Engaging mothers with substance use issues and their children in early intervention: Understanding use of service and outcomes

Child Abuse Negl. 2018 Sep;83:10-20. doi: 10.1016/j.chiabu.2018.06.011. Epub 2018 Jun 27.


Mothers who use substances need integrated, multi-sectoral intervention services to support substance use discontinuation. We explored mothers' service use at Breaking the Cycle, an early intervention and prevention program for pregnant and parenting women and their young children in Toronto, Canada. We conducted retrospective analyses of families' service records and client charts (N = 160). Aims were to 1) describe women's use of service, 2) examine how early engagement of pregnant women related to postnatal service use, and 3) examine the circumstances in which women ended their service relationship with Breaking the Cycle. Specifically, we examined circumstances at service ending relating to women's service goals; custody status with children; and global substance-use, parent-child relationship, and child development outcomes. We found that these vulnerable women were actively engaged in many services and for a long duration, early engagement was associated with greater service use, and greater service use was associated with more positive circumstances upon ending service. Results provide support for a relational approach to service that promotes not only the relationship between mother and child, and mother and service provider, but also highlights relationships among staff, between staff and management, and between community partners as integral to effective service delivery. Integrating positive relationships at all levels is critical to support vulnerable families with complex needs.

Keywords: Early engagement; Integrated service; Polysubstance use; Pregnancy; Relational approach; Service use.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Early Medical Intervention / statistics & numerical data*
  • Facilities and Services Utilization
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Longitudinal Studies
  • Middle Aged
  • Mother-Child Relations
  • Mothers / psychology
  • Ontario
  • Parenting
  • Patient Acceptance of Health Care / statistics & numerical data
  • Pregnancy
  • Retrospective Studies
  • Substance-Related Disorders / rehabilitation*
  • Treatment Outcome
  • Young Adult

Grant support