Skip to main content

Advertisement

Log in

Description of a Behavioral Intervention to Reduce Substance Use and Related Risk and Increase Positive Parenting among Urban Mothers with Alcohol and Other Drug Problems

  • Original Paper
  • Published:
Journal of Child and Family Studies Aims and scope Submit manuscript

Abstract

The abuse of alcohol and other substances by mothers raising adolescent children has serious adverse effects on family functioning and youth outcomes, and on mothers’ own health and adaptation. Mothers who are also HIV-infected face additional challenges. In the present report, we describe a multi-session intervention conducted in individual sessions for mothers with alcohol and other substance use problems who are raising adolescent children. We outline the primary components of the intervention and include case studies and examples of exercises and tools. We found that engagement with the intervention and high rates of attendance were facilitated by tapping into mothers’ desires to improve their relationships with their adolescent children, the use of a harm reduction approach toward substance use, and intensive outreach. We also discuss lessons learned in the course of implementing and evaluating the intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Aktan, G. B., Kumpfer, K. L., & Turner, C. W. (1996). Effectiveness of a family skills training program for substance use prevention with inner city African-American families. Substance Use & Misuse, 31, 157–175.

    Google Scholar 

  • Armistead, L., & Forehand, R. (1995). For whom the bell tolls: Parenting decisions and challenges faced by mothers who are HIV seropositive. Clinical Psychology: Science & Practice, 2, 239–250.

    Article  Google Scholar 

  • Bandura, A. (1986). Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  • Bohn, M. J., Babor, T. F., & Kranzler, H. R. (1995). The alcohol use disorders identification test (AUDIT): Validation of a screening instrument for use in medical settings. Journal of Studies on Alcohol, 56, 423–432.

    PubMed  Google Scholar 

  • Britton, J. (2003). Smokeless tobacco: Friend or foe? Addiction, 98, 1199–1201.

    Article  PubMed  Google Scholar 

  • Burke, B. L., Dunn, C. W., Atkins, D. C., & Phelps, J. S. (2004). The emerging evidence base for motivational interviewing: A meta-analytic and qualitative inquiry. Journal of Cognitive Psychotherapy, 18, 309–322.

    Google Scholar 

  • Chassin, L., Pitts, S. C., DeLucia, C., & Todd, M. (1999). A longitudinal study of children of alcoholics: Predicting young adult substance use disorders, anxiety, and depression. Journal of Abnormal Psychology, 108, 106–119.

    Article  PubMed  Google Scholar 

  • Chilcoat, H. D., & Anthony, J. C. (1996). Impact of parent monitoring on initiation of drug use through late childhood. Journal of American Academy of Child and Adolescent Psychiatry, 35, 91–100.

    Article  Google Scholar 

  • Copeland, J. (1997). A qualitative study of barriers to formal treatment among women who self-managed change in addictive behaviors. Journal of Substance Abuse Treatment, 14, 183–190.

    Article  PubMed  Google Scholar 

  • Corby, N. H., & Wolitski, R. J. (1996). Condom use with main other sex partners among high-risk women: Intervention outcomes and correlates of reduced risk. Drugs and Society, 9, 75–96.

    Article  PubMed  Google Scholar 

  • Culverhouse, R., Bucholz, K. K., Crowe, R. R., Hesselbrock, V., Nurnberger, J. I., Jr., Porjesz, B., et al. (2005). Long-term stability of alcohol and other substance dependence diagnoses and habitual smoking. Archives of General Psychiatry, 62, 753–760.

    Article  PubMed  Google Scholar 

  • de Guzman, R., Leonard, N., Gwadz, M., Young, R., Ritchie, A., Arredondo, G., & Riedel, M. (2006). “I thought there was no hope for me”: A behavioral intervention for urban HIV-infected and HIV-uninfected mothers with problem drinking. Qualitative Health Research, 16, 1262–1266.

    Google Scholar 

  • Denning, P. (2000). Practicing Harm Reduction Psychotherapy. New York: Guilford.

    Google Scholar 

  • Dishion, T. J., Patterson, G. R., Stoolmiller, M., & Skinner, M. (1991). Family, school and behavioral antecedents to early adolescent involvement with antisocial peers. Developmental Psychology, 27, 172–180.

    Article  Google Scholar 

  • Dishion, T. J., & McMahon, R. J. (1998). Parental monitoring and the prevention of child and adolescent problem behavior: A conceptual and empirical formulation. Clinical Child and Family Psychology Review, 1, 61–75.

