Parenting Programs for Substance Abuse-related Parent-Child Relationship Issues

Recruiting at 1 trial location

Overseen By Nicole Racine, PhD, C.Psych

Age: Any Age

Sex: Female

Trial Phase: Academic

Sponsor: University of Ottawa

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

Compensation: Varies

Number of Visits: 13

100 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial compares two programs designed to support mothers dealing with substance use and their young children. The Breaking the Cycle (BTC) program focuses on the child's mental health, while the Maxxine Wright (MW) program centers primarily on the mothers. The study aims to determine whether the BTC program leads to better mental health outcomes for children and enhances mother-child relationships. This trial may suit mothers receiving services at either BTC or MW, who have a child under 6 years old and can complete a questionnaire in English. Participants will answer questions at the start, after 12 months, and after 24 months to help researchers assess each program's effectiveness. As an unphased trial, this study offers a unique opportunity to contribute to research that may improve support programs for mothers and children.

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 prior data suggests that these parenting programs are safe for participants?

Research has shown that the Breaking the Cycle (BTC) and Maxxine Wright (MW) programs positively impact mothers dealing with substance use and their children. In these studies, mothers in the BTC program improved their mental health and relationship skills, indicating that the program is generally well-received and beneficial.

The Maxxine Wright program supports vulnerable mothers with substance use issues. These programs aim to provide a supportive and safe environment, focusing on improving the health and well-being of both mothers and children.

No specific reports of negative effects have emerged from these studies, suggesting that the programs are safe for participants. They emphasize mental health and support rather than medical treatments, which usually carry more risks. Overall, evidence shows that both programs are safe and potentially helpful for mothers and their children. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Parenting Programs for Substance Abuse-related Parent-Child Relationship Issues because these programs are designed to address the unique dynamics of families dealing with substance use. Unlike traditional family therapy or parenting classes, these programs focus specifically on rebuilding the parent-child relationship in the context of substance abuse. The Breaking the Cycle Program is experimental, offering innovative strategies to break negative cycles of behavior and communication. On the other hand, the Maxxine Wright Program serves as an active comparator, using established techniques to support parents and children, but with a focus on outcomes specific to substance abuse contexts. Both programs aim to provide targeted support that could lead to healthier family dynamics and better long-term outcomes.

What evidence suggests that this trial's programs could be effective for improving parent-child relationships in substance-involved families?

Research has shown that the Breaking the Cycle (BTC) program, one of the interventions in this trial, can improve babies' mental health and reduce negative experiences in families dealing with substance use. Studies have found that mothers in the BTC program often experience better mental health and relationships, including less severe addiction issues and improved parenting skills. The Maxxine Wright (MW) program, another intervention in this trial, primarily supports mothers. BTC also focuses on infants' mental health, potentially leading to better outcomes for children. Both programs aim to strengthen the mother-child bond, but BTC's additional focus on children could offer more benefits. ^{1 2 3 5 6}

Are You a Good Fit for This Trial?

This trial is for English-speaking mothers with a child under 6 years old, who are receiving services at either the Breaking the Cycle (BTC) or Maxxine Wright (MW) programs due to substance involvement.

Inclusion Criteria

Patients receiving services at either BTC or MW

Patients being able to answer a questionnaire in English

I have a child who is under 6 years old.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intake

Participants complete initial assessments and questionnaires as part of the intake process

1 week

1 visit (in-person)

Intervention

Participants receive services from either the Breaking the Cycle (BTC) or Maxxine Wright (MW) programs

24 months

Ongoing engagement with program services

Follow-up

Participants are monitored for changes in child development and maternal mental health outcomes

24 months

Assessments at 12 and 24 months post-engagement

What Are the Treatments Tested in This Trial?

Interventions

• Breaking the Cycle Program
• Maxxine Wright Program

Trial Overview The study compares two programs: BTC, which includes infant mental health care, and MW, focusing on mothers. It evaluates effects on children's mental health and mother-child relationships over a period of up to 2 years post-intervention.

How Is the Trial Designed?

