A Type I Hybrid Effectiveness-Implementation Trial of Mothering From the Inside Out (MIO)

What this Trial Is About

Mothers recovering from substance use disorders face unique challenges balancing parenting with maintaining their own recovery. This research evaluates the Mothering from the Inside Out (MIO) intervention, an attachment-based parenting program designed specifically to support mothers in recovery. The study aims to test MIO's effectiveness in outpatient treatment settings, examine how well it can be implemented in different clinics, and identify factors that help with wider adoption. This addresses a critical gap in care for mothers with substance use disorders and their children. Participants will be randomly assigned in a 2:1 ratio to receive either MIO combined with usual treatment or usual treatment alone. MIO is an individual psychotherapy that helps mothers better understand their own and their children's feelings and behaviors through a supportive, reflective approach. The study will involve 200 mothers caring for children aged 0 to 5 years, recruited from four community clinics. The intervention period spans 21 weeks, followed by assessments at 13 weeks, post-treatment at 21 weeks, and follow-up at 33 weeks. Throughout the study, mothers will complete various assessments including measures of parental reflective functioning, parenting stress, quality of mother-child interactions, substance use, and mental health symptoms like anxiety and depression. Implementation factors such as treatment fidelity and feasibility will also be evaluated. Data collection includes baseline, during treatment, post-treatment, and follow-up visits, ensuring comprehensive monitoring of both clinical outcomes and how well the intervention is delivered. The total study period extends to 33 weeks per participant with ongoing evaluation of organizational and counselor-related factors.

A Type I Hybrid Effectiveness-Implementation Trial of MIO