This study examines the relationship between levels of psychological distress in substancedepende... more This study examines the relationship between levels of psychological distress in substancedependent mothers and their differential response to a dyadic parent-child intervention. A sample of 66 mothers who were receiving treatment for substance abuse, as well as a simultaneous parenting intervention, were interviewed pre and post-treatment on measures of psychological distress, adult and child trauma history, parental reflective functioning, and child social-emotional development. Additionally, clinicians provided assessments of the parent-child relationships. As anticipated, trauma histories for mothers and children, children's social emotional development, and parental reflective functioning were associated with aspects of maternal psychological distress. Kruskal-Wallis and subsequent Wilcoxson signed rank tests revealed that women with highest levels of baseline psychological distress showed significant improvements in psychological functioning post-treatment while women with moderately elevated levels of psychological distress did not. Women who were most distressed at baseline showed increased levels of parental reflective functioning post-treatment while women with moderate and lower levels of baseline psychological distress showed improvements on clinician-rated assessments of parent-child relationships. Chi Square analyses showed that parents who endorsed the highest levels of distress at baseline reported that their children's risk status regarding social-emotional development decreased post-treatment. Despite similarities in substance dependence, mothers in this sample had different needs and outcomes in the context of this parenting intervention due to variation in mental health. Given this variation, parenting interventions for substancedependent mothers need to account for the individual differences in levels of psychological distress.
Society for Social Work and Research 17th Annual Conference: Social Work for a Just Society: Making Visible the Stakes and Stakeholders, Jan 20, 2013
ABSTRACT Background and Purpose: Past studies of mothers with Substance Use Disorders (SUDs) ofte... more ABSTRACT Background and Purpose: Past studies of mothers with Substance Use Disorders (SUDs) often demonstrate decreased capacities to understand and reflect upon their children's development and emotional experience (RF, reflective functioning) (Levy, Truman, & Mayes, 2001). These mothers frequently have histories of multiple trauma exposures, which in turn can be linked to elevated levels of psychological distress (Suchman, et al., 2005). Their children often experience increased trauma exposure and impaired development. All of these factors can contribute to dysfunction in mother-child interactions and attachment insecurities. Responding to the needs of these families and community service providers , two agencies and a university developed BRIGHT, an adaptation of evidence-based Child-Parent Psychotherapy (Lieberman & Van Horn, 2005), for mothers with children birth to five in residential treatment for SUDs. While this is the first time that CPP has been adapted for use with this population, the need for evidence-based interventions in community SUD settings is well-established (Bromberg et al, 2010). The weekly dyadic intervention (M= 14 sessions) concentrates on strengthening the parent-child relationship by improving mothers' mental health and promoting increased parental RF and parent-child attachment. This study focuses on outcome data from maternal self-reports and observer-rated parent-child interactions. Methods: Participants were 76 mothers (treatment group, n=52; comparison group, n=24), who were predominantly Caucasian, in their late 20s, with a child birth to five (M= 19 months). Most were high school educated, unemployed, single and in treatment for addiction to heroin and other opiates. All had severe histories of trauma exposure and high levels of psychological distress. The comparison group received SUD treatment, but did not receive BRIGHT. Data were collected with standardized measures at baseline and post-treatment and used to assess change in mothers' self-reported psychological distress, parental RF and attitudes, and observer ratings of parent-child interactions. Bivariate and multivariate analyses were computed to assess change over time in both treatment and comparison groups. Results: Maternal psychological distress levels at baseline were significantly associated with greater levels of traumatic exposure in children, and a higher risk of child maltreatment. BRIGHT mothers experienced significant improvements in their overall psychological distress. Those who improved most at follow-up self-reported more empathy with and appropriate expectations of their children. Clinician observers rated those same mothers as most improved in their parent-child relationships. Additionally, mothers who had more sessions demonstrated greater improvement in RF. None of these changes were found in comparison group participants. Conclusions and Implications: This study provides support for the multiple foci of BRIGHT and the feasibility of adapting evidence-based interventions to community settings. Specifically, improvement in psychological distress of mothers, which in turn was related to positive changes in self-reported parenting abilities and attitudes, and observer-rated parent-child interactions speaks to the complexities of shifting parenting relationships in highly traumatized substance using populations. Augmenting community SUD treatment with an evidence-based parenting intervention can improve mental health and parent-child relationships. Social work researchers and practitioners can benefit from this knowledge in order to advance effective programs and outcomes for families struggling with SUDs.
