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Lowell AF, DeCoste C, Dalton R, Dias H, Borelli JL, Martino S, McMahon TJ, Suchman NE. Mothering from the Inside Out: Results of a community-based randomized efficacy trial testing a mentalization-based parenting intervention for mothers with addictions. Infant Ment Health J 2023; 44:142-165. [PMID: 36862381 PMCID: PMC10050102 DOI: 10.1002/imhj.22043] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 12/22/2022] [Accepted: 01/12/2023] [Indexed: 03/03/2023]
Abstract
Mothering from the Inside Out (MIO) is a mentalization-based parenting intervention developed to address challenges common among mothers experiencing substance use disorders (SUDs) and previously deemed effective when delivered by research clinicians. This randomized clinical trial was designed to test the efficacy of MIO when delivered by community-based addiction counselors in Connecticut, USA. Ninety-four mothers [M(SD)age = 31.01(4.01) years; 75.53% White] caring for a child 11-60 months of age were randomly assigned to participate in 12 sessions of either MIO or psychoeducation. Caregiving, psychiatric, and substance use outcomes were assessed repeatedly from baseline through 12-week follow-up. Mothers who participated in MIO showed decreased certainty about their child's mental states, and decreased depression; their children demonstrated increased clarity of cues. Participation in MIO was not associated with the same degree of improvement that was observed in prior trials where MIO was delivered by research clinicians. However, when delivered by community-based clinicians, MIO may be protective against a deterioration in caregiving over time often seen in mothers with addictions. The drop in efficacy of MIO in this trial raises questions about intervention-intervenor fit. Research should examine factors influencing MIO effectiveness to close the science-to-service gap common in the dissemination of empirically validated interventions.
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Affiliation(s)
- Amanda F. Lowell
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
- Yale Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Cindy DeCoste
- Yale Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Rachel Dalton
- Yale Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- The APT Foundation, Inc., New Haven, Connecticut, USA
| | - Hailey Dias
- Yale Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- The APT Foundation, Inc., New Haven, Connecticut, USA
| | - Jessica L. Borelli
- Department of Psychological Science, School of Social Ecology, University of California, Irvine, Irvine, California, USA
| | - Steve Martino
- Yale Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Thomas J. McMahon
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
- Yale Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Nancy E. Suchman
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
- Yale Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
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Sperandio KR, Goshorn JR, Moh YS, Gonzalez E, Johnson NG. Never ready: Addictions counselors dealing with client death. JOURNAL OF COUNSELING AND DEVELOPMENT 2022. [DOI: 10.1002/jcad.12440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Katharine R. Sperandio
- Department of Counseling & Behavioral Health Thomas Jefferson University Philadelphia Pennsylvania USA
| | - Jeremy R. Goshorn
- Clinical Mental Health Counseling Department of Psychology Lebanon Valley College Annville Pennsylvania USA
| | - Yoon Suh Moh
- Department of Counseling & Behavioral Health Thomas Jefferson University Philadelphia Pennsylvania USA
| | - Edith Gonzalez
- Department of Counseling Texas A&M University Commerce Texas USA
| | - Nicole G. Johnson
- Department of Counseling & Behavioral Health Thomas Jefferson University Philadelphia Pennsylvania USA
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