    Article  PubMed  Google Scholar 

  • Dishion, T. J., & Kavanagh, K. (2004). The adolescent transitions program: A family-centered prevention strategy for schools. In J. B. Reid, G. R. Patterson, & J. Snyder (Eds.), Antisocial Behavior in Children and Adolescents (pp. 257–272). Washington, DC: American Psychological Association.

    Google Scholar 

  • Ewart, C. K. (1991). Social action theory for a public health psychology. American Psychology, 46, 931–941.

    Article  Google Scholar 

  • Forehand, R., Miller, K. S., Dutra, R., & Chance, M. W. (1997). Role of parenting in adolescent deviant behavior: Replication across and within two ethnic groups. Journal of Consulting Clinical Psychology, 65, 1036–1041.

    Article  Google Scholar 

  • Galvan, F. H., Burnam, M. A., & Bing, E. G. (2003). Co-occurring psychiatric symptoms and drug dependence or heavy drinking among HIV-positive people. Journal of Psychoactive Drugs, 35(Suppl. 1), 153–160.

    PubMed  Google Scholar 

  • Grella, C. E., Anglin, D., & Annon, J. J. (1996). HIV risk behaviors among women in methadone maintenance treatment. Substance Use and Misuse, 31, 277–301.

    PubMed  Google Scholar 

  • Gwadz, M., De Vogli, R., Rotheram-Borus, M. J., Diaz, M. M., Cisek, T., James, N. B., et al. (1999). Behavioral practices regarding combination therapies for HIV/AIDS. Journal of Sex Education & Therapy, 24, 81–88.

    Google Scholar 

  • Gwadz, M. V., Leonard, N. R., Riedel, M., Arredondo, G., & Cleland, C. (2005). Interventions for Mothers with Problem Drinking and Drug use. Manuscript submitted for publication.

  • Hettema, J., Steele, J., & Miller, W. (2005). Motivational interviewing. Annual Review of Clinical Psychology, 1, 91–111.

    Article  PubMed  Google Scholar 

  • Humphreys, K. (2003). Research-based analysis of the moderation management controversy. Psychiatric Services, 54, 621–622.

    Article  PubMed  Google Scholar 

  • Kelley, M. L., & Fals-Stewart, W. (2002). Couples- versus individual-based therapy for alcohol and drug abuse: Effects on children's psychosocial functioning. Journal of Consulting and Clinical Psychology, 70, 417–427.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Crum, R. M., Warner, L. A., Nelson, C. B., Schulenberg, J., & Anthony, J. C. (1997). Lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the national comorbidity survey. Archives of General Psychiatry, 54, 313–321.

    PubMed  Google Scholar 

  • Klinkenberg, W. D., & Sacks, S. (2004). Mental disorders and drug abuse in persons living with HIV/AIDS. AIDS Care, 16, S22–S42.

    Article  PubMed  Google Scholar 

  • Leonard, N., Gwadz, M., Cleland, C., Rotko, L., & Gostnell, K. (2005). Physical and Mental Health Functioning of Urban HIV-Infected and Uninfected Mothers with Problem Drinking. Manuscript submitted for publication.

  • Lindenberg, C. S., Strickland, O., Solorzzno, R., Galvis, C., Dreher, M., & Darrow, V. C. (1999). Correlates of alcohol and drug use among low-income Hispanic immigrant childbearing women living in the USA. International Journal of Nursing Studies, 36, 3–11.

    Article  PubMed  Google Scholar 

  • Longabaugh, R., & Morgenstern, J. (1999). Cognitive-behavioral coping-skills therapy for alcohol dependence: Current status and future directions. Alcohol Research & Health, 23, 79–85.

    Google Scholar 

  • Marcenko, M. O., Kemp, S. P., & Larson, N. C. (2000). Childhood experiences of abuse, later substance use, and parenting outcomes among low-income mothers. American Journal of Orthopsychiatry, 70, 316–326.

    PubMed  Google Scholar 

  • Marlatt, G. A., Blume, A. W., & Parks, G. A. (2001). Integrating harm reduction therapy and traditional substance abuse treatment. Journal of Psychoactive Drugs, 33, 13–21.

    PubMed  Google Scholar 

  • Mellins, C. A., Ehrhardt, A. A., Rapkin, B., & Havens, J. F. (2000). Psychosocial factors associated with adaptation in HIV-infected mothers. AIDS and Behavior, 4, 317–328.

    Article  Google Scholar 

  • Miller, B. A., Smyth, N. J., & Mudar, P. J. (1999). Mothers’ alcohol and other drug problems and their punitiveness toward their children. Journal of Studies on Alcohol, 60, 632–642.

