"I Finally Found My Voice": The Role of Insight and Self-Reflection for Parents of Young Children in Substance Use Recovery

Background: Many substance use disorder (SUD) treatment programs emphasize self-reflection and self-development as critical aspects to recovery (Breuninger, et al., 2020). Similarly, the BRIGHT attachment-based therapeutic parenting intervention offered as an enhancement to SUD treatment encourages clients’ reflective processes which can help connect work in substance use recovery with parenting practices (Paris, et al., 2018). Effectively addressing parenting for women with SUDs is essential as children’s development is profoundly dependent on being optimally parented. However, the literature on parenting-focused recovery programs has largely neglected the insights that emerge for participants, and how the self-reflections are applied to parenting. The aims of this study are to explore 1) the insights that BRIGHT participants report developing about themselves through their work in the intervention, and 2) applications of these insights to parenting, including benefits to the parent-child relationship and self-confidence.

Methods: Qualitative interview data were used from an evaluation of the BRIGHT intervention. Interviews were conducted with mothers of young children at discharge (N=24; 92% white; 88% unmarried; M age=32; hs/some college 67%; top substances of misuse- heroin, opioids, cocaine, alcohol). Interviewers asked participants about parenting experiences before and after entering recovery and BRIGHT intervention participation, including questions about motivation to enroll in BRIGHT, relationship with their child, and perceived changes in parenting. Transcripts from audiotaped interviews were coded by two research assistants and supervised by the study’s PI using the QDA software NVivo. Analyses used grounded theory techniques (Charmaz, 2014) including line-by-line coding and subsequent creation of concise themes and categories.

Results: Data analysis revealed that participants in the BRIGHT intervention developed insights about themselves as parents in recovery and directly applied those insights to their parenting. Women reflected on the inner and environmental shifts that solidified their sense of readiness to enroll in BRIGHT and pursue recovery. Many attributed their work in BRIGHT to gaining a deeper understanding of how their emotions can influence their child, and how their trauma and guilt related to past substance use can manifest in their parenting. In response to these insights, some women reported that they learned to apply emotion regulation skills to their parenting, benefiting their child and their own wellbeing. Many participants noted that their identities as parents had changed as they developed confidence and self-acceptance through reflective work in BRIGHT. Finally, numerous women expressed a new understanding of the importance of self-focused work to parenting in recovery, such as processing trauma, engaging in self-care habits, and developing self-advocacy and emotion regulation skills.

Conclusions: Findings highlight the ability of participants to engage in self-reflection as a central aspect of a therapeutic parenting-in-recovery intervention. By providing guidance to participants as they process their past traumas, guilt, and identity as parents, BRIGHT clinicians supported participants' development of self-confidence, self-acceptance, self-care, and emotion regulation skills that are critical to parenting in recovery. Given the limited access to effective social work interventions addressing mothering with SUDs, a major social justice concern, these findings offer details of one empowering intervention from the voices of participants themselves.