Long-Term Follow-Up of Mothers and Children Treated for Maternal Substance Use: A Mixed Methods Approach

Maternal substance use is a major public health concern that can lead to various negative outcomes for women, children, and society. Previous research has shown how integrated substance use interventions promote positive short-term outcomes for these families, although more long-term evidence is needed. Emerging evidence points to several treatment processes by which integrated programs enhance client outcomes, yet more research is needed here as well. For this research, I worked together with Mothercrafts Breaking the Cycle [BTC] to co-create a long-term follow-up evaluation of mothers who participated in BTCs integrated, relationship-based substance use intervention for pregnant or mothering women to examine the trajectories of mothers and children in the years following treatment, as well as to identify those elements of treatment mothers perceived as most helpful. Case studies and a general summary of outcomes are presented that detail the journeys of four women and their children through substance use and recovery, and themes that arose from interviews with these women are explored. In the years following treatment, each woman continued to abstain from problematic substance use and reported generally good physical and psychological health for themselves and their children. Where health challenges existed, they were actively coped with. Mothers reported good family and peer relationships for themselves and their children. Each family lived in stable housing and had consistent sources of income, and two mothers advanced their education post-treatment. Children were each enrolled in school at the appropriate grade for their age; where needed, accommodations had been arranged. No involuntary child protection or legal involvement was reported. Thematic analysis of the interviews yielded six central themes factoring into families development post-treatment: choosing change, coping is ongoing, healthy boundaries, self-advocacy, stigma, and continuum of harm reduction. Intervention elements at BTC identified by mothers as instrumental to positive post-treatment outcomes included: acceptance and safety, open-door policy, wraparound services, quality of care and education, teaching and modelling healthy relationships, and the uniqueness of BTC. The present results will inform larger scale follow-up research at BTC and will contribute to the literature on treatment processes and outcomes for women who participate in integrated substance use treatment.