Maternal Substance Use Treatment During A Time Of Crisis: The Effect Of COVID-19 Restrictions On Programming, Family Functioning, And Community Service Engagement

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dc.contributor.advisorDebra Pepler
dc.contributor.authorJanus, Monika Kamila
dc.date.accessioned2025-07-23T15:22:22Z
dc.date.available2025-07-23T15:22:22Z
dc.date.copyright2025-05-05
dc.date.issued2025-07-23
dc.date.updated2025-07-23T15:22:22Z
dc.degree.disciplinePsychology (Functional Area: Clinical-Developmental)
dc.degree.levelDoctoral
dc.degree.namePhD - Doctor of Philosophy
dc.description.abstractSubstance use among pregnant and parenting women is a problem in Canada which was exacerbated by the COVID-19 pandemic. Stressors that drive and sustain maternal substance use can be understood through a domain-specific conceptualization of risk and protection. Although integrated treatment promotes positive outcomes in substance-involved families, there is limited understanding of how the pandemic affected clients referred to treatment. Methods: This study used qualitative and quantitative data to evaluate the influence of the pandemic and its related health restrictions on families referred to Breaking the Cycle (BTC), an integrated treatment program for maternal substance use. In Study 1, interviews from three BTC staff members were analysed using thematic analysis to investigate changes to BTC programming, client engagement and psychosocial functioning, and access to partnering agencies, from pre-pandemic to during the pandemic. Subsequently, quantitative analyses were completed to compare clients referred to BTC pre-pandemic vs. during the pandemic using the profiles of 68 families (Study 2) and to evaluate cumulative risk and protection profiles of 30 families (Study 3). Results: Thematic analyses in Study 1 yielded 2 primary themes, 5 secondary themes, and 12 tertiary themes. Marginalized, substance-involved families referred during the pandemic, compared to pre-pandemic, were found to have increased rates of displacement, interpersonal violence, substance use, and reduced access to family supports, among others. In turn, protective intervention factors, including the relational and predictable nature of programming, emerged as critical to service engagement. Study 2 indicated that women referred during the pandemic, compared to pre-pandemic, reported less engagement with services, more depressive symptoms, lower self-efficacy around their substance use and a trend suggesting increased use during pregnancy. Study 3 revealed that 7% of pre-pandemic families vs. 50% of pandemic families were characterized by more domains of risk relative to protection. A mixed-methods investigation revealed specific factors of risk and protection that characterized moderate-to-high-risk vs. low-risk families. Conclusions: The findings revealed exacerbated levels of adversity experienced by these families during the pandemic. This research contributes to an evolving understanding of the interplay of cumulative risk and protective factors, with clinical and policy implications for early intervention work.
dc.identifier.urihttps://hdl.handle.net/10315/43057
dc.languageen
dc.rightsAuthor owns copyright, except where explicitly noted. Please contact the author directly with licensing requests.
dc.subjectDevelopmental psychology
dc.subjectPublic health
dc.subjectMental health
dc.subject.keywordsMaternal substance use; COVID-19 pandemic; Integrated treatment program; Public health; Marginalized populations; Pregnant and parenting women; Child development; Qualitative analysis; Thematic analysis; Mixed-methods design
dc.titleMaternal Substance Use Treatment During A Time Of Crisis: The Effect Of COVID-19 Restrictions On Programming, Family Functioning, And Community Service Engagement
dc.typeElectronic Thesis or Dissertation

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