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This pilot study utilized phenomenological methodology to explore relational systems for ten mothers enrolled in family-centered substance use treatment. Participants described their experiences during motherhood and addiction. Analysis revealed themes that captured the interpersonal relationships of maternal substance use: (1) parent-child relationships in the context of maternal substance use disorders (SUDs), (2) interaction between romantic relationships and maternal substance use, and (3) intergenerational relationships among mothers and grandmothers. Mothers discussed these complicated and simultaneous roles and relationships that impacted their substance use and recovery within the context of family. Using ecostructural family therapy, we offer clinical recommendations with the aim of creating organizational change for families in recovery.

Substance use among pregnant and postpartum women (PPW) is a serious public health concern. The COVID-19 pandemic has exacerbated substance use among the general population including pregnant women, and disrupted operations for substance use treatment centers. Little is known about the outcomes of substance use treatment for PPW before and during the COVID-19 pandemic.Data from a longitudinal program evaluation were analyzed to examine outcomes among 136 PPW participating in a residential SUD treatment program, and to explore differences in treatment outcomes for women who enrolled in services before versus during the COVID-19 pandemic. Analyses were used to test the significance of change from treatment intake to 6-month post-intake on assessments of substance use, mental health symptoms, and functioning collected to evaluate the Healthy Families Program (HFP), a comprehensive program for PPW located within a gender-specific SUD treatment facility in the United States.Results indicated that from treatment intake to follow-up assessment, clients self-reported statistically significant improvements in family functioning and daily functioning as well as reduced days of substance use. Notably, the rate of treatment intakes declined during the COVID-19 pandemic. In separate analyses by subgroup, mental health indicators showed improvements only for clients engaged in treatment before the COVID-19 pandemic and not for clients served during the COVID-19 pandemic, but substance use decreased significantly for both pre-pandemic and pandemic enrollees.Specialized treatment considerations and implications for PPW are discussed, including a need for added emphasis on co-occurring mental health symptoms and family system stress during a pandemic, and the role of nurses in identifying and addressing these concerns. Additionally, potential relapse prevention efforts during COVID-19 for PPW with substance use disorders are examined.The present research continues to highlight the importance of specialized treatment programming for PPW with SUDs as well as the potential need for additional recovery support mechanisms to be utilized during the COVID-19 pandemic.

Hybrid identity theory was utilized to understand how race and ethnicity were perceived from the perspective of Afro-Caribbean women living in the U.S. Thematic analysis revealed four themes: (1) inability to understand African Americans’ experiences, (2) feelings of racial and gender bias, (3) racial pride in the Black community, and (4) ethnic pride in the Caribbean community as a protective factor. Findings indicate that women's observed racial role distancing was a fluid process where women moved freely between ethnic difference and racial togetherness depending on their perceptions of racial stereotypes among the African American community. Clinical implications are offered.

The purpose of this Delphi pilot study was to 1) identify potential benefits to people who experienced perinatal loss if a term were established; 2) develop a term for people who experienced a peri...

The present study used a process evaluation to explore a women-specific program that addresses the complex treatment needs of pregnant and postpartum women (PPW) with substance use disorders (SUDs). Data was collected from program participants (N = 29), the primary treatment center, key partners (N = 7), and representatives from community stakeholders (N = 11). Successes and challenges of implementing a program for PPW with SUDs were determined. Results indicated successes among initial planning stages, client satisfaction, and stakeholder collaboration, while challenges to service delivery and larger system collaboration are discussed.

The role of religion for resettled refugees is particularly complex and illuminating. In the context of migration, the opportunity for increased positive outcomes has the potential to play a vital role in coping with the often tumultuous migration and resettlement experiences of refugees. We share qualitative findings from 14 Karen refugees for whom religious practices are inextricably tied to resilience through family closeness and community-building. Ethnographic methods were used to deeply understand participants’ resilience, and all described their faith and trust in God as an important part of their coping with traumatic experiences before and following resettlement in the United States. Findings are focused around descriptions of overcoming adversity, continuity in chaos, and connecting with their community and family.

This study was conducted to determine the generalizability of the Mother–Adult Daughter Questionnaire (MAD) for first- and second-generation Afro-Caribbean women. The measure was created specifically to explore adult daughters’ reports of their relationship with their mothers in order to capture the values of connectedness, trust in hierarchy, and interdependence in the mother–daughter relationship. We test this cross-generational applicability to (1) determine the generalizability of the measure for first- and second-generation women and (2) assess whether the means of the subscales differ across first- and second-generation women. Confirmatory factor analysis (CFA) was used to test the factor structure of the MAD with this population. The sample ( N = 285) was comprised of reports from 129 adult daughters born in the United States and 156 born in the Caribbean. CFAs indicated that the scoring algorithm for the subscales fit these data well. Results indicated that the MAD subscales (Connectedness, Trust in Hierarchy, and Interdependence) were applicable and may operate similarly across first- and second-generation Afro-Caribbean women.

