Mothering from the Inside Out: A mentalization-based therapy for mothers in treatment for drug addiction.

Not all mothers with histories of substance use struggle as parents, but many of them do. Research has shown that, although quality of caregiving varies widely, as a group, mothers with histories of chronic substance use are at greater risk than mothers with no substance use history for losing custody of their young children (Grant et al., 2011; Choi & Ryan, 2006; Department of Health and Human Services, 1999). In observational studies, mothers with substance use disorders have demonstrated lower levels of sensitivity and responsiveness to their young children's emotional cues and marked oscillation between intrusive, over-controlling behavior and passive withdrawal (Hans et al., 1999; Burns et al., 1997). Recent developments in the neuroscience of addiction and parenting may help to explain the marked absence of sensitivity and the dramatic juxtaposition of parenting behaviors.