This month, Caroline Phillips, Amy Sommer, and I, all clinicians from Project NESST® (Newborns Exposed to Substances: Support and Therapy), presented at the Infant-Parent Training Institute's Master Class regarding themes and challenges we have encountered working with mothers who are struggling with the dual tasks of substance-use recovery and early parenting. Some of the thoughts and lessons we shared regarding our work with these vulnerable families included:
- Clinical case management, which involves building a collaborative relationship around obtaining concrete needs such as housing, food, income, is an intervention that can successfully create a feeling of safety and trust with clients who have experienced complex trauma. It can also be an entry point into working therapeutically with clients who are unable or unwilling to explore their emotional lives.
- Assistance with concrete needs allows a client to identify herself and her baby as having needs, both physical and psychological, that can be described and met.
- Mothers with substance use disorders often struggle to hold their children in mind, to be responsive to their children's needs, and to stay emotionally connected to their children. Mothers in recovery often have multiple vulnerabilities that impact their capacity to be reflective and to regulate their emotions.
- Working with mothers with substance use disorders and in recovery can be challenging for clinicians who must determine the most effective way to support the growth of a mother's ability to understand herself and the needs of her baby and to enhance the mother baby bond.
- As part of therapy, mothers can be supported to integrate the different parts of themselves, such as "addict" and "mother," and shifting identities and truths can be welcomed by a therapist. When the client's reality of self is made room for in therapy, the client's complex realities that she herself navigates can be explored and understood.
It was inspiring to be part of IPTI's Master Class and see how many providers are interested in learning about working with mothers who are struggling with the dual tasks of substance-use recovery and early parenting. While our work in Project NESST® is complex, a mother's progress towards emotional healing and a healthy parent-child relationship is often palpable.