This study examined the context of the early mothering experience and how that experience was rel... more This study examined the context of the early mothering experience and how that experience was related to personality change in 48 members of a longitudinal sample of women from age 21 (in 1958 or 1960), before any of them were married, to age 27 (in 1963 or 1964). Early motherhood was analyzed in terms of (a) how positively the woman described her experience and (b) how willing and able she was to maintain the full-time commitment considered necessary in the early 1960s. Path analyses showed that these two dimensions had somewhat different interrelations with mother's personality, the marriage, and husband's personality and participation as a father. However, both dimensions were related to relative increase in ego-resiliency and to relative decrease in feelings of vulnerability between ages 21 and 27, even when family and work variables were taken into account.
Although guilt is often identified as being a common emotion experienced by family caregivers in ... more Although guilt is often identified as being a common emotion experienced by family caregivers in the clinical literature and in small descriptive studies, it has only recently emerged as a construct in the empirical research focused on identifying predictors of caregiver distress. Using Pearlin's stress process model, and based on data from 66 midlife adult daughters caring for aging mothers, we explored the extent to which guilt contributes to caregiver burden. Hierarchical regression analysis revealed that guilt was positively correlated with burden and that it accounted for a significant amount of the variance in caregiver's sense of burden even after contextual and stressor variables were controlled. Our research suggests the importance of clinicians seeking to understand how individuals judge their caregiving performance and targeting negative self-appraisals, which affect individuals' mental health, for change. The challenge for clinicians is to help guilt-ridden caregivers revise their evaluative standards and engage in self-forgiveness and self-acceptance.
Posttraumatic stress symptoms are prominent in the lives of parents of young children with substa... more Posttraumatic stress symptoms are prominent in the lives of parents of young children with substance use disorders (SUD). Parenting experiences, particularly stress and competence, impact parenting behaviors and concomitant child growth and development. Factors that promote positive experiences of parenting, such as parental reflective functioning (PRF), and protect the mother and child from negative outcomes are crucial to understand to develop effective therapeutic interventions. The current US study analyzed baseline data from a parenting intervention evaluation to examine how length of substance misuse, PRF, and trauma symptoms were associated with parenting stress and parenting sense of competence among mothers in treatment for SUDs. Measures included the Addiction Severity Index, PTSD Symptom Scale‐Self Report, Parental Reflective Functioning Questionnaire, Parenting Stress Index/Short Form, and Parenting Sense of Competence Scale. The sample included 54 predominantly White mothers with SUDs who had young children. Two multivariate regression analyses found that (1) lower parental reflective functioning and higher posttraumatic stress symptoms were associated with higher parenting stress, and (2) only higher posttraumatic stress symptoms were associated with lower levels of parenting sense of competence. Findings underscore the importance of addressing trauma symptoms and PRF when aiming to improve parenting experiences for women with an SUD.
Turning points have been known to reverse the downward spiral of alcoholism and its concomitant a... more Turning points have been known to reverse the downward spiral of alcoholism and its concomitant associations with divorce, depression, and work-related difficulties. In this study, the authors present the stories of 3 women from the Mills Longitudinal Study who were alcoholic. Using a narrative approach, the authors tracked the women's developmental gains during recovery using Erik Erikson's theory of psychosocial development, specifically focusing on the tasks of identity, intimacy, and generativity. Results show that despite similar personal problems and turning points that moved them to stop drinking, each woman followed a different path to self-reconstruction and psychological growth. These accounts offer important information about individual differences in recovery from alcoholism, which are often lost in larger aggregate accounts of personal change.