In psychotherapy research, adherence refers to the extent to which therapists deliver a treatment as intended. This study examined whether therapist adherence to two different manualized treatments was associated with improved client outcomes and whether the association was moderated by therapeutic alliance. The study sample included 320 video recordings of therapy sessions from 118 cases in a randomized controlled trial (RCT) comparing attachment-based family therapy (ABFT) with family-enhanced nondirective supportive therapy (FE-NST). Recordings were selected from early, middle, and late stages of treatment. The adherence measure consisted of 24 items representing essential therapist interventions from both treatments. Trained raters coded tapes from both therapies. Adolescent self-report of alliance was measured at session 4. Adherence to ABFT was associated with a significant increase in family cohesion at mid-treatment but not at posttreatment. Adherence to FE-NST was significantly associated with an increase in suicide ideation posttreatment. Using therapeutic alliance as a moderator, adherence to ABFT was significantly associated with a reduction in suicide ideation, family conflict, and higher client satisfaction posttreatment. Alliance did not positively affect the association of FE-NST adherence to outcomes. Findings suggest that adherence to ABFT interventions may be better linked to treatment outcomes when adolescents feel a strong alliance with their therapist. Implications for future research and therapist training are explored.En la investigación sobre psicoterapia, la adhesión se refiere al grado en el cual los terapeutas brindan un tratamiento según lo previsto. Este estudio analizó si la adhesión del terapeuta a dos tratamientos estandarizados diferentes estuvo asociada con mejores resultados en los pacientes y si la asociación estuvo moderada por la alianza terapéutica. La muestra del estudio incluyó 320 videograbaciones de sesiones de terapia de 118 casos en un ensayo aleatorizado controlado donde se comparó la terapia familiar basada en el apego (TFBA) con la terapia de apoyo no directiva optimizada por la familia (TAND-OF). Se eligieron grabaciones de las etapas iniciales, intermedias y finales del tratamiento. El instrumento de medición de la adhesión consistió en 24 ítems que representaban intervenciones esenciales del terapeuta de ambos tratamientos. Un grupo de calificadores capacitados codificaron las grabaciones de ambas terapias. El autoinforme de alianza de los adolescentes se midió en la cuarta sesión. La adhesión a la TFBA estuvo asociada con un aumento considerable de la cohesión familiar en la mitad del tratamiento, pero no después del tratamiento. La adhesión a la TAND-OF estuvo asociada considerablemente con un aumento de la ideación suicida después del tratamiento. Utilizando la alianza terapéutica como moderadora, la adhesión a la TFBA estuvo asociada considerablemente con una reducción de la ideación suicida, el conflicto familiar y una mayor satisfacción del paciente después del tratamiento. La alianza no afectó positivamente la asociación de la adhesión a la TAND-OF con los resultados. Los resultados sugieren que la adhesión a las intervenciones de TFBA puede asociarse mejor con los resultados del tratamiento cuando los adolescentes sienten una alianza fuerte con su terapeuta. Se analizan las implicancias para futuras investigaciones y para la capacitación de los terapeutas.在心理治疗研究中,治疗一致性是指治疗师按照预设方案提供治疗的程度。本研究考察了治疗师自始至终地执行两种不同的遵循手册式的治疗是否与改善病人治疗结果相关,以及治疗联盟是否调节了这种关联性。研究样本包括来自118例随机对照试验(RCT)的320个治疗过程的视频记录, 试验比较了基于依恋的家庭治疗(ABFT)和家庭赋能强化的非指导性的支持治疗(FE-NST) 这两种方式。从治疗的早期、中期和晚期选取视频记录。治疗一致性措施由24个项目组成, 代表两种治疗手段中的基本的治疗师干预。训练有素的评价员对两种疗法的视频进行编码。在第4阶段测量了青少年关于联盟的自我报告。忠实执行ABFT与治疗中期的家庭凝聚力显著增加有关联, 但治疗后并没有。遵循FE-NST的治疗与治疗后自杀意念增加显著相关。以治疗联盟作为调节因子, 坚持ABFT与治疗后自杀意念的减少、家庭冲突减少和更高的病人满意度显著相关。联盟对FE-NST坚持治疗的一致性结果没有积极影响。研究结果表明, 当青少年感觉与他们的治疗师有很强的联盟时, 坚持ABFT干预可能与治疗结果有更好的联系。本文对未来的研究和治疗师培训的启示都进行了探讨。.

