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Cited by 218Attachment and Relationship DynamicsPsychoanalysis and Psychopathology ResearchPsychotherapy Techniques and Applications

The Mothers and Toddlers Program, an attachment-based parenting intervention for substance using women: Post-treatment results from a randomized clinical pilot

Open access
Suchman, Nancy E., DeCoste, Cindy, Castiglioni, Nicole, McMahon, Thomas J., Rounsaville, Bruce, Mayes, Linda·2010·Attachment & Human Development
DOI 10.1080/14616734.2010.501983PMC PMC2928150
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Abstract

This is a report of post-treatment findings from a completed randomized pilot study testing the preliminary efficacy of the Mothers and Toddlers Program (MTP), a 12 week attachment-based individual parenting therapy for mothers enrolled in substance abuse treatment and caring for children ages birth to 36 months. Forty-seven mothers were randomized to MTP versus the Parent Education Program (PE), a comparison intervention providing individual case management and child guidance brochures. At post-treatment, MTP mothers demonstrated better reflective functioning in the Parent Development Interview, representational coherence and sensitivity, and caregiving behavior than PE mothers. Partial support was also found for proposed mechanisms of change in the MTP model. Together, preliminary findings suggest that attachment-based interventions may be more effective than traditional parent training for enhancing relationships between substance using women and their young children.

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Crossref · 10.1080/14616734.2010.501983

Cites

58 of 58 references verified0 citation errors · 0 not checkable

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  • MIO has been associated with improved caregiving in multiple clinical trials.

    “MIO has been associated with reduced rates of relapse and depressive symptoms, improved caregiving, and enhanced child attachment in multiple clinical trials (Lowell, DeCoste, et al., 2023; Suchman et al., 2008; Suchman et al., 2010; Suchman et al., 2011; Suchman, DeCoste, et al., 2017; Suchman, Ordway, et al., 2016)”

    From Home‐based family recovery supports: Feasibility, acceptability, and adoption of training home visitors in “Mothering from the Inside Out” (2025) · cites this paper as Suchman et al., 2010

    The Results (Treatment outcomes; page unavailable) report moderately higher caregiving and contingency scores for mothers receiving MTP than for the comparison group, supporting improved caregiving in this randomized pilot. The paper calls the intervention MTP, not MIO, and reports one pilot trial; our copy does not establish the name equivalence or the claim about multiple trials. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • MIO has been associated with reduced depressive symptoms in multiple clinical trials.

    “MIO has been associated with reduced rates of relapse and depressive symptoms, improved caregiving, and enhanced child attachment in multiple clinical trials (Lowell, DeCoste, et al., 2023; Suchman et al., 2008; Suchman et al., 2010; Suchman et al., 2011; Suchman, DeCoste, et al., 2017; Suchman, Ordway, et al., 2016)”

    From Home‐based family recovery supports: Feasibility, acceptability, and adoption of training home visitors in “Mothering from the Inside Out” (2025) · cites this paper as Suchman et al., 2010

  • MIO has been associated with reduced rates of relapse in multiple clinical trials.

    “MIO has been associated with reduced rates of relapse and depressive symptoms, improved caregiving, and enhanced child attachment in multiple clinical trials (Lowell, DeCoste, et al., 2023; Suchman et al., 2008; Suchman et al., 2010; Suchman et al., 2011; Suchman, DeCoste, et al., 2017; Suchman, Ordway, et al., 2016)”

    From Home‐based family recovery supports: Feasibility, acceptability, and adoption of training home visitors in “Mothering from the Inside Out” (2025) · cites this paper as Suchman et al., 2010

    The Results (Treatment outcomes; page unavailable) report reduced drug use in both the MTP and comparison groups, not reduced relapse rates associated with MTP. The Discussion says relapse prevention was only a possibility and that follow-up analysis was needed to identify group differences. This single pilot does not establish the claimed relapse finding across multiple trials. (LLM, conf=0.74)

    Experimental — accuracy not yet measured

  • MIO has been associated with enhanced child attachment in multiple clinical trials.

