Co-Occurring Trajectory of Mothers' Substance Use and Psychological Control and Children's Behavior Problems: The Effects of a Family Systems Intervention

Fam Process. 2018 Mar;57(1):211-225. doi: 10.1111/famp.12279. Epub 2017 Feb 19.

Abstract

This study examined the effects of a family systems therapy (Ecologically-Based Family Therapy [EBFT]) on the co-occurring trajectory of mothers' substance use and psychological control, and its association with children's problem behaviors. Participants included 183 mothers with a substance use disorder who had at least one biological child in their care. Mothers were randomly assigned to one of the three intervention conditions: EBFT-home, n = 62; EBFT-office, n = 61; or Women's Health Education, n = 60. Participants were assessed at baseline, 3, 6, 12, and 18 months post-baseline. A dual-trajectory class growth analysis identified three groups of mothers in regard to their change trajectories. The majority of the mothers exhibited a synchronous decrease in substance use and psychological control (n = 107). In all, 46 mothers exhibited a synchronous increase in substance use and psychological control. For the remaining 30 mothers, substance use and psychological control remained stable. Mothers in the family therapy condition were more likely to show reduced substance use and psychological control compared to mothers in the control condition. Moreover, children with mothers who showed decreased substance use and psychological control exhibited lower levels of problem behaviors compared to children with mothers showing increased substance use and psychological control. The findings provide evidence for the effectiveness of family systems therapy, EBFT, in treating mothers' substance use, improving parenting behaviors, and subsequently improving child behavioral outcomes.

Keywords: Children's Behavior Problems; Family Systems Intervention; Psychological Control; Randomized Clinical Trial; Substance Using Mothers; control psicológico; ensayo clínico aleatorizado; intervención sistémica familiar; madres que consumen sustancias; problemas de comportamiento en los niños; 儿童行为问题; 家庭系统干预; 心理控制; 滥用药物的母亲们; 随机临床试验.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Child
  • Child Behavior / psychology
  • Child Behavior Disorders / psychology*
  • Child of Impaired Parents / psychology*
  • Family Therapy / methods*
  • Female
  • Humans
  • Maternal Behavior / psychology
  • Mother-Child Relations
  • Mothers / psychology*
  • Problem Behavior / psychology*
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / therapy*
  • Treatment Outcome