Families in society-The journal of contemporary social services, 2011
Parental alcoholism does not necessarily result in negative outcomes for the offspring; we examin... more Parental alcoholism does not necessarily result in negative outcomes for the offspring; we examined whether it would result in negative perceptions of the experience. Black women and White women with alcoholic parents (N = 126) rated and described the effect of parental alcoholism on them: 65% reported a negative effect, 26% reported a positive effect, and 7% reported a neutral effect. We examined these ratings in relation to the women's overall adult adjustment. More positive ratings were associated with being Black and with variables such as social support, experiencing lower family conflict, and having no alcohol problem oneself. human service providers need greater access to research findings to see that children from these families will be diverse in their psychological and social functioning.
Objectives Substance misuse during pregnancy can be harmful to the health of both mothers and inf... more Objectives Substance misuse during pregnancy can be harmful to the health of both mothers and infants. Existing recovery services or prenatal care for pregnant women with substance use disorders (SUD) in the U.S. and other countries typically fall short in providing the necessary specialized care women with SUDs need. Disclosure of substance misuse is one key factor in gaining access to specialized prenatal care; yet, barriers such as social stigma and internal shame and guilt lead many women to under-report any substance misuse during their pregnancy. This study sought to understand the process of how and why pregnant women with SUDs choose to disclose or not disclose their substance misuse to their providers when seeking prenatal care. Methods Data were collected through interviews with N = 21 women with SUDs in the northeast U.S. whose young children had been exposed to opioids, cocaine, or MAT in utero. Thematic, inductive analysis using line-by-line coding was conducted to understand the perspectives of the women. Results The women's narratives suggested a clear tension regarding whether to disclose their substance misuse to any providers during their pregnancy. Four themes describing the process of disclosure or non-disclosure were found, including reasons for and ways of being secret or choosing to disclose their substance misuse during pregnancy. Conclusions for Practice The centrality of shame, guilt, and stigma regarding substance misuse must be addressed by medical and mental health providers in order to increase disclosure and improve access to care for women with SUDs.
To date, few studies have examined suicidality in women with postpartum depression. Reports of su... more To date, few studies have examined suicidality in women with postpartum depression. Reports of suicidal ideation in postpartum women have varied (Lindahl et al. Arch Womens Ment Health 8:77-87, 2005), and no known studies have examined the relationship between suicidality and mother-infant interactions. This study utilizes baseline data from a multi-method evaluation of a home-based psychotherapy for women with postpartum depression and their infants to examine the phenomenon of suicidality and its relationship to maternal mood, perceptions, and mother-infant interactions. Overall, women in this clinical sample (n=32) had wide ranging levels of suicidal thinking. When divided into low and high groups, the mothers with high suicidality experienced greater mood disturbances, cognitive distortions, and severity of postpartum symptomotology. They also had lower maternal self-esteem, more negative perceptions of the mother-infant relationship, and greater parenting stress. During observer-rated mother-infant interactions, women with high suicidality were less sensitive and responsive to their infants' cues, and their infants demonstrated less positive affect and involvement with their mothers. Implications for clinical practice and future research directions are discussed.
Posttraumatic stress symptoms are prominent in the lives of parents of young children with substa... more Posttraumatic stress symptoms are prominent in the lives of parents of young children with substance use disorders (SUD). Parenting experiences, particularly stress and competence, impact parenting behaviors and concomitant child growth and development. Factors that promote positive experiences of parenting, such as parental reflective functioning (PRF), and protect the mother and child from negative outcomes are crucial to understand to develop effective therapeutic interventions. The current US study analyzed baseline data from a parenting intervention evaluation to examine how length of substance misuse, PRF, and trauma symptoms were associated with parenting stress and parenting sense of competence among mothers in treatment for SUDs. Measures included the Addiction Severity Index, PTSD Symptom Scale‐Self Report, Parental Reflective Functioning Questionnaire, Parenting Stress Index/Short Form, and Parenting Sense of Competence Scale. The sample included 54 predominantly White mo...
Advances in developmental psychology, child psychiatry, and allied disciplines have pointed to ev... more Advances in developmental psychology, child psychiatry, and allied disciplines have pointed to events and experiences in the early years as the origin of many adult mental health challenges. Yet, children’s mental health services still largely lack a developmental or prevention-focused orientation, with most referrals to mental health professionals occurring late, once problems are well established. An early childhood mental health system rooted in the principles of life-course health development would take a very different approach to designing, testing, and implementing prevention and intervention strategies directed toward early child mental health. Priorities for such a system include supporting healthy family environments, parent–child and family relationships, parents’ emotional/behavioral health, and family routines as a means of providing the best possible neurobiological foundation for mental health across the life span. The system would include proactive, trauma-informed, ...
