A comparative effectiveness study of the breaking the cycle and Maxxine Wright intervention programs for substance-involved mothers and their children: study protocol.

BACKGROUND: Children of substance-involved mothers are at especially high risk for exposure to adverse childhood experiences (ACEs) and poor mental health and development. Early interventions that support mothers, children, and the mother-child relationship have the greatest potential to reduce exposure to early adversity and the mental health problems associated with these exposures. Currently, there is a lack of evidence from the real-world setting demonstrating effectiveness and return on investment for intervention programs that focus on the mother-child relationship in children of substance-involved mothers. METHODS: One hundred substance-involved pregnant and/or parenting women with children between the ages of 0-6 years old will be recruited through the Breaking the Cycle and Maxxine Wright intervention programs, in Toronto, Ontario, Canada and Surrey, British Columbia, Canada, respectively. Children's socioemotional development and exposure to risk and protective factors, mothers' mental health and history of ACEs, and mother-child relationship quality will be assessed in both intervention programs. Assessments will occur at three time points: pre-intervention, 12-, and 24-months after engagement in the intervention program. DISCUSSION: There is a pressing need to identify interventions that promote the mental health of infants and young children exposed to early adversity. Bringing together an inter-disciplinary research team and community partners, this study aligns with national strategies to establish strong evidence for infant mental health interventions that reduce child exposure to ACEs and support the mother-child relationship. This study was registered with clinicaltrials.gov (NCT05768815) on March 14, 2023.

Trauma-informed and relational approaches to service provision: building community-based project capacity to respond to interpersonal violence through a national initiative.

BACKGROUND: Community services that engage and service marginalized families can act as an important entry point for mothers and children experiencing interpersonal violence. The purpose of this study was to use an initiative that included training, implementation, and evaluation of an interpersonal violence intervention to understand changes in the capacity of service providers in community-based organizations to use trauma-informed and relational approaches to support mothers and children experiencing violence in relationships. METHODS: Participants (N = 27) were service providers from 14 community-based organizations across Canada, who had been trained to implement an interpersonal violence intervention with mothers in their communities. Using a phenomenological approach, participants engaged in an open-ended interview in which they were encouraged to reflect on their experiences in the intervention initiative, with prompts relating to the ways in which their work and their organization may have changed as a result of their participation. RESULTS: Findings indicated that participants were able to identify changes in four key areas related to trauma-informed practice: awareness (e.g., attitudes toward interpersonal violence), competency (e.g., application of trauma-informed knowledge), collaboration (e.g., working with other organizations to provide services to children and families), and safety (e.g., organizational policies to ensure safe, welcoming spaces). Further, participants identified these areas of change at the level of themselves as facilitators of the interpersonal violence intervention, their organizations, and their communities. CONCLUSIONS: Results indicate that, through training, implementation, and evaluation of an interpersonal violence intervention, service providers in community-based projects were able to extend trauma-informed and relational principles not only to the intervention itself, but also to their own work, as well as that of their organizations and communities. With some additional support, leveraging the existing capacities within community-based projects may be an effective means to support mothers and children experiencing interpersonal violence and other challenges.

Using a Developmental-Relational Approach to Understand the Impact of Interpersonal Violence in Women Who Struggle with Substance Use.

Substance use among women is a major public health concern. This review article takes a developmental-relational approach to examine processes through which early relational trauma and violence in relationships may lead to substance use. We examine how early exposure to violence in relationships can impact neurological development, specifically through interference with physiological mechanisms (e.g., the hypothalamic-pituitary-adrenal axis), brain structure and functioning (e.g., the hippocampus and prefrontal cortex), and neuropsychological development (e.g., executive functioning and emotion regulation) across the lifespan. Further, we discuss the impact of exposure to violence on the development of relational capacity, including attachment, internal working models, and subsequent interpersonal relationships across the lifespan, and how these developmental pathways can lead to continued problematic substance use in women.

Addressing the Impact of Interpersonal Violence in Women Who Struggle with Substance Use Through Developmental-Relational Strategies in a Community Program.

From a developmental-relational framework, substance use in women can be understood as relating to early experiences of violence in relationships and across development. This article uses a developmental-relational approach to outline specific strategies that can be used by service providers and to guide interventions for women with substance use issues. By reviewing research and clinical work with women attending a community-based prevention and early intervention program, we describe how specific components of programming can target the developmental and intergenerational pathway between experiences of violence in relationships and substance use. We include the voices of women who attended the program to support the strategies discussed. Specifically, these strategies address the impact of interpersonal violence on substance use by promoting the process of repair and reintegration for women whose neurological development, sense of self, and capacity to form relationships have been significantly impacted by experiences of violence in relationships.

Myself or someone like me: a review of the literature on the psychological well-being of child actors.

The number of child actors on television, in movies, and on stage has increased dramatically in recent years. While many regulations and laws are in place to protect the physical and financial well-being of these young performers, little attention has been given to their psychological health and the strength of their self-concepts. This paper reviews the literature related to child actors' psychological well-being and makes a case for future research into the topic. Available data are very limited but suggest that actors may have a weaker self-concept and more psychological concerns than people who are not actors, and that the personalities and behaviors actors display publically may be incorporated into their self-concepts. As a result, child actors appear to have unique psychological needs that should be addressed.

Perspectives of mothers with substance use problems on father involvement.

BACKGROUND: A number of complex factors contribute to pregnant and parenting women's alcohol and substance use. To date, little research has focused on the implications, meaning and experiences of father involvement on mothers with substance use problems. OBJECTIVE: The current study explores the experiences of mothers with substance use problems with respect to the role, impact and meaning of father involvement. METHODS: This study conducted two focus groups utilizing a phenomenological approach. Mothers receiving clinical services at a comprehensive, community based program serving pregnant and parenting women with substance use problems were recruited to participate in this research. RESULTS: The meaning of father involvement among this group of women centered on four dimensions: emotional support, financial contributions to the family, amount and quality of time spent with the children and the family, and was dependent upon the particular expectations of the mother involved. Barriers and influences of father involvement were identified. The nature of father involvement had negative and positive impacts on participants. DISCUSSION: Maternal use of alcohol is a complex issue, one factor often ignored in father involvement. For mothers with substance use problems father involvement has a number of implications, both positive and negative.