Fatherhood Engagement Program for Substance Use Disorders

Overseen By Alessandra de Marchena, LCSW

Age: 18+

Sex: Male

Trial Phase: Academic

Sponsor: Montefiore Medical Center

Disqualifiers: All children in foster care

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 6 months

240 Participants Needed

Trial Summary

What is the purpose of this trial?

Montefiore will engage fathers in families at risk of substance misuse in the Bronx and neighboring communities. Families will be referred from Bronx and neighboring community-based child welfare systems, substance use disorder (SUD) treatment providers, and medical providers if identified at risk of substance use concerns and will be randomly assigned to receive services as usual as part of the comparison group, or to receive enhanced services as part of the program group. Enhanced services include: (1) Motivational Enhancement; (2) referral to Healthy, Empowered, Resilient, and Open (HERO) Dads fatherhood engagement program; (3) Contingency Management; and (4) Case Management.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the Fatherhood Engagement Program for Substance Use Disorders treatment?

Research shows that incorporating fatherhood-focused interventions in substance use disorder treatment can improve parenting skills, reduce ineffective parenting, and decrease anger and emotional regulation issues. These programs have shown promise in enhancing fathers' involvement and reducing substance use, which can positively impact their children's behavior. ^{1 2 3 4 5}

Is the Fatherhood Engagement Program for Substance Use Disorders safe for participants?

The studies reviewed suggest that fatherhood-focused interventions in substance use disorder treatment are generally safe, with high participant satisfaction and completion rates. Participants reported improvements in parenting skills, reduced anger, and better emotional regulation, indicating positive and safe outcomes. ^{1 3 4 5 6}

How is the HERO Dads Fatherhood Program treatment different from other treatments for substance use disorders?

The HERO Dads Fatherhood Program is unique because it specifically integrates fatherhood and parenting support into substance use disorder treatment for men, which is rarely done. This approach is modeled after successful programs for women that focus on motherhood, aiming to improve parenting skills and family relationships, which can enhance recovery outcomes. ^{1 3 4 7 8}

Research Team

Scott Wetzler, PhD

Principal Investigator

Montefiore Medical Center

Eligibility Criteria

This trial is for fathers, whether they live with their children or not, who have at least one child under 18. They must be part of a family where someone is at risk for substance use issues. Fathers whose children are all in foster care cannot participate.

Inclusion Criteria

Is a custodial or non-custodial father

I have at least one child under 18.

Someone in the family is identified as at-risk for substance use

Exclusion Criteria

The placement of all children in the family in foster care

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive enhanced services including Motivational Enhancement, referral to HERO Dads program, Contingency Management, and Case Management

6 months

Follow-up

Participants are monitored for child well-being and behavior outcomes after receiving services

6 months

Treatment Details

Interventions

• Case Management
• Contingency Management
• HERO Dads Fatherhood Program
• Motivational Enhancement

Trial Overview The study tests if extra support services can help fathers in families at risk of substance misuse. Some dads will get usual services; others will also get motivational talks, the HERO Dads program, rewards for positive behavior (Contingency Management), and Case Management.

Participant Groups

Group I: Enhanced Fatherhood Services through Regional Partnership Grant Round 7 (RPG7) Experimental Treatment 4 Interventions

Randomly assigned to receive enhanced RPG7 services (motivational enhancement, fatherhood engagement services, contingency management, case management)

Group II: Services as Usual Active Control 1 Intervention

Randomly assigned to receive services as usual

Who Is Running the Clinical Trial?

Montefiore Medical Center

Lead Sponsor

Trials

468

Recruited

599,000+

Albert Einstein College of Medicine

Collaborator

Trials

302

Recruited

11,690,000+

Findings from Research

A study involving 44 fathers in a substance use disorder treatment program showed that incorporating a fatherhood-focused intervention significantly reduced anger-related thoughts and emotion regulation problems after the program.

The intervention, called Fathers for Change, had a high completion rate of 84.1% among participants, indicating strong feasibility and satisfaction with the program's content.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Integrating intimate partner violence and parenting intervention into residential substance use disorder treatment for fathers. Stover, CS., Carlson, M., Patel, S.[2019]

In a study of 125 children with an average age of 9.8 years, it was found that greater involvement of alcohol-dependent fathers in 12-step treatment programs was linked to lower externalizing problems in their children after 12 months.