Group I: Breaking the Cycle Intervention group Experimental Treatment 1 Intervention

Group II: Maxxine Wright Intervention group Active Control 1 Intervention

Breaking the Cycle Program is already approved in Canada for the following indications:

Approved in Canada as Breaking the Cycle Program for:

• Substance abuse intervention for mothers and children
• Infant mental health support

Who Is Running the Clinical Trial?

University of Ottawa

Lead Sponsor

Trials

231

Recruited

267,000+

Published Research Related to This Trial

The Family Check-Up (FCU) is an evidence-based program that has been effective for over 25 years in improving parenting skills and reducing risk behaviors, particularly in families affected by substance use, including opioid misuse.

An online version of the FCU has been developed to reach families with opioid use histories, providing accessible resources and harm reduction strategies tailored for young adult parents, especially in remote areas where services are limited.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Family Check-Up Online: A Telehealth Model for Delivery of Parenting Skills to High-Risk Families With Opioid Use Histories. Stormshak, EA., Matulis, JM., Nash, W., et al.[2021]

The study focuses on a new parenting intervention designed specifically for substance-abusing mothers and their infants, addressing the critical issue of child maltreatment and neglect linked to parental substance abuse.

Conducted in Florida, the research aims to develop effective and cost-efficient strategies to mitigate the risks of multi-generational drug abuse, highlighting the importance of early intervention in improving outcomes for both mothers and their children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Methodological challenges in intervention studies. Porter, B., Porter, L., McCoy, V., et al.[2009]

Substance use (SU) did not affect the relationship between treatment condition and potential for child abuse, but it did influence improvements in depression and parental distress, with parents experiencing higher SU showing less improvement.

The SafeCare program did not provide additional benefits for parents with substance use issues compared to standard treatment, highlighting the need for tailored interventions to better address the unique challenges faced by these parents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Examining an In-Home Behavioral Parent Training Protocol Among Parents Who Use Substances Involved Child Welfare: Effectiveness of SafeCare. Moreland, A., Crum, K., Rostad, WL., et al.[2023]

In a study involving 172 families participating in the Strong African American Families Program, higher family risk factors, such as a lower ratio of adults to children and youth unconventionality, were linked to lower attendance at intervention sessions.

Increased attendance (dosage) at the program was associated with positive changes in parenting behavior over a 7-month period, particularly in families facing greater risks, emphasizing the importance of strategies to engage high-risk families in such interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of family risk factors on dosage and efficacy of a family-centered preventive intervention for rural African Americans. Brody, GH., Murry, VM., Chen, YF., et al.[2022]

In a study of 125 addiction treatment programs in the U.S., only 43% offered any form of parenting classes, and even fewer utilized a structured curriculum, highlighting a gap in integrating parenting skills education into addiction treatment.

Effective parenting practices are known to reduce negative outcomes for children of parents with substance use disorders, yet the lack of structured parenting interventions in treatment programs suggests a missed opportunity to improve family outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Integration of parenting skills education and interventions in addiction treatment. Arria, AM., Mericle, AA., Rallo, D., et al.[2021]

A review of 21 studies on dual treatment for parental substance abuse and parenting showed generally positive outcomes, with reductions in substance use and improvements in parenting skills.

The research highlights the need for more rigorous methodologies, such as randomized controlled trials, to strengthen findings and address challenges in studying this high-risk population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Interventions to address parenting and parental substance abuse: conceptual and methodological considerations. Neger, EN., Prinz, RJ.[2022]

The Parents Translational Research Center (PTRC) is focused on helping parents of adolescents who are using alcohol or other substances by providing practical tools based on scientific evidence.

The PTRC aims to empower parents to intervene early and facilitate treatment for their children, translating proven clinical interventions into actionable strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Introduction to Special Issue: Translational Research to Help Parents Respond to Adolescent Substance Use Problems. Arria, AM., Kirby, KC.[2020]

Family treatment approaches for drug abuse are becoming increasingly accepted and show significant promise in effectively addressing drug-related issues, as highlighted by a review of 68 studies across various treatment modalities.

