The impact of the Circle of Security-Parenting© program on mothers in residential substance abuse treatment: an action research study

Child maltreatment (CM) is a pervasive social problem in the United States that occurs across all socioeconomic, religious, cultural, and ethnic groups (United States Department of Health & Human Services, 2012). Though the causes of CM are complex and involve multiple factors, researchers have found that specific parenting factors are associated with child maltreatment, including harsh discipline practices, hostile attributions, difficulties with emotion regulation, maternal substance abuse, and a parent's personal history of child abuse (Azar, 2002; Belsky & Jaffee, 2006; Mayes & Truman, 2002). Improving parenting through parenting programs is one of the most important approaches to reducing CM (Barth, 2009). The primary purpose of this study was to determine the impact of a manualized, group-based, parenting program on mothers in residential treatment for substance abuse. The Circle of Security-Parenting© (COS-P; Cooper, Hoffman, & Powell, 2009) program is a shortened, eight session version of the original Circle of Security® protocol that has shown efficacy in working with parents at risk for CM (Cassidy et al., 2010; Hoffman, Marvin, Cooper, & Powell, 2006). A secondary purpose involved assessing if COS-P can positively impact three measurable social information processing and attachment variables associated with child maltreatment: (a) hostile attributions (b) emotion regulation, and (c) harsh discipline practices. Utilizing action research methodology, qualitative, quantitative, and secondary data sets were gathered. Quantitative results indicated that some participants who attended the majority of COS-P sessions showed reliable change (Jacobson & Truax, 1991) from pretest to posttest, with the largest changes in parental discipline practices. Qualitatively, COS-P participants, staff members at the agency, and the group researcher/facilitator overwhelmingly commented positively on the new curriculum, with the only noted weakness being more time needed with the curriculum. Further, a review of the participant's background demographic data indicated that participants who had reliable change (i.e., change that was larger than measurement error) on their dependent pretest to posttest measures differed from those who did not have reliable change on their measures on three background variables: education level, self-reported personal history of CM, and time in residential treatment. Results indicate that COS-P is a well-received, engaging program that may impact the parenting factors associated with CM for mothers in residential substance abuse treatment

Neonatal outcomes and their relationship to maternal buprenorphine dose during pregnancy

Buprenorphine pharmacotherapy for opioid-dependent pregnant women is associated with maternal and neonatal outcomes superior to untreated opioid dependence. However, the literature is inconsistent regarding the possible existence of a dose-response relationship between maternal buprenorphine dose and neonatal clinical outcomes

Concurrent Opioid and Alcohol Use Among Women Who Become Pregnant: Historical, Current, and Future Perspectives

The numbers of women using opioids who become pregnant have captured the attention of media, research, policy, and community. At the same time, there is an ever-growing use of alcohol among women who continue drinking during pregnancy that has received less focus. Although both untreated opioid use disorder and alcohol misuse pose risks for maternal, fetal, and child morbidities, alcohol is the substance with the most significant documentation of harms. As we focus on the opioid epidemic in the United States, it is critical that we do not overlook alcohol use during pregnancy. Both opioid use and alcohol use during pregnancy are important public health challenges and often happen concurrently. Thus, this commentary aims to (1) highlight the historical and current context of opioid and alcohol use during pregnancy; (2) summarize the current knowledge of opioids and alcohol use during pregnancy; and (3) detail future directions in how health care providers can help identify and therapeutically respond to women with concurrent opioid and alcohol use disorder

Domestic Violence Service Providers’ Perceptions Of Safety Planning: A Focus Group Study

Although safety planning is a widespread practice with clients impacted by domestic violence, the research on it is limited. In this article, we present a review of existing literature describing practices and research in order to understand the gaps in the field’s current understanding of safety planning practices. Next, we describe the methodology, findings, and implications of a focus group study that aimed to identify domestic violence service providers’ perspectives toward safety planning. The major themes discussed include safety risks for domestic violence victims; safety planning within the community context; and agency policies, procedures, and forms related to safety planning

Neonatal outcomes and their relationship to maternal buprenorphine dose during pregnancy

BACKGROUND: Buprenorphine pharmacotherapy for opioid-dependent pregnant women is associated with maternal and neonatal outcomes superior to untreated opioid dependence. However, the literature is inconsistent regarding the possible existence of a dose-response relationship between maternal buprenorphine dose and neonatal clinical outcomes. METHODS: The present secondary analysis study (1) examined the relationship between maternal buprenorphine dose at delivery and neonatal abstinence syndrome (NAS) peak score, estimated gestational age at delivery, Apgar scores at 1 and 5 minutes, neonatal head circumference, length, and weight at birth, amount of morphine needed to treat NAS, duration of NAS treatment, and duration of neonatal hospital stay; and (2) compared neonates who required pharmacotherapy for NAS to neonates who did not require such pharmacotherapy on these same outcomes, in 58 opioid-dependent pregnant women receiving buprenorphine as participants in a randomized clinical trial. RESULTS: (1) Analyses failed to provide evidence of a relationship between maternal buprenorphine dose at delivery and any of the 10 outcomes (all p-values>.48); and (2) significant mean differences between the untreated (n=31) and treated (n=27) for NAS groups were found for duration of neonatal hospital stay and NAS peak score (both p-values<.001). CONCLUSIONS: (1) Findings failed to support the existence of a dose-response relationship between maternal buprenorphine dose at delivery and any of 10 neonatal clinical outcomes, including NAS severity; and (2) that infants treated for NAS had a higher mean NAS peak score and, spent a longer time in the hospital than did the group not treated for NAS is unsurprising