Families who enter the Child Welfare System (CWS) as a result of a caregiver's substance use fare... more Families who enter the Child Welfare System (CWS) as a result of a caregiver's substance use fare worse at every stage from investigation to removal to reunification (Marsh et. al 2007). Intervening with caregivers with Substance Use Disorders (SUDs) and their children poses unique challenges related to the structure and focus of the current CWS. Research demonstrates that caregivers with SUDs are at a greater risk for maladaptive parenting practices, including patterns of insecure attachment and difficulties with attunement and responsiveness (Suchman, 2006). Caregivers with SUDs have also often experienced early adversity and trauma. However, traditional addiction services generally offer limited opportunities to focus on parenting or trauma, and traditional parenting programs rarely address the special needs of parents with SUDs. This article details four innovative interventions that integrate trauma-informed addiction treatments with parenting for families involved in the child welfare system. Common mechanisms for change across programs are identified as critical components for intervention. This work suggests the need for a paradigm Dr. Emily Bosk serves as the Principle Investigator for the C.
Turning points have been known to reverse the downward spiral of alcoholism and its concomitant a... more Turning points have been known to reverse the downward spiral of alcoholism and its concomitant associations with divorce, depression, and work-related difficulties. In this study, the authors present the stories of 3 women from the Mills Longitudinal Study who were alcoholic. Using a narrative approach, the authors tracked the women’s developmental gains during recovery using Erik Erikson’s theory of psychosocial development, specifically focusing on the tasks of identity, intimacy, and generativity. Results show that despite similar personal problems and turning points that moved them to stop drinking, each woman followed a different path to self-reconstruction and psychological growth. These accounts offer important information about individual differences in recovery from alcoholism, which are often lost in larger aggregate accounts of personal change.
This study examines the relationship between levels of psychological distress in substancedepende... more This study examines the relationship between levels of psychological distress in substancedependent mothers and their differential response to a dyadic parent-child intervention. A sample of 66 mothers who were receiving treatment for substance abuse, as well as a simultaneous parenting intervention, were interviewed pre and post-treatment on measures of psychological distress, adult and child trauma history, parental reflective functioning, and child social-emotional development. Additionally, clinicians provided assessments of the parent-child relationships. As anticipated, trauma histories for mothers and children, children's social emotional development, and parental reflective functioning were associated with aspects of maternal psychological distress. Kruskal-Wallis and subsequent Wilcoxson signed rank tests revealed that women with highest levels of baseline psychological distress showed significant improvements in psychological functioning post-treatment while women with moderately elevated levels of psychological distress did not. Women who were most distressed at baseline showed increased levels of parental reflective functioning post-treatment while women with moderate and lower levels of baseline psychological distress showed improvements on clinician-rated assessments of parent-child relationships. Chi Square analyses showed that parents who endorsed the highest levels of distress at baseline reported that their children's risk status regarding social-emotional development decreased post-treatment. Despite similarities in substance dependence, mothers in this sample had different needs and outcomes in the context of this parenting intervention due to variation in mental health. Given this variation, parenting interventions for substancedependent mothers need to account for the individual differences in levels of psychological distress.