The positive impact of fathers' treatment involvement on children's behavior was mediated by the fathers' subsequent behaviors, including increased attendance at Alcoholics Anonymous and greater abstinence from alcohol, which were associated with improved child outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Alcoholics Anonymous attendance following 12-step treatment participation as a link between alcohol-dependent fathers' treatment involvement and their children's externalizing problems. Andreas, JB., O'Farrell, TJ.[2022]

Substance use treatment programs often overlook the parenting status of men, despite evidence that programs focusing on gender and motherhood improve treatment outcomes for women.

The paper presents pilot outcomes from a fatherhood-focused intervention in a residential treatment program, suggesting that integrating parenting components could enhance treatment effectiveness and positively impact child welfare.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Where's Dad? The Importance of Integrating Fatherhood and Parenting Programming into Substance Use Treatment for Men. Stover, CS., Carlson, M., Patel, S., et al.[2020]

The Fathering in Recovery (FIR) intervention, a video-based program adapted for fathers in their first year of recovery from substance use disorders, significantly improved parenting knowledge and fathering efficacy among participants, based on a pilot study of 41 fathers.

FIR also showed potential in reducing ineffective parenting practices and child behavior problems, indicating that this intervention could positively impact families affected by substance use disorders, although further research is needed to confirm these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized controlled trial to improve fathering among fathers with substance use disorders: Fathering in recovery intervention. Cioffi, CC., Browning O'Hagan, AM., Halvorson, S., et al.[2023]

In a study of 230 divorced fathers over 18 months, one third were clinically depressed, but overall, there were reductions in depression, smoking, and marijuana use, indicating potential improvements in mental health and substance use.

Fathering identity and involvement were linked to better health outcomes, as increased father involvement was associated with reduced drinking and marijuana use, highlighting the importance of supportive fathering in promoting healthier behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patterns and predictors of growth in divorced fathers' health status and substance use. DeGarmo, DS., Reid, JB., Leve, LD., et al.[2021]

Community-based programs for low-income fathers often face challenges in achieving high attendance rates, but some programs successfully engage fathers in parenting and economic security classes.

Higher levels of participation (or dosage) in these programs are positively associated with better outcomes for fathers, including increased engagement with children, improved parenting satisfaction, and higher earnings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Fathers' Dosage in Community-based Programs for Low-income Fathers. Fagan, J., Pearson, J.[2021]

Drug-addicted fathers often struggle with feelings of inadequacy and confusion about their roles as parents, believing their children may be better off without them, regardless of their actual contact with them.

Interventions such as workshops that provide positive fathering examples and facilitate discussions about parenting experiences can help these fathers reconnect with their children and address their feelings of guilt and inadequacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Issues of fatherhood and recovery for VA substance abuse patients. Arenas, ML., Greif, GL.[2004]

The commentary emphasizes the need for the substance abuse research community to recognize and study the role of substance-abusing fathers, as their experiences and challenges are often overlooked in public policy and service delivery.

The authors outline key areas for further research, including the prevalence of substance-abusing fathers, the impact of their substance use on parenting and child development, and potential interventions to reduce harm associated with paternal substance abuse.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Substance abuse and fathering: adding poppa to the research agenda. McMahon, TJ., Rounsaville, BJ.[2019]

References

1. United States pubmed.ncbi.nlm.nih.gov

Integrating intimate partner violence and parenting intervention into residential substance use disorder treatment for fathers. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Alcoholics Anonymous attendance following 12-step treatment participation as a link between alcohol-dependent fathers' treatment involvement and their children's externalizing problems. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Where's Dad? The Importance of Integrating Fatherhood and Parenting Programming into Substance Use Treatment for Men. [2020]

4. United States pubmed.ncbi.nlm.nih.gov

A randomized controlled trial to improve fathering among fathers with substance use disorders: Fathering in recovery intervention. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Patterns and predictors of growth in divorced fathers' health status and substance use. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Fathers' Dosage in Community-based Programs for Low-income Fathers. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Issues of fatherhood and recovery for VA substance abuse patients. [2004]

8. England pubmed.ncbi.nlm.nih.gov

Substance abuse and fathering: adding poppa to the research agenda. [2019]