The proposed study will involve a randomized clinical trial of the Relational Parenting Mothers' Group, (RPMG), an intervention designed for opioid abusing women with children less than 14 years of age, which was manualized and pilot tested as part of a Phase I study (P50-DA09241). This intervention was developed in recognition of the substantial psychosocial risks faced by substance abusing mothers and their offspring, and the notable lack of parenting interventions currently available for addicted mothers with children past the infancy years. Based on developmental psychopathology perspectives on resilience, this integrative treatment addresses multiple levels of adversity (individual, community, and family) faced by drug abusing mothers: risks that typically result in negative parenting behaviors and psychosocial distress among the mothers and concomitantly, psychiatric disturbance among their offspring. RPMG is a structured treatment, entailing 24 weekly group sessions of 1 1/2 hours each. Preliminary data collected in the Phase I study have attested to the promise of RPMG in terms of diverse parenting behaviors and psychiatric outcomes among both the mothers and their children, and in the proposed study, we seek to conduct a randomized clinical trial in which RPMG will be compared with Recovery Training (RT; a manualized treatment resembling standard drug counseling). Both RPMG and RT interventions will be offered as supplements to treatment regularly offered at the methadone clinics. Eighty methadon-maintained mothers will be randomized to each of the two treatment conditions, yielding a total sample size of 160. Multiple-method, multiple-informant assessments will be obtained to measure salient outcomes, including reports from the mothers and their children, and from the mothers' clinicians and the children's teachers. The following specific goals will be addressed within this study: (1.) To evaluate the comparative effectiveness of RPMG versus RT in terms of improvements in (a.) mothers' parenting behaviors and attitudes, and their psychiatric disturbance; as well as and (b.) in their children's levels of symptomatology and everyday social competence; (2.) To evaluate the durability of RPMG treatment gains, as well as potentially delayed treatment effects, via follow-up assessments of both mothers and children six months after the active phase of RPMG treatment; and (3.) To examine ways in which specific maternal characteristics relate to treatment success. Guided by previous research, these characteristics will include (a.) intelligence (b.) sensation seeking (c.) ethnicity; and (d.) readiness for treatment.
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