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. Author manuscript; available in PMC: 2007 Apr 6.
Published in final edited form as: Fam Relat. 2006 Apr;55(2):211–226. doi: 10.1111/j.1741-3729.2006.00371.x

Table 1.

Overview of Parenting Interventions for Drug Using Mothers

Outcome Measures and Results
Program Name Theoretical Approach Treatment Format Study Design Target Population Sample Parent Parent-Child Child
1. Systematic Training for Effective Parenting (STEP; Huebner, 2002). Cognitive behavioral skill building. Weekly 2-hr group sessions conducted at pediatric clinic for 8-week duration; concurrent drug treatment. Nonrandom assignment to three intervention groups (one drug treatment and two nondrug treatment). Parents at risk for child maltreatment due to poverty, low social support, poor education, substance abuse, and/or domestic violence with children from birth to 36 months of age. 200 parents (57 in drug treatment) recruited from inner-city pediatric clinics for low-income families; M age = 28 years; 95% female; 89% single; 35% Caucasian, 32% African American; M education = 12 years. Attendance: Mothers in the drug-treatment group attended at least 38% of the sessions.
Drug use: Serious problems reported during and after intervention.
Parental adjustment: Parenting Stress Inventory (Abidin, 1995): At 8 weeks postenrollment, mothers in drug-treatment group reported lower levels of parental distress.		 Maternal sensitivity: Nursing Child Assessment Teaching Scale (NCAST; Barnard, 1978): At 8 weeks postenrollment, mothers in drug-treatment group showed no improvement in maternal sensitivity to child cues, but their children were more expressive with cues and more responsive to mothers. Home Observation Measurement of the Environment (HOME; Caldwell & Bradley, 1978): No improvement in maternal avoidance of punishment or opportunities for stimulation.
2. Focus on Families (FOF; Catalano et al., 1997, 1999). Behavioral parent skills training; home-based case management to reinforce parenting skills; dual focus on addiction and parenting. 32 parent skills group sessions conducted or 16 weeks; 0 – 5 hr per week of home-based case management for 9 months; methadone maintenance concurrent. Random assignment to FOF + methadone treatment versus methadone treatment alone. Parents enrolled in methadone maintenance with children 3 – 14 years of age. 144 parents recruited from two methadone maintenance clinics; M age = 35 years; 75% female; 80% single; 77% Caucasian; 78% high school educated; 66% unemployed. Attendance: 50% of FOF parents attended half of the parenting groups, and 75% attended a third of the case management sessions.
Drug use: At 6 months postenrollment, no group differences. At 12 months postenrollment, FOF parents had better relapse-related problem-solving and refusal skills.
Parental adjustment: At 6 months postenrollment, no group differences. At 12 months postenrollment, FOF parents reported less domestic conflict and involvement with deviant peers.		 Family relations: At 6 months postenrollment, no group differences in parent reports of family bonding, conflict, or meetings, and FOF children reported that parents were less involved. At 12 months postenrollment, FOF parents reported more household rule initiation; no group differences in parents’ reports of family bonding, conflict, or meetings or children’s reports of family relations. Child outcomes not assessed for children younger than 6 years of age.
3. Home-based intervention using the Carolina Preschool Curriculum and Hawaii Early Learning Program (Black et al., 1994). Case management for personal needs; cognitive behavioral parent skills training; psychoeducation about child development; drug treatment encouraged, not required. 2 weekly home visits from pregnancy to 18 months postpartum. Drug treatment encouraged. Random assignment to home-visit intervention versus no intervention control group. Pregnant women with histories of prenatal cocaine and/or heroin use 60 women recruited from hospital prenatal clinics in metropolitan teaching hospital; M age = 26 years; 97% single; 89% African American; M education = 11 years; 72% retention in study. Attendance: Intervention attendance not reported. No group differences in compliance with primary care.
Drug use: At 18 months postpartum, no group differences; 57% of total sample continued drug use.
Parental adjustment: Parenting Stress Index (Abidin, 1990): At 3 months postpartum, intervention and control groups report elevated stress. Child Abuse Potential Inventory (CAPI; Milner, 1986): At 18 months postpartum, intervention group total scores did not differ from normative scores reported by Milner and control group scores were higher than normative scores. Intervention group had significantly elevated scores on two of six subscales and control group had significantly elevated scores on six of six subscales.		 HOME Scales (Caldwell & Bradley, 1979): Intervention group scored higher on two of six subscales, (maternal emotional and verbal responsivity and opportunity for variety in daily stimulation). Bayley Infant Development Scales (Bayley, 1969): No group differences at 6, 12, and 18 months postpartum.