The review categorizes different family treatment techniques, such as marital and group treatments, and emphasizes the importance of tailored approaches, indicating that specific methods can lead to better outcomes in managing drug abuse problems.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family treatment approaches to drug abuse problems: a review. Stanton, MD.[2019]

Children of substance-abusing parents are at a significantly higher risk for various negative outcomes, including poor academic performance, emotional and behavioral issues, and an earlier onset of substance use disorders.

Parenting deficits, such as lack of warmth and harsher interaction styles, contribute to these risks, highlighting the need for targeted support and intervention strategies for these families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Understanding the diverse needs of children whose parents abuse substances. Solis, JM., Shadur, JM., Burns, AR., et al.[2022]

The pilot study tests the SafeCare+® program, which combines an evidence-based parenting curriculum with a healthy relationships curriculum, specifically for Latinx families facing both domestic violence and child maltreatment, aiming to improve family communication and reduce violence.

This randomized control trial will assess the feasibility and potential effectiveness of SafeCare+® in enhancing mental health and reducing violence, with results guiding future larger-scale studies to better support families involved in the child welfare system.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementation of a trauma-informed, evidence-informed intervention for Latinx families experiencing interpersonal violence and child maltreatment: protocol for a pilot randomized control trial of SafeCare+®. Fettes, DL., Aarons, GA., Brew, V., et al.[2022]

The Nurturing Program for Families in Substance Abuse Treatment and Recovery effectively improves parenting skills and enhances parents' satisfaction and competence, as shown by objective scales and participant reports.

The program is grounded in principles that have been proven to reduce the risks of child abuse, neglect, and substance abuse for both parents and children, indicating its potential for long-term positive outcomes in affected families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parenting services for families affected by substance abuse. Moore, J., Finkelstein, N.[2004]

The project aims to train parents to help their treatment-resistant adolescents enter community-based treatment, adapting the Community Reinforcement and Family Training (CRAFT) approach specifically for this age group.

Initial pilot results suggest that the tailored CRAFT program could effectively support parents in managing their child's substance abuse, although controlled trials are still needed to validate these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing Community Reinforcement and Family Training (CRAFT) for Parents of Treatment-Resistant Adolescents. Kirby, KC., Versek, B., Kerwin, ME., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10768363/

A comparative effectiveness study of the Breaking ... This study aligns with national strategies to establish strong evidence for infant mental health interventions that reduce child exposure to ACEs and support ...

2. tandfonline.com tandfonline.com/doi/abs/10.3109/16066359.2016.1140148

'Breaking the Cycle' of maternal substance use through ... Results: While both groups of mothers improved in addiction severity, women receiving RFI also improved in mental health functioning and relationship capacity.

3. clinicaltrials.gov clinicaltrials.gov/study/NCT05768815

Optimizing Mental Health for Infants Exposed to Early ... The goal of this clinical trial is to compare the effectiveness of the Breaking the Cycle (BTC) and Maxxine Wright (MW) programs in substance-involved ...

4. researchgate.net researchgate.net/publication/377185838_A_comparative_effectiveness_study_of_the_breaking_the_cycle_and_Maxxine_Wright_intervention_programs_for_substance-involved_mothers_and_their_children_study_protocol

(PDF) A comparative effectiveness study of the Breaking ... This study aligns with national strategies to establish strong evidence for infant mental health interventions that reduce child exposure to ACEs and support ...

5. ncbi.nlm.nih.gov ncbi.nlm.nih.gov/books/NBK64889/

Chapter 5—Breaking the Cycle: The Substance-Dependent ... Research shows that childhood maltreatment has developmental, behavioral, and emotional consequences that continue into adolescence and adulthood.

6. bridgesinc.net bridgesinc.net/wp-content/uploads/2020/11/AFamilyCenteredProgramtoBreaktheCycleofAddiction.pdf

A Family-Centered Program to Break the Cycle of Addiction Data from 20 cycles of the program revealed that parents (N = 263), referred from family drug court, expressed significant behavior changes toward their ...