The experiences of formerly incarcerated mothers are rarely examined despite the sharp rise in female incarceration over the past 2 decades. This project used a transcendental phenomenological approach and in-depth interviews with 12 formerly incarcerated mothers as they reflected on their motherhood experiences before, during and after their incarceration. Mothers described how they struggled to negotiate their own stress, trauma, addiction, and shame, and offer insights for how service systems and professionals can help mothers reunify with their families and re-enter society. Clinical implications for systems of care, policy and practice are explored.

Sexual scripts are socially constructed guidelines that purportedly determine sequencing of individual sexual behavior. For older adults' sexual scripts are often ageist, perceiving them as asexual...

Refugee related issues have become more prominent in Western policy-makers’ discussions as families fleeing oppression and unimaginable violence cross borders seeking safety and are sometimes reset...

The middle initial of coauthor Bertranna A. Muruthi was incorrectly given as “M.” in this article as originally published.

Behavioral health and substance use centers have started focusing efforts on creating, adopting, and implementing evidence-based practices and programs that effectively address the needs of women and, particularly, mothers entering treatment with children. However, women with substance use disorders (SUDs) remain an underserved and understudied population; even less studied are the complexities and unique SUD treatment needs of women who have children. Family therapists' systemic training is a valued approach in conceptualizing and implementing treatment for mothers with SUDs and their families. This study explored the construct of mothering children during family-centered substance use treatment using a transcendental phenomenological approach. Analysis revealed themes related to motherhood, parenting, and support for mothers and children. Two themes emerged from the data: (a) grappling with motherhood and addiction leading to the decision for treatment and (b) specific aspects of the treatment program conducive to motherhood. Results indicated the positive impact of mothers' experiences in family-centered substance use treatment, aligning with previous literature that suggests mothers are more engaged in treatment when their children remain in their care. The insights gleaned from the participants in this study provide suggestions for further improving programming that supports mothers and their children during the recovery process. Treatment considerations are offered for family therapists working with mothers with SUDs and their families.Los centros para la salud conductual y el consumo de sustancias han comenzado a centrar sus esfuerzos en la creación, la adopción y la implementación de prácticas y programas factuales que aborden eficazmente las necesidades de las mujeres y, particularmente, de las madres que ingresan en un tratamiento con hijos. Sin embargo, las mujeres con trastorno por consumo de sustancias siguen siendo una población marginada y poco estudiada; y aun menos estudiadas son las complejidades y las necesidades exclusivas de tratamiento para los trastornos por consumo de sustancias de las mujeres que tienen hijos. La capacitación sistémica de los terapeutas familiares es un enfoque valioso a la hora de conceptualizar e implementar el tratamiento para las madres con trastornos por consumo de sustancias y sus familias. Este estudio analizó el constructo de la maternidad durante el tratamiento para el consumo de sustancias centrado en la familia utilizando un enfoque fenomenológico trascendental. El análisis reveló temas relacionados con la maternidad, la paternidad y el apoyo para las madres y los hijos. De los datos surgieron dos temas: (a) la lucha con la maternidad y la adicción conducente a la decisión de recibir tratamiento y (b) aspectos específicos del programa de tratamiento favorables para la maternidad. Los resultados indicaron el efecto positivo de las experiencias de las madres en el tratamiento para el consumo de sustancias centrado en la familia en consonancia con bibliografía anterior que sugiere que las madres se comprometen más con el tratamiento cuando sus hijos quedan a su cuidado. Las apreciaciones recogidas de los participantes de este estudio ofrecen sugerencias para mejorar más las programaciones que apoyen a las madres y a sus hijos durante el proceso de recuperación. Se ofrecen consideraciones sobre el tratamiento para los terapeutas familiares que trabajan con madres con trastornos por abuso de sustancias y sus familias.行为健康和物质使用中心开始把努力的重心放在创造、采用、实施循证措施和相关项目,以期有效地针对女性的需要,特别是那些带孩子一起开始接受治疗的母亲们的需要。但是,药物滥用失常(SUDs)的女性仍然是较少被关注和较少被研究的人群,更不用说关注和研究那些有孩子要抚养的女性,她们对于治疗药物滥用失常症状的特殊治疗需要及其复杂性。家庭治疗师的系统性训练是一个受到重视的方法,它有助于增进对针对药物滥用失常(SUDs)的母亲们及其家庭的治疗的理解和治疗的具体实施。这项研究使用超验的现象学研究方法,探索了在家庭为中心的物质使用治疗期间的母亲们如何抚育孩子。数据分析归纳出和母亲,养育孩子,给母亲和孩子的支持相关方面的主题。有两个明显的主题浮现出来: (a) 从养育孩子和物质使用上瘾两方面的斗争中确定下对母亲的治疗方案； (b) 治疗方案里的有助于母亲养育的特定方面。结果显示在家庭为中心的物质使用治疗中对母亲方面的积极影响作用,这和以前的研究中提到的母亲同时抚养孩子时母亲会更加投入参与治疗保持一致。本研究的参与者们提出的洞见提供了进一步改善项目的建议,有助于在康复过程中更好地支持母亲们及其孩子们。给治疗有SUDs的母亲及其家庭的家庭治疗师的建议和有待考虑的问题都有所讨论。.