Society for Social Work and Research 17th Annual Conference: Social Work for a Just Society: Making Visible the Stakes and Stakeholders, Jan 20, 2013
ABSTRACT Background and Purpose: Past studies of mothers with Substance Use Disorders (SUDs) ofte... more ABSTRACT Background and Purpose: Past studies of mothers with Substance Use Disorders (SUDs) often demonstrate decreased capacities to understand and reflect upon their children's development and emotional experience (RF, reflective functioning) (Levy, Truman, & Mayes, 2001). These mothers frequently have histories of multiple trauma exposures, which in turn can be linked to elevated levels of psychological distress (Suchman, et al., 2005). Their children often experience increased trauma exposure and impaired development. All of these factors can contribute to dysfunction in mother-child interactions and attachment insecurities. Responding to the needs of these families and community service providers , two agencies and a university developed BRIGHT, an adaptation of evidence-based Child-Parent Psychotherapy (Lieberman & Van Horn, 2005), for mothers with children birth to five in residential treatment for SUDs. While this is the first time that CPP has been adapted for use with this population, the need for evidence-based interventions in community SUD settings is well-established (Bromberg et al, 2010). The weekly dyadic intervention (M= 14 sessions) concentrates on strengthening the parent-child relationship by improving mothers' mental health and promoting increased parental RF and parent-child attachment. This study focuses on outcome data from maternal self-reports and observer-rated parent-child interactions. Methods: Participants were 76 mothers (treatment group, n=52; comparison group, n=24), who were predominantly Caucasian, in their late 20s, with a child birth to five (M= 19 months). Most were high school educated, unemployed, single and in treatment for addiction to heroin and other opiates. All had severe histories of trauma exposure and high levels of psychological distress. The comparison group received SUD treatment, but did not receive BRIGHT. Data were collected with standardized measures at baseline and post-treatment and used to assess change in mothers' self-reported psychological distress, parental RF and attitudes, and observer ratings of parent-child interactions. Bivariate and multivariate analyses were computed to assess change over time in both treatment and comparison groups. Results: Maternal psychological distress levels at baseline were significantly associated with greater levels of traumatic exposure in children, and a higher risk of child maltreatment. BRIGHT mothers experienced significant improvements in their overall psychological distress. Those who improved most at follow-up self-reported more empathy with and appropriate expectations of their children. Clinician observers rated those same mothers as most improved in their parent-child relationships. Additionally, mothers who had more sessions demonstrated greater improvement in RF. None of these changes were found in comparison group participants. Conclusions and Implications: This study provides support for the multiple foci of BRIGHT and the feasibility of adapting evidence-based interventions to community settings. Specifically, improvement in psychological distress of mothers, which in turn was related to positive changes in self-reported parenting abilities and attitudes, and observer-rated parent-child interactions speaks to the complexities of shifting parenting relationships in highly traumatized substance using populations. Augmenting community SUD treatment with an evidence-based parenting intervention can improve mental health and parent-child relationships. Social work researchers and practitioners can benefit from this knowledge in order to advance effective programs and outcomes for families struggling with SUDs.
This study examined the context of the early mothering experience and how that experience was rel... more This study examined the context of the early mothering experience and how that experience was related to personality change in 48 members of a longitudinal sample of women from age 21 (in 1958 or 1960), before any of them were married, to age 27 (in 1963 or 1964). Early motherhood was analyzed in terms of (a) how positively the woman described her experience and (b) how willing and able she was to maintain the full-time commitment considered necessary in the early 1960s. Path analyses showed that these two dimensions had somewhat different interrelations with mother's personality, the marriage, and husband's personality and participation as a father. However, both dimensions were related to relative increase in ego-resiliency and to relative decrease in feelings of vulnerability between ages 21 and 27, even when family and work variables were taken into account.
Although guilt is often identified as being a common emotion experienced by family caregivers in ... more Although guilt is often identified as being a common emotion experienced by family caregivers in the clinical literature and in small descriptive studies, it has only recently emerged as a construct in the empirical research focused on identifying predictors of caregiver distress. Using Pearlin's stress process model, and based on data from 66 midlife adult daughters caring for aging mothers, we explored the extent to which guilt contributes to caregiver burden. Hierarchical regression analysis revealed that guilt was positively correlated with burden and that it accounted for a significant amount of the variance in caregiver's sense of burden even after contextual and stressor variables were controlled. Our research suggests the importance of clinicians seeking to understand how individuals judge their caregiving performance and targeting negative self-appraisals, which affect individuals' mental health, for change. The challenge for clinicians is to help guilt-ridden caregivers revise their evaluative standards and engage in self-forgiveness and self-acceptance.
