Addressing Substance Use Among Maltreated Young Mothers to Prevent Intergenerational Child Maltreatment Transmission: Experiences of Child Welfare Social Workers

Background and Purpose: Both the opioid crisis and increasing marijuana legalization have recently led to increased awareness and criminalization of substance use among pregnant women. Substance use during pregnancy has potentially serious health implications for both the mother and fetus (and later, infant), and can lead to impaired parenting, including child abuse and neglect, if continued into the postpartum period. Mothers with a history of their own neglect or abuse are at higher risk for substance use. The purpose of this study is to understand the experiences of social workers who work with young mothers who have a history of maltreatment and are struggling with substance use, particularly as they support mothers to prevent or reduce the intergenerational transmission of child maltreatment.

Methods: Our team conducted in-depth phenomenological interviews with N=4 social workers (all women; mean age 29.3 years) regarding their experiences working with maltreated adolescent mothers struggling with substance use. We transcribed the audio files verbatim, then used the iterative six-step Interpretative Phenomenological Analysis (IPA) approach to explore themes in social workers’ lived experiences of addressing substance use among young, maltreated mothers of very young children.

Results: Social workers experienced working with young mothers as dually frustrating yet extremely important. Workers expressed frustration with the process of recovery and relapse and its effects on families, systems ill-equipped to manage the volume of need for mental health and substance use treatment for those mothers seeking to address their substance use, and inconsistent advice being given by medical providers to young mothers using substances, particularly regarding breastfeeding. An emerging area of concern was mothers’ legal use of medical marijuana being a potential risk to her ability to sensitively care for her children.

Conclusions and Implications: Social workers working with mothers struggling with substance use face a myriad of challenges in navigating legal, medical, and social service systems to best serve young, maltreated mothers with very young children. There are multiple opportunities to support families of pregnant and parenting maltreated youth who have used or currently use substances and their children by integrating the experiences of frontline social workers into a broader multi-disciplinary approach to policy and practice for young mothers in recovery. The introduction of medical marijuana stands out as an issue that needs immediate consideration in child welfare policy and practice. Social workers need to help mothers navigate addressing the health concerns prompting use of medical marijuana with consideration of the impact usage may have on multiple health and parenting outcomes.