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Relationship-Based Home Visiting Services for Families Affected by Substance Use Disorders: A Qualitative Study

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Abstract

Home visiting programs face many challenges when providing evidence-based services to families affected by substance use disorders (SUDs). We conducted interviews and focus groups with community stakeholders and parents to elucidate important considerations when intentionally attempting to meet the needs of families affected by SUDs through home visiting programs. We identified one primary theme “Who is the client?” that describes how to ensure caregivers perceive themselves as an important focus of the program. Collectively, participants revealed that understanding caregivers’ emotional experiences was critical for effectively transforming their subjective experiences of the program. These emotional experiences were related to the quality of their relationships with their children, other family members, and service providers. Three sub-themes illustrate specific examples: 1) responding to the unique emotional needs of mothers in recovery, 2) considering emotional states to inform inclusion in programs, and 3) addressing complex family dynamics related to SUDs in the home. Implications of these findings are discussed.

Highlights

  • Barriers to providing relationship-based interventions to families affected by substance use disorders still exist within traditionally child-focused home visiting programs.

  • Participants revealed that understanding the caregivers’ emotional experiences was critical for effectively transforming from a child-focused to a relationship-focused program that meets the needs of mothers in recovery.

  • Responding to the emotional needs of mothers in recovery could inform changes in program inclusion criteria and address complex family dynamics.

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Acknowledgements

This work was supported by the National Center for Advancing Translational Sciences, National Institutes of Health (award no. 1KL2TR002545), and the National Institute on Drug Abuse (award no. K23DA050731). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funded by the National Institutes of Health (NIH).

Funding

N.B. received honoraria from The Kinetix Group, Global Learning Collaborative, Medscape, Miller Medical Communications and Mathematica. She has served on Advisory Boards for Sage Therapeutics. She has also served as a consultant for Ovia Health, Sage Therapeutics or their agents, and has received speaking honoraria from Sage Therapeutics.

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Authors and Affiliations

  1. Department of Pediatrics, UMass Chan Medical School-Baystate, Springfield, MA, USA

    Elizabeth Peacock-Chambers & Maria Carolina Clark

  2. Department for Healthcare Delivery and Population Science, 3601 Main Street, Third Floor, Springfield, MA, 01199, USA

    Elizabeth Peacock-Chambers & Maria Carolina Clark

  3. UMass Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA

    Deirdre Buckley

  4. Department of Psychiatry, Yale School of Medicine, 300 George Street #901, New Haven, CT, 06511, USA

    Amanda Lowell

  5. Yale Child Study Center, Yale School of Medicine, 230 South Frontage Road, New Haven, CT, 06519, USA

    Amanda Lowell

  6. Department of Medicine, UMass Chan Medical School-Baystate, 3601 Main Street, Third Floor, Springfield, MA, 01199, USA

    Peter D. Friedmann

  7. Department of Psychiatry, UMass Chan Medical School, 222 Maple Ave – Chang Building, Shrewsbury, MA, 01655, USA

    Nancy Byatt

  8. Department of Pediatrics, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA

    Emily Feinberg

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  1. Elizabeth Peacock-Chambers
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  7. Emily Feinberg
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Non-financial Interests N.B. has served on the Medscape Steering Committee on Clinical Advances in Postpartum Depression. The other authors have indicated that they have no competing interests to declare that are relevant to the content of this article.

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Peacock-Chambers, E., Buckley, D., Lowell, A. et al. Relationship-Based Home Visiting Services for Families Affected by Substance Use Disorders: A Qualitative Study. J Child Fam Stud 31, 2121–2133 (2022). https://doi.org/10.1007/s10826-022-02313-1

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