Fostering Mothers Emotionally-Responsive Parenting

培养母亲情绪敏感的养育方式

• 批准号: 8912076
• 负责人: NANCY E SUCHMAN
• 金额: $ 61.97万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-20 至 2020-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8912076
• 关键词: Abstinence; Address; Adult; Aftercare; Age; Age-Months; Alcohol or Other Drugs use; Award; Behavioral; Caring; Child; Child Care; Child Guidance; Child Rearing; Child Support; Chronic; Classification; Clinic; Communities; Disease; Drops; Drug usage; Effectiveness; Emotional; Enrollment; Evaluation; Family; Fostering; Funding; Future; Future Generations; Impulsivity; Individual; Intervention; Intervention Studies; Investigation; Measures; Mediating; Medical; Modeling; Monitor; Mothers; Outcome; Parenting Education; Parents; Patients; Professional counselor; Randomized; Regulation; Relapse; Science; Secure; Security; Services; Severities; Societies; Staging; Substance abuse problem; Supervision; Testing; Training; Training Programs; Treatment outcome; Underserved Population; Ursidae Family; Woman; addiction; base; clinical efficacy; community based treatment; community setting; cost; design; effectiveness trial; efficacy trial; emotion dysregulation; emotional distress; evidence base; follow up assessment; follow-up; foster parent; high risk; improved; prevent; programs; psychologic; public health relevance; skills; stress tolerance; therapy design; therapy development; transmission process; treatment center; treatment duration

 DESCRIPTION (provided by applicant): This is an application to fund a new Stage III community-based randomized clinical efficacy trial testing Mothering from the Inside Out (MIO), the first evidence-based parenting intervention designed to be delivered by addiction counselors in addiction treatment settings where parents of young children are enrolled in treatment. In two (Stage I and II) randomized clinical efficacy trials conducted during the first 9 years of this award, when compared with a standard parent education program (PE), MIO demonstrated efficacy for improving parenting, child attachment security and for positively impacting abstinence from drug use. Importantly, mothers with high addiction severity assigned to MIO showed notable improvement across all outcomes. MIO is a weekly individual parenting therapy developed as an enhancement to standard addiction treatment that targets the addicted mother's capacity to recognize and regulate her own emotional distress during stressful parenting situations so that she can support her child's developing capacity for emotional and behavioral regulation. This capacity, called reflective functioning (RF), is a psychological skill that promotes abstinence and also helps parents foster their young children's secure attachment. Now that MIO has demonstrated efficacy in two randomized efficacy trials, the next step will be to conduct a new Stage III community-based efficacy trial where addiction counselors are trained to deliver MIO and PE with fidelity in an addiction treatment setting and to evaluate treatment outcomes and mechanisms of change in this community setting. This will be one of the first investigations implementing a new stage model for intervention research (Onken et al., 2014) where efficacious interventions are first tested under conditions of high internal validity (with treatment fidelity assured) before effectiveness is tested under conditions of high external validity. At the end of this trial, if MIO demonstrates efficacy, we will have allthe necessary materials to train addiction counselors across a broad range of treatment settings in a Stage IV effectiveness trial. In the first year, we will conduct a training pilot where 14 addicton counselors in an addiction treatment clinic will be randomly assigned to training in MIO vs PE delivery and complete a training case with a real patient during which fidelity will be measured. In years 2 - 5, 160 mothers in addiction treatment and caring for children ages 12 - 24 months will be randomized to 12 sessions of MIO vs PE with a trained addiction counselor and fidelity will be monitored and maintained for treatment duration. We predict that 1. When delivered by trained addiction counselors, MIO and PE can be discriminated; 2. MIO-assigned mothers will demonstrate greater improvement in reflective functioning and abstinence from substance use and their children will show greater improvement in attachment security at post-treatment and follow up; 3. MIO will confer greater advantage than PE for mothers with high addiction severity; and 4. Higher treatment fidelity will mediate better treatment outcomes and improvements in RF will mediate improvement in abstinence and child attachment security.

 描述（由应用程序提供）：这是一种用于资助新的基于III阶段的基于III期的随机临床效率试验试验，该试验是从Inside Out（MIO）母亲（MIO），这是第一个基于证据的育儿干预措施，旨在由成瘾治疗环境提供，其中幼儿的父母接受治疗。与标准的父母教育计划（PE）相比，在两项（I和II期）（第I和II阶段）进行的随机临床效率试验中，MIO表现出改善育儿，儿童依恋安全性和对药物使用的积极影响的效率。重要的是，分配给MIO的高成瘾严重程度的母亲在所有结果中都表现出显着改善。 MIO是每周一次的个人育儿疗法，是对标准成瘾治疗的增强，其目标是母亲在压力育儿的情况下识别和调节自己的情绪困扰的能力，以便她可以支持孩子对情绪和行为调节的发展能力。这种称为反射功能（RF）的能力是一种心理技能，可促进禁欲，并帮助父母培养幼儿的安全依恋。现在，MIO已经在两项随机效率试验中表现出效率，下一步将是进行新的基于III期的社区效率试验，其中成瘾硬币经过培训，可以在成瘾的治疗环境中以忠诚度传递MIO和PE，并评估该社区环境中的治疗结果和变化机制。这将是实施新的干预研究阶段模型的首次研究之一（Onken等，2014），该模型在高度内部有效性的条件下（假定的治疗保真度假定）首先在条件下测试有效性之前先进行有效的干预措施。 在这次试验结束时，如果MIO具有有效性，我们将拥有所有必要的材料来训练成瘾的次数在IV阶段有效性试验中的广泛治疗环境中。在第一年，我们将进行培训飞行员，其中有14个成瘾治疗诊所中的Addicton计数将被随机分配给MIO vs PE交付中的培训，并与真正的患者一起完成培训案例，在此期间将测量富达。在2 - 5年中，成瘾治疗中的160名母亲将在12-24个月的儿童中随机分配12个会议，并在训练有素的成瘾辅导员中进行12个会议，并将在治疗期限内监视和维持忠诚度。我们预测1。当通过受过训练的成瘾计数交付时，MIO和PE可能会被歧视； 2。由Mio分配的母亲将表现出对药物使用的反射功能和禁欲的改善，其子女将在治疗后和随访时显示出更大的依恋安全性； 3. Mio将比PE比PE更大的优势，对于高成瘾严重程度的母亲；和4。较高的治疗保真度将中位数更好的治疗结果和RF的改善将改善禁欲和儿童依恋安全。