Teaching Parenting Skills in a Methadone Treatment Setting

Abstract

Family factors significantly affect children's risk of substance abuse, delinquency, and other problem behaviors (Arthur, Hawkins, Pollard, Catalano, & Baglioni, 2002). Children of substance abusers represent a particularly high-risk population. Prenatal exposure to addictive substances and the medical complications that may arise are important factors that, from conception, place this population at high risk of drug abuse and other problem behaviors (Griffith, Azuma, & Chasnoff, 1994). As children of substance abusers mature, their lives are characterized by exposure to continued drug and alcohol abuse by family members, recurrent or chronic illnesses, frequent moves, financial troubles, legal conflicts, family disorganization, and family conflict (Keller, Catalano, Haggerty, & Fleming, 2002; Kolar, Brown, Haertzen, & Michaelson, 1994). Furthermore, substance-abusing parents tend to have poorer family management practices than nonabusers (Kolar et al.). Substance-abusing parents in treatment are dealing not only with their addiction, the possibility of relapse, and struggles with employment and living arrangements, but also with their role as parents and the influence of their addiction on their children (Greif, 2005). Parenting skills training is increasingly used as a preventive intervention (see reviews by Cedar & Levant, 1990; Howard & Shepard, 2005; Polster, Dangel, & Rasp, 1987). Several programs have been developed to help substance-abusing parents reduce their children's risk of substance abuse (Camp & Finkelstein, 1997; Catalano, Haggerty, Fleming, Brewer, & Gainey, 2002; Dawe, Harnett, Rendalls, & Staiger, 2003; DeMarsh & Kumpfer, 1985; Gross & McCaul, 1992).Theoretical and empirical work suggests that methadone maintenance programs may be a strategic setting for parenting skills training programs because methadone has been shown to reduce illicit heroin use and criminal activity and to provide greater stability in the lives of users (Ward, Mattick, & Hall, 1998). Methadone treatment by itself, however, is unlikely to ameliorate dysfunctional family relationships. To date, only a few programs for this population have been evaluated for their effect on improving parenting skills (Dawe et al.; DeMarsh & Kumpfer). Data reported here come from the Focus on Families (FOF) field experiment (see Catalano et al., 2002 for a full description of the program). The intervention combined relapse prevention (Marlatt & Gordon, 1985) and parenting skills training (33 sessions) with home-based case management services that lasted approximately nine months. Case managers worked with families in their homes, helping parents generalize the skills learned in the training to the home environment and taking advantage of naturally occurring situations to practice and reinforce skills. Parents were taught positive family management practices (including monitoring, limit setting, and using positive and negative consequences for socially appropriate and antisocial behavior), how to communicate more effectively with their children, how to hold family meetings to increase children's involvement in family tasks and activities, how to teach children problem-solving and drug-refusal skills, and strategies to help their children succeed in school. The intervention was successful in increasing parents' relapse-prevention skills and self-efficacy while reducing parental substance use, domestic conflict, and deviant peer networks (Catalano, Gainey, Fleming, Haggerty, & Johnson, 1999; Catalano et al., 2002; Gainey, Catalano, Haggerty, & Hoppe, 1995).To date the project has not published data specifically on the success or failure of the intervention in increasing parenting skills. Given the importance of evidence-based practice in social work (Jenson, 2005; Whittaker et al., 2006), this article describes an instrument specifically designed to measure parenting skills among substance-abusing parents and reports results from a field experiment using this instrument to assess the efficacy of a family-based program for the parents receiving methadone treatment. …