Posttraumatic stress symptoms are prominent in the lives of parents of young children with substa... more Posttraumatic stress symptoms are prominent in the lives of parents of young children with substance use disorders (SUD). Parenting experiences, particularly stress and competence, impact parenting behaviors and concomitant child growth and development. Factors that promote positive experiences of parenting, such as parental reflective functioning (PRF), and protect the mother and child from negative outcomes are crucial to understand to develop effective therapeutic interventions. The current US study analyzed baseline data from a parenting intervention evaluation to examine how length of substance misuse, PRF, and trauma symptoms were associated with parenting stress and parenting sense of competence among mothers in treatment for SUDs. Measures included the Addiction Severity Index, PTSD Symptom Scale‐Self Report, Parental Reflective Functioning Questionnaire, Parenting Stress Index/Short Form, and Parenting Sense of Competence Scale. The sample included 54 predominantly White mothers with SUDs who had young children. Two multivariate regression analyses found that (1) lower parental reflective functioning and higher posttraumatic stress symptoms were associated with higher parenting stress, and (2) only higher posttraumatic stress symptoms were associated with lower levels of parenting sense of competence. Findings underscore the importance of addressing trauma symptoms and PRF when aiming to improve parenting experiences for women with an SUD.
Turning points have been known to reverse the downward spiral of alcoholism and its concomitant a... more Turning points have been known to reverse the downward spiral of alcoholism and its concomitant associations with divorce, depression, and work-related difficulties. In this study, the authors present the stories of 3 women from the Mills Longitudinal Study who were alcoholic. Using a narrative approach, the authors tracked the women's developmental gains during recovery using Erik Erikson's theory of psychosocial development, specifically focusing on the tasks of identity, intimacy, and generativity. Results show that despite similar personal problems and turning points that moved them to stop drinking, each woman followed a different path to self-reconstruction and psychological growth. These accounts offer important information about individual differences in recovery from alcoholism, which are often lost in larger aggregate accounts of personal change.
Families in society-The journal of contemporary social services, 2011
Parental alcoholism does not necessarily result in negative outcomes for the offspring; we examin... more Parental alcoholism does not necessarily result in negative outcomes for the offspring; we examined whether it would result in negative perceptions of the experience. Black women and White women with alcoholic parents (N = 126) rated and described the effect of parental alcoholism on them: 65% reported a negative effect, 26% reported a positive effect, and 7% reported a neutral effect. We examined these ratings in relation to the women's overall adult adjustment. More positive ratings were associated with being Black and with variables such as social support, experiencing lower family conflict, and having no alcohol problem oneself. human service providers need greater access to research findings to see that children from these families will be diverse in their psychological and social functioning.
Objectives Substance misuse during pregnancy can be harmful to the health of both mothers and inf... more Objectives Substance misuse during pregnancy can be harmful to the health of both mothers and infants. Existing recovery services or prenatal care for pregnant women with substance use disorders (SUD) in the U.S. and other countries typically fall short in providing the necessary specialized care women with SUDs need. Disclosure of substance misuse is one key factor in gaining access to specialized prenatal care; yet, barriers such as social stigma and internal shame and guilt lead many women to under-report any substance misuse during their pregnancy. This study sought to understand the process of how and why pregnant women with SUDs choose to disclose or not disclose their substance misuse to their providers when seeking prenatal care. Methods Data were collected through interviews with N = 21 women with SUDs in the northeast U.S. whose young children had been exposed to opioids, cocaine, or MAT in utero. Thematic, inductive analysis using line-by-line coding was conducted to understand the perspectives of the women. Results The women's narratives suggested a clear tension regarding whether to disclose their substance misuse to any providers during their pregnancy. Four themes describing the process of disclosure or non-disclosure were found, including reasons for and ways of being secret or choosing to disclose their substance misuse during pregnancy. Conclusions for Practice The centrality of shame, guilt, and stigma regarding substance misuse must be addressed by medical and mental health providers in order to increase disclosure and improve access to care for women with SUDs.
