Mothers in therapy for drug and alcohol use recover faster if their children take part in their treatment sessions, according to a first-of-its-kind study.
Researchers found that women who were in family therapy - which included their 8- to 16-year-old children - showed a quicker decline in alcohol, marijuana and cocaine use over 18 months compared to mothers who were in individual therapy.
This is the first study to examine the effectiveness of family therapy for mothers who are substance users, said Natasha Slesnick, lead author of the study and professor of human sciences at The Ohio State University.
"Interpersonal stress, especially within the family, has been shown to be an important factor in drug and alcohol abuse," Slesnick said. "So it makes sense that having mothers and children working together in therapy can help moms with substance use problems do better over time.
"Family therapy is not generally part of the treatment options for substance-using mothers, but this study suggests it should be."
Slesnick conducted the study with Jing Zhang, a postdoctoral researcher at Ohio State. The study appears in the current issue of Psychology of Addictive Behaviors.
The study involved 183 mothers who were seeking outpatient treatment and met diagnostic criteria for having an alcohol or drug use disorder. All had at least one biological child aged 8 to 16.
Some of the mothers were placed in a 12-session program called Ecologically Based Family Therapy. EBFT focuses on improving social interactions, emotional connectedness and problem resolution skills among family members.
Other mothers were assigned to an individual therapy program called Women's Health Education.
All participants were assessed at the beginning of the study and then three, six, 12 and 18 months later.
Substance use was assessed using structured interviews with the mothers in which the researchers calculated the percentage of mothers' total days of alcohol, marijuana, cocaine and opioids use in the past 90 days.
For the EBFT group, the mother and child participated in a 10-minute interaction task at the beginning of the study and six and 18 months later. The researchers watched the interaction and rated the mother and child relationship quality.
Results showed that all mothers showed reduced alcohol, marijuana and cocaine use over time, but mothers in the family therapy saw their substance use decrease more quickly.
The exception involved opioids, such as heroin - mothers reported similar decreases in use after both the individual and family therapies.
"Different drugs affect family dynamics in different ways, and we need more research to determine why opioids respond differently to family therapy," Slesnick said.
Family therapy is probably more helpful to moms battling most substance use issues than individual therapy because it deals with the family stresses that contribute to drug and alcohol use, she said.
The researchers hoped that assessing differences in the mother-child interaction before and after treatment would help them determine whether changes in these family dynamics were the key to the success of family therapy, but the results did not confirm that link. Slesnick said she still believes the link is there, but that there weren't enough subjects in the study to prove it.
Preliminary data from upcoming studies by the researchers suggests that family therapy is not only good for the mothers - it helps their children's mental health, as well.
"Children are usually not included in the treatment plans of their mothers, but they should be. They already have to deal with their moms' substance use in many ways. Being part of the therapy can help both them and their mothers," she said.
The study was funded by the National Institutes of Health.
Article: Family systems therapy for substance-using mothers and their 8- to 16-year-old children, Slesnick, Natasha; Zhang, Jing, Psychology of Addictive Behaviors, doi: 10.1037/adb0000199, published September 2016.