    “MIO has been associated with reduced rates of relapse and depressive symptoms, improved caregiving, and enhanced child attachment in multiple clinical trials (Lowell, DeCoste, et al., 2023; Suchman et al., 2008; Suchman et al., 2010; Suchman et al., 2011; Suchman, DeCoste, et al., 2017; Suchman, Ordway, et al., 2016)”

    From Home‐based family recovery supports: Feasibility, acceptability, and adoption of training home visitors in “Mothering from the Inside Out” (2025) · cites this paper as Suchman et al., 2010

    The Results (Treatment outcomes; page not available) report improvements in maternal representations and caregiving, but no overall MTP-versus-comparison difference in child behavior. The outcome-measures section describes assessments of mothers and caregiver–child interactions, not child attachment. The Introduction discusses child attachment findings from other interventions; this paper does not establish enhanced child attachment for MTP. (LLM, conf=0.77)

    Experimental — accuracy not yet measured

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Cites

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1 of the 59 references couldn’t be matched to a known paper.

Research works printed but not linked: 7

  1. Cohen NJ Muir E Lojkasek M Muir R Parker CJ Barwick M Brown M Watch, wait, and wonder: Testing the effectiveness of a new approach to mother-infant psychotherapy. Infant Mental Health Journal 1999 20 429 451
  2. Egeland B Weinfield NS Bosquet M Cheng VK Osofsky JD Fitzgerald HE Remembering, repeating, and working through: Lessons from attachment-based interventions. WAIMH Handbook of infant mental health: Vol. 4. Infant mental health in groups at high risk 2000 38 89 John Wiley & Sons, Inc. NY
  3. Howard J Beckwith L Rahdert ER Issues in subject recruitment and retention with pregnant and parenting substance-abusing women. Treatment for drug-exposed women and children: Advances in research methodology 1996 68 86 NIDA Research Monograph 165 8818166
  4. Main M Goldwyn R Main M Adult attachment classification system. Behavior and the Development of Representational Models of Attachment: Five Methods of Assessment 1995 Cambridge University Press
  5. National Center on Addiction and Substance Abuse Women under the influence 2006 Johns Hopkins University Press Baltimore, MD
  6. Suchman N The Mothers and Toddlers Program: An attachment-based intervention for mothers in substance abuse treatment. 2008 Invited presentation to the National Abandoned Infants Assistance Resources Center Strengthening Connections Conference San Francisco, CA 3/14/08
  7. Suchman NE DeCoste C Mayes L Zeanah C The Mothers and Toddlers Program: An attachment-based parenting intervention for mothers in substance abuse treatment. Handbook of infant mental health Guilford Press New York 3rd. ed. in press

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Authors
Suchman, N. E., DeCoste, C., Castiglioni, N., McMahon, T. J., Rounsaville, B., & Mayes, L.
Affiliations
Yale University (US)
Corresponding author
Suchman, Nancy E.
ORCID
Venue
Attachment & Human Development
Publisher
Informa UK Limited
Published
2010-08-18
Volume
12
Issue
5
Pages
483-504
ISSN
  • 1461-6734 (ISSN-L)
  • 1469-2988
DOI
10.1080/14616734.2010.501983
PMC
PMC2928150
OpenAlex
W1986326595
Cited by
218
References
59
Citations by year
2026: 4 · 2025: 12 · 2024: 7 · 2023: 16 · 2022: 12 · 2021: 19 · 2020: 19 · 2019: 13 · 2018: 17 · 2017: 18 · 2016: 19 · 2015: 19 · 2014: 13 · 2013: 12 · 2012: 14
FWCI
13.12
Type
journal article
Language
en
Open access
Locations
  • Attachment & Human Development (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Drug Abuse (R01DA017294, K02DA023504)
Topics
  • Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
maternal substance use, reflective functioning, maternal sensitivity, caregiver behavior, parent education, young children, mechanisms of change, parent-child relationship
MeSH terms
Adult, Child Behavior, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Interviews as Topic, Male, Maternal Behavior, Mother-Child Relations, Mothers, Object Attachment, Pilot Projects, Parenting, Treatment Outcome, Caregivers, Substance-Related Disorders, Young Adult, Intention to Treat Analysis

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