    PubMed  Google Scholar 

  • Miller, W. R., & Rollnick, S. (2002). Motivational Interviewing: Preparing People for Change (2nd edn.). New York: Guilford.

    Google Scholar 

  • Monti, P. M., Abrams, D. B., Kadden, R. M., & Cooney, N. L. (1989). Treating Alcohol Dependence: Treatment Manuals for Practitioners. New York: Guilford.

    Google Scholar 

  • Moore, J., Schuman, P., Schoenbaum, E., Boland, B., Solomon, L., & Smith, D. (1999). Severe adverse life events and depressive symptoms among women with, or at risk for, HIV infection in four cities in United States of America. AIDS, 13, 2459–2468.

    Article  PubMed  Google Scholar 

  • Morley, J. A., Finney, J. W., Monahan, S. C., & Floyd, A. S. (1996). Alcoholism treatment outcome studies, 1980–1992: Methodological characteristics and quality. Addictive Behavior, 21, 429–443.

    Article  Google Scholar 

  • O’Connor, P. G., & Fiellin, D. A. (2000). Pharmacologic treatment of heroin-dependent patients. Annals of Internal Medicine, 133, 40–54.

    PubMed  Google Scholar 

  • Ohannessian, C. M., Hesselbrock, V. M., Kramer, J., Kuperman, S., Bucholz, K. K., Schuckit, M. A., et al. (2004). The relationship between parental alcoholism and adolescent psychopathology: A systematic examination of parental comorbid psychopathology. Journal of Abnormal Child Psychology, 32, 519–533.

    Article  PubMed  Google Scholar 

  • Petry, N. M. (1999). Alcohol use in HIV patients: What we don't know may hurt us. International Journal of STD and AIDS, 10, 561–570.

    Article  PubMed  Google Scholar 

  • Project MATCH Research Group. (1997). Project MATCH secondary a priori hypotheses. Addiction, 92, 1671–1698.

    Article  Google Scholar 

  • Rotheram-Borus, M. J., Lee, M., Leonard, N., Lin, Y. Y., Franzke, L., Turner, E., et al. (2003). Four-year behavioral outcomes of an intervention for parents living with HIV and their adolescent children. AIDS, 17, 1217–1225.

    Article  PubMed  Google Scholar 

  • Springer, E. (1996). The spectrum of harm reduction. Harm Reduction Communications, 3, 5–7.

    Google Scholar 

  • te Vaarwerk, M., & Gaal, E. (2001). Psychological distress and quality of life in drug-using and non-drug-using HIV-infected women. European Journal of Public Health, 11, 109–115.

    Article  PubMed  Google Scholar 

  • Watkins, K. E., Burnam, A., Kung, F. Y., & Paddock, S. (2001). A national survey of care for persons with co-occurring mental and substance use disorders. Psychiatry Services, 52, 1062–1068.

    Article  Google Scholar 

  • Wills, T. A., Schreibman, D., Benson, G., & Vaccaro, D. (1994). Impact of parental substance use on adolescents: A test of a mediational model. Journal of Pediatric Psychology, 19, 537–555.

    Article  PubMed  Google Scholar 

  • Wilsnack, S. C., & Wilsnack, R. W. (1995). Drinking and problem drinking in US women. In M. Galanter (Series Ed.), Recent Developments in Alcoholism (Vol. 12, pp. 29–60). New York: Plenum Press.

    Google Scholar 

  • Windle, M. (1996). On the discriminative validity of a family history of problem drinking index with a national sample of young adults. Journal of Studies on Alcohol, 57, 378–386.

    PubMed  Google Scholar 

Download references

Acknowledgments

We would like to express our appreciation to the women who participated in the study; project staff members Katherine Aracena, Natalie Brumblay, Tri Cisek, Mindy Finkelstein, Karla Gostnell, Carol Moorer, Maria Elena Ramos, Amanda Ritchie, Lauren Rotko, Alberta Springer, and Maya Tharaken; the Center for Drug Use and HIV Research, Sherry Deren, Ph.D., Robert Freeman, Ph.D., and Kendall Bryant, Ph.D. for their assistance; and Jennifer K. Brown for editorial assistance. This study was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (R01-12113) to the second author.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Noelle R. Leonard.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Leonard, N.R., Gwadz, M.V., Arredondo, G.N. et al. Description of a Behavioral Intervention to Reduce Substance Use and Related Risk and Increase Positive Parenting among Urban Mothers with Alcohol and Other Drug Problems. J Child Fam Stud 16, 531–544 (2007). https://doi.org/10.1007/s10826-006-9104-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10826-006-9104-3

Keywords

Navigation