“It's Just Broken Branches”: Maternal Dual Experiences of Insecurity and Striving for Resilience in the Aftermath of Complex Trauma and Familial Substance Abuse”

Background and Purpose: Limited literature exists bringing the voices of child-welfare system (CWS) affected mothers into the conversation on youth and family well-being. Specifically, the use of maternal experiences and perspectives to harness existing potential for the support of healthy youth development within stable and safe families and communities is unexplored. This study helps fill this gap, focusing on the lived experiences of CWS-affected mothers jointly impacted by complex trauma and familial substance abuse. Many such mothers are embedded within intergenerational patterns of CWS involvement, having experienced intervention both as children and parents, wherein the effects of complex trauma (including family violence) and substance use ripple unfettered across generations. Analysis of these perspectives may lead to better-targeted, attuned interventions that support healthy development for youth within the context of their families and communities.

Methods: Twenty-seven detailed, semi-structured interviews were conducted using a phenomenological life histories approach. Data were collected in Baltimore and New York City with CWS-affected adult mothers (N = 15; ages 19 to 46). Participants were majority African American (40%) and Latina (40%), whereas 20% self-identified as biracial. Participants all came from low- to lower-middle income backgrounds. Data were secondarily analyzed, drawn from two very similar, larger phenomenological qualitative studies on maternal experiences of trauma, home of origin or personal substance use, and motherhood. Recruitment occurred primarily through community-based organizations using nominations sampling and snowball sampling. Phenomenological analysis included a detailed, case-level examination of mothers’ experiences, producing a set of case-level themes for each participant. Patterns of convergence and divergence were compared across case-level themes and corresponding experiences, producing final sub-themes and themes characterizing participants’ experiences of complex trauma and substance use. Study rigor was enhanced by using a team approach to analysis, with regular peer debriefing where any analytic disagreements were managed through discussion until consensus was reached.

Findings: Emergent themes in CWS-affected mothers’ lives included tremendous insecurity across domains of experience (relational, financial, and housing), yet striking resilience over time (perseverance, empathy, and faith) despite the devastation wrought by substance abuse and violence within participants’ families. Mothers shared the profound impact of complex trauma, including family violence, which was both complicated and relieved by substance use in their families, as a central part of their life experience as children and mothers.

Implications: With limited access to effective mental health (MH) treatments for the deleterious effects of exposure to trauma, CWS-affected mothers may turn to harmful coping mechanisms, such as substance abuse (SA). SA thus emerges as a somewhat understandable alternative to continually experiencing the pain of complex trauma, with complicated effects: providing relief from experiencing the emotional consequences of trauma exposure, yet wreaking havoc on the fundamentals of daily living. Using a developmentally adaptive lens, these study findings suggest that SA can be understood as symptomatic of a larger issue - untreated complex and compound trauma within a particularly marginalized group - which profoundly impacts youth and families within and across generations. As such, comprehensive trauma-informed behavioral health prevention and intervention is critical for CWS-affected families.