Reducing potential for child abuse among methadone-maintained parents: Results from a randomized controlled trial
Abstract
High rates of child abuse and neglect occur in many families in which either or both parents abuse illicit drugs. This study reports on the results of a randomized controlled trial with families having a parent on methadone maintenance (N = 64), in which an intensive, home-based intervention, the Parents Under Pressure (PUP) program, was compared to standard care. A second brief intervention control group of families received a two-session parenting education intervention. The PUP intervention draws from the ecological model of child development by targeting multiple domains of family functioning including the psychological functioning of individuals in the family, parent-child relationships, and social contextual factors. Mindfulness skills were included to address parental affect regulation, a significant problem for this group of parents. At 3- and 6-month follow-up, PUP families showed significant reductions in problems across multiple domains of family functioning, including a reduction in child abuse potential, rigid parenting attitudes, and child behavior problems. Families in the brief intervention group showed a modest reduction in child abuse potential but no other changes in family function. There were no improvements found in the standard care group and some significant worsening was observed. Results are discussed in terms of their implications for improved treatment.
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Four studies compared an eligible intervention group with two eligible control groups.
“In four studies, an eligible intervention group was compared to two eligible control groups (Coatsworth 2010; Coatsworth 2015; Dawe 2007; Whittingham 2013).”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Dawe 2007
For Dawe 2007, the risk of selection bias from random sequence generation was judged unclear because information on how randomisation was achieved was lacking.
“Unclear risk There was a lack of information provided about how randomisation was achieved:”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Dawe 2007
For Dawe 2007, the risk of performance bias was judged high because information on blinding was insufficient and blinding is generally unfeasible in this type of study.
“High risk There was insufficient information provided about whether participants or researchers were blinded.However, sufficient blinding to reduce performance bias is generally unfeasible in this type of study, and so the risk of bias has been assessed as high.”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Dawe 2007
In Dawe 2007, there were no differences between completers and leavers on any intake variables (age, child's age, parent's methadone dose, abuse potential, rigidity, hazardous drinking, child gender).
“There were no differences between those who completed the study and those who le on any of the intake variables (i.e.age, child's age, parent's methadone dose, abuse potential, rigidity, level of hazardous drinking, or child gender).”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Dawe 2007
For Dawe 2007, the risk of selection bias from allocation concealment was judged unclear because information on concealment measures was insufficient.
“Unclear risk Insufficient information was reported about the measures undertaken to conceal the allocation of participants to each group.”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Dawe 2007
In Dawe 2007, missing data were handled by carrying forward assessment scores in line with an intention-to-treat analysis.
“In the case of missing data, the assessment scores were carried forward in line with an intent-to-treat analysis.”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Dawe 2007
For Dawe 2007, the risk of attrition bias was judged high.
“High risk There was 17% attrition at 6 months follow up.”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Dawe 2007
For Dawe 2007, the risk of reporting bias was judged low because all expected outcomes were reported, though uncertainty exists due to the absence of a trial protocol.
“Low risk All expected outcomes are reported.However, in the absence of a trial protocol, there is some uncertainty here.”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Dawe 2007
The attrition rate in Dawe 2007 was 17% at 6 months follow-up.
“There was 17% attrition at 6 months follow up.”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Dawe 2007
For Dawe 2007, the risk of other bias was judged high because there were clear treatment differences between groups other than the main intervention.
“High risk There were clear treatment differences between the groups other than the main intervention, which may introduce performance bias.”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Dawe 2007
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Interventions for women prisoners and their children in the post-release period
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Self-citationEffectiveness of psychosocial interventions for reducing parental substance misuse
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Self-citationCognitively‐Based Compassion Training for parents reduces cortisol in infants and young children
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Feasibility study of a family-focused intervention to improve outcomes for children with FASD.
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Self-citationChildren of substance‐using mothers: child health engagement and child protection outcomes
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The Relationship between Child Stress, Child Mindfulness and Parent Mindfulness
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Day, C., Kowalenko, S., Ellis, M. M., Dawe, S., Harnett, P. H., & Scott, S. (2010) · Child and Adolescent Mental Health · doi:10.1111/j.1475-3588.2010.00588.x · Cited by 25 · see citing works
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Review of Nonverbal Communication in Parent–Child Relationships: Assessment and Intervention
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Cost‐Effectiveness Analysis of the Parents under Pressure Programme for Methadone‐Maintained Parents
Dalziel, K., Dawe, S., Harnett, P. H., & Segal, L. (2015) · Child Abuse Review · doi:10.1002/car.2371 · Cited by 24 · see citing works
Self-citationAssessing Capacity to Change in High‐Risk Pregnant Women: A Pilot Study
Harnett, P. H., Barlow, J., Coe, C., Newbold, C., & Dawe, S. (2017) · Child Abuse Review · doi:10.1002/car.2491 · Cited by 23 · see citing works
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Effectiveness of psychosocial interventions for reducing parental substance misuse.
McGovern, R., Newham, J., Addison, M., Hickman, M., & Kaner, E. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012823 · Cited by 30 · see citing works
Buddhist Approaches to Addiction Recovery
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Accelerating the Pace of Science: Improving Parenting Practices in Parents with Opioid Use Disorder
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Governing Parental Drug Use in the UK: What’s Hidden in “Hidden Harm?”
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An Evidence-Based, Pre-Birth Assessment Pathway for Vulnerable Pregnant Women
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A Pilot Randomized Trial of a Mindfulness-Informed Intervention for Child Welfare-Involved Families
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Systematic review of economic evaluations of children’s social care interventions
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- Authors
- Dawe, S., & Harnett, P.
- Affiliations
- Griffith University (AU)
- The University of Queensland (AU)
- Corresponding author
- Dawe, Sharon
- Venue
- Journal of Substance Abuse Treatment
- Publisher
- Elsevier BV
- Published
- 2007-06
- Volume
- 32
- Issue
- 4
- Pages
- 381-390
- ISSN
- 0740-5472 (ISSN-L)
- OpenAlex
- W2168040041
- Cited by
- 175
- References
- 59
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 9 · 2023: 3 · 2022: 11 · 2021: 12 · 2020: 12 · 2019: 8 · 2018: 10 · 2017: 14 · 2016: 13 · 2015: 18 · 2014: 13 · 2013: 9 · 2012: 11
- FWCI
- 3.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Substance Abuse Treatment (publishedVersion)
- PubMed (publishedVersion)
- Griffith Research Online (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Safety Research › Child Welfare and Adoption
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- child abuse prevention, methadone maintenance treatment, home-based intervention, parent education, mindfulness, family functioning, child behavior problems, child abuse potential
- MeSH terms
- Adult, Child, Child Abuse, Child, Preschool, Family Therapy, Female, Humans, Male, Methadone, Opioid-Related Disorders, Queensland, Multivariate Analysis, Linear Models, Parenting
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