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Parenting and Substance Abuse: Developmental Approaches to Intervention

Gorodzinsky, Fabian MD, FRPCP, APPd

Journal of Developmental & Behavioral Pediatrics: February/March 2014 - Volume 35 - Issue 2 - p 164
doi: 10.1097/DBP.0000000000000044
Book Review

Western University, London, Ontario, Canada

Disclosure: The author declares no conflict of interest.

This is the first edition of a book on a topic that is seldom analyzed in detail, yet of utmost importance given its prevalence in our society. This book is divided into 2 parts, the first focusing on understanding substance abuse and its implications for parenting, and the second part dealing with risk assessment and intervention. As per the authors, “Both addiction and parenthood are conditions and states of being that impact many others—family, friends, children and bring profound transformative changes in a person's life, sometimes for the worse in both instances.”

We have long known that substance abuse is an addictive behavior, and that the stress of parenting can be a trigger for relapse or continuing use. The authors report studies that mothers with a history of cocaine use have less emotional engagement and responsiveness to their infants and toddlers. Furthermore, although genetics play an important role, the authors feel that environmental influences may be even stronger.

Chapter 3 is devoted to an exploration of impulsivity as the main factor leading to substance abuse. “Substance abuse itself is often conceptualized as an impulsive behavior, according to Dewitt, 2008. Factors influencing impulsive behavior include the need to pursue opportunities for reward, negative effect, and lack of urge inhibition and cognitive resource depletion.”

In the sixth chapter, the authors review the impact of the substance abuse on mother's ability to care for their infants. According to the authors, “The infants are often neglected and develop representations of the outside world as unavailable and unsoothing.”

In chapter 10, the authors review evidence that, “older children who experience both prenatal or postnatal exposure to parental addiction are at risk for a range of emotional, academic, and developmental problems. This has been recorded on a number of different cognitive, social, and academic scales.”

Mothers who abuse drugs during pregnancy often question themselves on their ability to be able to keep their babies properly nourished, to satisfy their emotional needs and learn to love and respect themselves enough to see themselves as adequate and loving mothers. The mainstay of intervention is an excellent collaboration with drug counselors. This is especially important in cases where there is neonatal drug withdrawal.

Chapter 16 details the psychoanalytic Attachment-Oriented Group Intervention for Substance-Abusing Mothers and their Infants. This type of intervention has as its main goal to reduce the possibility of the mothers transmitting their traumatic past into negative interactions with their infants. This is provided in small group therapy sessions beginning in late pregnancy and lasting for 6 months. This technique allows the mother to regard the group therapy as her first attachment object, thereby enhancing her ability to attach with the baby when it's born.

There is widespread acceptance of the definition of recovery. The Parent Child Assistance program was developed at the University of Washington, Seattle. Its prime goal is to help mothers obtain treatment, stay in recovery, and assure their children a stable home environment. The definition of recovery is the voluntarily maintained lifestyle with sobriety, personal health, and being an active member of society.

In summary, Nancy E. Suchman, Marjukka Pajulo, and Linda C. Mayes have edited this collection of chapters from various authors. It offers a comprehensive review of multiple issues related to parenting and substance abuse.

© 2014 by Lippincott Williams & Wilkins