To date, few studies have examined suicidality in women with postpartum depression. Reports of su... more To date, few studies have examined suicidality in women with postpartum depression. Reports of suicidal ideation in postpartum women have varied (Lindahl et al. Arch Womens Ment Health 8:77-87, 2005), and no known studies have examined the relationship between suicidality and mother-infant interactions. This study utilizes baseline data from a multi-method evaluation of a home-based psychotherapy for women with postpartum depression and their infants to examine the phenomenon of suicidality and its relationship to maternal mood, perceptions, and mother-infant interactions. Overall, women in this clinical sample (n=32) had wide ranging levels of suicidal thinking. When divided into low and high groups, the mothers with high suicidality experienced greater mood disturbances, cognitive distortions, and severity of postpartum symptomotology. They also had lower maternal self-esteem, more negative perceptions of the mother-infant relationship, and greater parenting stress. During observer-rated mother-infant interactions, women with high suicidality were less sensitive and responsive to their infants' cues, and their infants demonstrated less positive affect and involvement with their mothers. Implications for clinical practice and future research directions are discussed.
Posttraumatic stress symptoms are prominent in the lives of parents of young children with substa... more Posttraumatic stress symptoms are prominent in the lives of parents of young children with substance use disorders (SUD). Parenting experiences, particularly stress and competence, impact parenting behaviors and concomitant child growth and development. Factors that promote positive experiences of parenting, such as parental reflective functioning (PRF), and protect the mother and child from negative outcomes are crucial to understand to develop effective therapeutic interventions. The current US study analyzed baseline data from a parenting intervention evaluation to examine how length of substance misuse, PRF, and trauma symptoms were associated with parenting stress and parenting sense of competence among mothers in treatment for SUDs. Measures included the Addiction Severity Index, PTSD Symptom Scale‐Self Report, Parental Reflective Functioning Questionnaire, Parenting Stress Index/Short Form, and Parenting Sense of Competence Scale. The sample included 54 predominantly White mo...
Advances in developmental psychology, child psychiatry, and allied disciplines have pointed to ev... more Advances in developmental psychology, child psychiatry, and allied disciplines have pointed to events and experiences in the early years as the origin of many adult mental health challenges. Yet, children’s mental health services still largely lack a developmental or prevention-focused orientation, with most referrals to mental health professionals occurring late, once problems are well established. An early childhood mental health system rooted in the principles of life-course health development would take a very different approach to designing, testing, and implementing prevention and intervention strategies directed toward early child mental health. Priorities for such a system include supporting healthy family environments, parent–child and family relationships, parents’ emotional/behavioral health, and family routines as a means of providing the best possible neurobiological foundation for mental health across the life span. The system would include proactive, trauma-informed, ...
Families who enter the Child Welfare System (CWS) as a result of a caregiver's substance use fare... more Families who enter the Child Welfare System (CWS) as a result of a caregiver's substance use fare worse at every stage from investigation to removal to reunification (Marsh et. al 2007). Intervening with caregivers with Substance Use Disorders (SUDs) and their children poses unique challenges related to the structure and focus of the current CWS. Research demonstrates that caregivers with SUDs are at a greater risk for maladaptive parenting practices, including patterns of insecure attachment and difficulties with attunement and responsiveness (Suchman, 2006). Caregivers with SUDs have also often experienced early adversity and trauma. However, traditional addiction services generally offer limited opportunities to focus on parenting or trauma, and traditional parenting programs rarely address the special needs of parents with SUDs. This article details four innovative interventions that integrate trauma-informed addiction treatments with parenting for families involved in the child welfare system. Common mechanisms for change across programs are identified as critical components for intervention. This work suggests the need for a paradigm Dr. Emily Bosk serves as the Principle Investigator for the C.
Turning points have been known to reverse the downward spiral of alcoholism and its concomitant a... more Turning points have been known to reverse the downward spiral of alcoholism and its concomitant associations with divorce, depression, and work-related difficulties. In this study, the authors present the stories of 3 women from the Mills Longitudinal Study who were alcoholic. Using a narrative approach, the authors tracked the women’s developmental gains during recovery using Erik Erikson’s theory of psychosocial development, specifically focusing on the tasks of identity, intimacy, and generativity. Results show that despite similar personal problems and turning points that moved them to stop drinking, each woman followed a different path to self-reconstruction and psychological growth. These accounts offer important information about individual differences in recovery from alcoholism, which are often lost in larger aggregate accounts of personal change.
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Papers by Ruth Paris