Trial of Mothering from the Inside Out MIO Parenting Support for Women in Outpatient Treatment for Substance Use Disorders

What this Trial Is About

This research evaluates Mothering from the Inside Out MIO, an attachment-based parenting intervention designed for mothers recovering from substance use disorders SUDs. The study focuses on women enrolled in outpatient SUD treatment who care for children aged 0 to 5 years. It aims to test MIOs effectiveness in real-world community settings, assess implementation across different clinics, and identify factors that support wider use of this therapy to improve maternal and child health. Participants are randomly assigned in a 21 ratio to receive either MIO plus treatment as usual TAU or TAU alone. MIO involves individual psychotherapy sessions that help mothers reflect on their own and their childrens mental states to improve parenting and reduce stress. The study involves 16 counselors delivering MIO in four clinics, with the goal to evaluate both clinical outcomes and implementation processes over the treatment period. During the study, mothers will undergo assessments of parental reflective functioning, parenting stress, mother-child interaction quality, substance use, anxiety, and depression at multiple timepoints up to 33 weeks. Counselors fidelity and feasibility delivering MIO are also monitored. The trial includes mixed-methods evaluations of organizational culture and attitudes to understand implementation success. Participation extends up to about 8 months, including treatment and follow-up visits.

A Type I Hybrid Effectiveness-Implementation Trial of MIO