Background: Integratedtreatment programs (those that include on-site pregnancy-, parenting-,or child-related services with addiction services) were developed tobreak the intergenerational cycle of addiction, dysfunctional parenting,and poor outcomes for mothers and children, yet there has been nosystematic review of studies of parenting outcomes.
Objectives:Aspart of larger systematic review to examine the effectiveness ofintegrated programs for mothers with substance abuse issues, weperformed a systematic review of studies published from 1990 to 2011with data on parenting outcomes.
Methods: Literaturesearch strategies included online bibliographic database searches,checking printed sources, and requests to researchers. Studies wereincluded if all participants were mothers with substance abuse problemsat baseline, the treatment program included at least one specificsubstance use treatment and at least one parenting or child service, andthere were quantitative data on parenting outcomes. We summarized dataon parenting skills and capacity outcomes.
Results: Therewere 24 cohort studies, 3 quasi-experimental studies, and 4 randomizedtrials. In the three randomized trials comparing integrated programs toaddiction treatment-as-usual (N = 419), most improvements inparenting skills favored integrated programs and most effect sizesindicated that this advantage was small, ds = -0.02 to 0.94.Results for child protection services involvement did not differ bygroup. In the three studies that examined factors associated withtreatment effects, parenting improvements were associated withattachment-based parenting interventions, children residing in thetreatment facility, and improvements in maternal mental health.
Conclusions:Thisis the first systematic review of studies evaluating the effectivenessof integrated programs on parenting. The limited available evidencesupports integrated programs, as findings suggest that they areassociated with improvements in parenting skills. However, more researchis required comparing integrated programs to addictiontreatment-as-usual. This review highlights the need for improvedmethodology, study quality, and reporting to improve our understandingof how best to meet the parenting needs of women with substance abuseissues. (Authors)