression in the face of stressful life events? Journal of Consulting and Clinical Psychology, 70, 908915.Google Scholar
Hawley, T. L., Halle, T. G., Drasin, R. E., & Thomas, N. G. (1995). Children of addicted mothers: Effects of the “crack epidemic” on the caregiving environment and the development of preschoolers. American Journal of Orthopsychiatry, 65, 364379.CrossRefGoogle Scholar
Hedeker, D., & Mermelstein, R. J. (1996). Methods for analyzing longitudinal data on relapse: Application of random-effects regression models in relapse research. Addiction, 91(Suppl.), S211S229.CrossRefGoogle Scholar
Hogan, D. M. (1998). Annotation: The psychological development and welfare of children of opiate and cocaine users: Review and research needs. Journal of Child Psychology and Psychiatry and Allied Disciplines, 39, 609620.CrossRefGoogle Scholar
Howard, J., Beckwith, L., Espinosa, M., & Tyler, R. (1995). Development of infats born to cocaine-abusing women: Biological/maternal influences. Neurotoxicology and Teratology, 17, 403411.CrossRefGoogle Scholar
Huebner, C. E. (2002). Evaluation of a clinic-based parent education program to reduce the risk of infant and toddler maltreatment. Public Health Nursing, 19, 377389.CrossRefGoogle Scholar
Kaufman, A. S., & Kaufman, N. L. (1990). Kaufman Brief Intelligence Test. Circle Pines, MN: American Guidance Service.
Klerman, G. L., Weissman, M. M., Rounsaville, B. J., & Chevron, E. S. (1984). Interpersonal psychotherapy of depression. New York: Basic Books.
Knitzer, J., Yoshikawa, H., Cauthen, N. K., & Aber, J. L. (2000). Welfare reform, family support, and child development: Perspectives from policy analysis and developmental psychopathology. Development and Psychopathology, 12, 619632.CrossRefGoogle Scholar
Kovacs, M. (1992). The Children's Depression Inventory. New York: Multi-Health Systems.
Kumpfer, K. L. (1998). Selective prevention interventions: The Strengthening Families Program. NIDA Research Monograph Series, 177, 160207.Google Scholar
Laird, N. M., & Ware, J. H. (1982). Random-effects models for longitudinal data. Biometrics, 38, 963974.CrossRefGoogle Scholar
Levy, S. J., & Rutter, E. (1992). Children of drug abusers. New York: Lexington Books.
Lieberman, A. F., Silverman, R., & Pawl, J. H. (2000). Infant–parent psychotherapy: Core concepts and current approaches. In C. Zeanah (Ed.), Handbook of Infant Mental Health (2nd ed., pp. 472484). New York: Guilford Press.
Littell, R. C., Milliken, G. A., Stroup, W. W., & Wolfinger, R. (1996). SAS system for mixed models. Cary, NC: SAS Institute, Inc.
Luthar, S. S., & Cicchetti, D. (2000). The construct of resilience: Implications for interventions and social policies. Development and Psychopathology, 12, 857885.CrossRefGoogle Scholar
Luthar, S. S., Cushing, G., Merikangas, K., & Rounsaville, B. J. (1998). Multiple jeopardy: Risk and protective factors among addicted mothers' offspring. Development and Psychopathology, 10, 117136.CrossRefGoogle Scholar
Luthar, S. S., & Suchman, N. E. (1999). Developmentally informed parenting interventions: The Relational Psychotherapy Mothers' Group. In D. Cicchetti & S. Toth (Eds.), Rochester Symposium on Developmental Psychopathology: Vol. 9. Developmental approaches to prevention and intervention (pp. 271309). Rochester, NY: University of Rochester Press.
Luthar, S. S., & Suchman, N. E. (2000a). Relational Psychotherapy Mothers' Group: A developmentally informed intervention for at-risk mothers. Development and Psychopathology, 12, 235253.Google Scholar
Luthar, S. S., & Suchman, N. E. (2000b). Clinical assessment of functioning. Unpublished manuscript, Yale University School of Medicine.
Luthar, S. S., Suchman, N. E., & Boltas, D. (1997). Relational Parenting Mothers' Group: A therapist's manual. Unpublished manuscript, Yale University.
Mayes, L. C. (1995). Substance abuse and parenting. In M. H. Bornstein (Ed.), Handbook of parenting: Vol. 4. Applied and practical parenting (pp. 101125). Mahwah, NJ: Erlbaum.
McCall, R. B., & Green, B. L. (2004). Beyond the methodological gold standards of behavioral research: Considerations for practice and policy. Society for Research on Child Development Social Policy Report, 17, 313.Google Scholar
McConnaughy, E. A., DiClemente, C. C., Prochaska, J. O., & Velicer, W. F. (1989). Stages of change in psychotherapy: A follow-up report. Psychotherapy, 26, 494503.CrossRefGoogle Scholar
McMahon, T. J., & Luthar, S. S. (1998). Bridging the gap for children as their parents enter substance abuse treatment. In R. L. Hampton, V. Senatore, & T. P. Gullota (Eds.), Bridging the fields of substance abuse and child welfare: Vol. 7. Issues in children's and families' lives (pp. 143187). Thousand Oaks, CA: Sage.