4. Home-based intervention using Infant Health and Development Program (Schuler et al., 2000, 2002). Case management and empowerment for personal needs; psycho-education about interactions with child. 2 weekly home visits in first year postpartum; parent skills group and child attendance at development center in second year postpartum. Drug treatment encouraged Random assignment to home-visit intervention versus tracking-visit control group. Mothers with histories of prenatal cocaine and/or heroin use caring for newborn infants. 127 women with cocaine or heroin use recruited from inner-city university hospital: M age = 27; 94% single; M education = 11 years. 98% unemployed 95% African American Attendance: 66% attended 1–60% of visits.
Drug use: At 6 months postpartum, no group differences; 46% of total sample continued drug use. At 18 months postpartum, no group differences; 43% continued drug use.
Parental adjustment: Child Abuse Potential Inventory (CAPI; Milner, 1986).		 Mother-infant feeding interaction ratings (Cowan & Cowan, 1992; Hutcheson et al., 1997): No group differences at 6 or 18 months postpartum. Not assessed.
5. Multicomponent intervention for teen mothers and their infants (Field et al.,1998). Psychoeducational and cognitive behavioral approach for addiction and social rehabilitation; developmental guidance about child milestones; interaction coaching with mother-child dyad. Mothers attended vocational high school in morning; 4-h daily intervention based on site at high school with nursery designed for multilevel infant enrichment for 4 months. Drug treatment concurrent. Nonrandom assignment. Mothers with no drug use history were assigned to non–drug user control group; mothers with drug use history were assigned to intervention group or drug-user control group. Polydrug-using adolescent mothers who used illicit drugs (cocaine, opiates, or marijuana) during pregnancy. 126 polydrug-using adolescent mothers recruited from a vocational high school; M age = 18 years; 64% African American; M education = 10 years; M Hollingshead SES = 4.4 Attendance: Not reported.
Drug use and repeated pregnancies: Lower rates for drug-treatment group than drug-control group.
Parental adjustment: Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mach, & Erbaugh, 1961): At 3 months postpartum, drug-treatment and drug-control groups scored higher than nondrug-control group. At 6 months postpartum, drug-treatment and nondrug-control groups had similar scores. At 12 months postpartum, drug-treatment group score lower than drug-control group score.
Maternal stress indicated by salivary cortisol levels: At 3 months postpartum, cortisol levels for mothers in drug treatment and nondrug groups were lower than levels for drug-control group. At 6 months postpartum, levels for drug treatment and nondrug-control groups were lower than drug-control group levels.		 Feeding and Play Interactions (Field, 1980): At 3 months postpartum, drug-treatment and nondrug-control groups had higher ratings than drug-control group. At 6 months postpartum, drug-treatment group scores similar to nondrug-control group scores. Infant stress: Salivary cortisol levels: At 3 months postpartum, infant cortisol levels for drug-treatment and nondrug group were lower than drug-control group levels. At 6 months postpartum, infant cortisol levels for drug-treatment and nondrug groups were lower than drug-control group levels. Early Social Communication Scales (Seibert & Hogan, 1982; Seibert, Hogan, & Mundy, 1987) At 12 months, infants in drug-treatment group scored higher than infants in drug-control group. Bayley Infant Development Scales (Bayley, 1969): At 12 months, infants in drug-treatment group had better scores on Mental Health Scale than infants in drugcontrol group but lower scores than infants in nondrug-control group.
6. Seattle Birth to Three Program (Ernst et al., 1999). Case management stressing therapeutic alliance; Motivational interviewing to promote treatment engagement. 1 home visit per weak from birth to 6 weaks. 2 home visits per weak from 6 weeks to 36 months. Drug treatment encouraged. Random assignment to home-visit versus tracking-visit control group. Mothers with heavy alcohol and drug use during pregnancy. 65 mothers identified at 1 month pre- to 1 month postpartum; M age = 27 years; 77% single; M education = 11 years; 48% African American; 29% Caucasian Attendance: 38% attended 32/36 months; 51% attended 9 – 31/36 months.
Drug use: At 32 months, mothers receiving home visits were more likely to be enrolled in drug treatment and to have longer periods of abstinence than control group mothers.		 Not assessed. Bayley Infant Development Scales (Bayley, 1969): At 36 months, both groups below clinical norms. Health care: At 36 months, children in both groups had adequate care.