Parenting self-efficacy has been linked to positive parent and child outcomes however, little research exists on factors that influence parenting self-efficacy among pregnant women with substance use disorders.This study explored substance use severity, social support, and family empowerment as predictors of parenting self-efficacy among pregnant women (N = 71) entering SUD treatment.The study used a quantitative cross-sectional design.Statistically significant positive correlations emerged between social support and parenting self-efficacy as well as family empowerment and parenting self-efficacy. Family empowerment and social support were also correlated. A backward elimination regression analysis revealed family empowerment to be the strongest predictor of parenting self-efficacy. No relationships were found among substance use severity and the study variables.When promoting parenting self-efficacy, both social support and family empowerment are important domains to consider for treatment planning and resource development among pregnant women with substance use disorders.

The current study addressed treatment engagement, or lack thereof, for women in a residential substance use treatment facility who had co-occurring post-traumatic stress disorder (PTSD) and heroin dependency diagnoses. Results indicated that having previous drug treatment was positively related to treatment engagement and children in care was marginally positively related to engagement, while stressors related to employment and education were a detriment to remaining engaged in treatment. Trends in participants’ family history indicated that (1) participants who had received previous mental health treatment, had a family history of mental health problems, and (2) use of multiple substances was marginally associated with a family history of drug use.

The co-morbidity of personality disorders (PDs) and other dysregulatory personality patterns with addiction have been well-established, although few studies have examined this interplay on long-term sobriety outcome. In addition, health care professionals suffering from addiction have both a significant public health impact and a unique set of treatment and recovery challenges. The aim of this study was to investigate if personality variables differentiated sobriety outcome in this population over a two year interval. A clinical sample of health care professionals participated in a substance abuse hospital treatment program individually tailored with respect to personality. Participants took the Temperament and Character Inventory and the Millon Clinical Multiaxial Inventory at intake, and were tracked two years post-discharge to determine sobriety status. Univariate analyses showed antisocial personality, female gender, and alcohol dependence were independent predictors of relapse, however a significant relationship between personality and substance use did not exist in multivariate analysis when controlling for demographic variables The lack of multivariate relationships demonstrates the heterogeneity in self-report measures of personality, which suggests the interplay of personality and addiction is complex and individualized.

Objective to describe parenting self-efficacy and family empowerment among expectant mothers with substance use disorders. Design the study employed a quantitative cross-sectional design. Participants participants were 71 pregnant women with substance use disorders entering a gender-specific, substance use disorder, residential treatment facility. Measurements measurement tools included: the demographic data form, the Parenting Sense of Competence Scale, the Addiction Severity Index, and the Family Empowerment Scale. Findings women in their third trimester reported statistically significant higher levels of both parenting self-efficacy and family empowerment than women in their first trimester. Key conclusions interventions that promote parenting self-efficacy and family empowerment need to target women in their first trimester. Implications for practice midwives with specialized training in substance abuse disorders are in a unique position to bolster expectant mothers' parenting capabilities during the addiction recovery process.

This article explores attachment theory from a multicultural perspective to highlight adaptive considerations for immigrant families. The specific considerations of the theory reviewed are (1) attachment sensitivity based on social and cultural context and (2) the effect of maturation on families’ developmental needs and how this can be integrated within context. A case conceptualization of a Bosnian immigrant family living within the United States will highlight potential variations in the adaptation process. How therapists can support in providing culturally-sensitive applications of attachment theory to promote family relationships will be discussed.