Mercer, D., Carpenter, G., Daley, D., Patterson, C., & Vopicelli, J. (1994). Group drug counseling manual. Unpublished manuscript, University of Pittsburgh Medical Center.
Millar, G. M., & Stermac, L. (2000). Substance abuse and childhood maltreatment: Conceptualizing the recovery process. Journal of Substance Abuse Treatment, 19, 175182.CrossRefGoogle Scholar
Najavits, L. M., Griffin, M. L., Luborsky, L., Frank, A., Weiss, R. D., Liese, B. L., et al. (1995). Therapists' emotional reactions to substance abusers: A new questionnaire and initial findings. Psychotherapy: Theory, Research, Practice, Training, 32, 669677.CrossRefGoogle Scholar
Najavits, L. M., Sullivan, T. P., Schmitz, M., Weiss, R. D., & Lee, C. S. N. (2004). Treatment utilization by women with PTSD and substance dependence. American Journal on Addictions, 13, 215224.CrossRefGoogle Scholar
Najavits, L. M., Weiss, R. D., & Shaw, S. R. (1997). The link between substance abuse and posttraumatic stress disorder in women: A research review. American Journal on Addictions, 6, 273283.Google Scholar
Najavits, L. M., Weiss, R. D., Shaw, S. R., & Muenz, L. R. (1998). “Seeking Safety”: Outcome of a new cognitive–behavioral psychotherapy for women with posttraumatic stress disorder and substance dependence. Journal of Traumatic Stress, 11, 437456.CrossRefGoogle Scholar
National Center on Addiction and Substance Abuse (NCASA). (1996). Substance abuse and the American woman. New York: Author.
Nich, C., & Carroll, K. M. (2001). “Intention-to-treat” meets “missing data”: Implications of alternate strategies for analyzing clinical trials data. Drug and Alcohol Dependence, 68, 121130.Google Scholar
Reynolds, C. R., & Kamphaus, R. W. (1992). Behavioral Assessment System for Children. Circle Pines, MN: American Guidance Service.
Rogosch, F. A., Cicchetti, D., Shields, A., & Toth, S. L. (1995). Parenting dysfunction in child maltreatment. In M. Bornstein (Ed.), Handbook of parenting: Vol. 4. Applied and practical parenting (pp. 127159). Hillsdale, NJ: Erlbaum.
Rohner, R. P. (1991). Handbook for the study of parental acceptance and rejection. Unpublished manuscript, University of Connecticut.
SAMHSA, Office of Applied Studies. (2002/2003). National Survey on Drug Use and Health. Retrieved January 17, 2004, from http://oas.samhsa.gov/nhsda/2k3tabs/Sect1peTabs1to66.htm#tab1.31a
Schuler, M. E., Nair, P., & Black, M. M. (2002). Ongoing maternal drug use, parenting attitudes, and a home intervention: Effects on mother–child interaction at 18 months. Journal of Developmental and Behavioral Pediatrics, 23, 8795.CrossRefGoogle Scholar
Singer, L., Arendt, R., Farkas, K., Minnes, S., Huang, J., & Yamashita, T. (1997). Relationship of prenatal cocaine exposure and maternal postpartum psychological distress to child developmental outcome. Development and Psychopathology, 9, 473489.Google Scholar
Wald, R., Harvey, S. M., Hibbard, J. (1995). A treatment model for women substance users. International Journal of the Addictions, 30, 881888.CrossRefGoogle Scholar
Webster-Stratton, C., & Hammond, M. (1999). Marital conflict management skills, parenting style, and early-onset conflict problems: Processes and pathways. Journal of Child Psychology and Psychiatry, 40, 917927.CrossRefGoogle Scholar
Westermeyer, J., & Boedicker, A. E. (2000). Course, severity, and treatment of substance abuse among women versus men. The American Journal of Drug and Alcohol Abuse, 26, 523535.CrossRefGoogle Scholar
Yalom, I. (1985). The theory and practice of group psychotherapy. New York: Basic Books.
Zackon, F., McAuliffe, W., & Ch'ien, M. N. (1994). Recovery training and self-help: Relapse prevention and aftercare for drug addicts (pp. 320). Washington, DC: National Institute on Drug Abuse.
Zuckerman, M. (1984). Sensation seeking: A comparative approach to a human trait. Behavioral and Brain Sciences, 7, 413471.CrossRefGoogle Scholar
Zuckerman, M. (1994). Behavioral expressions and biosocial bases of sensation seeking. New York: Cambridge University Press.