Biography
Biography: Eli Marie Wiig
Abstract
Background: Children born to substance-dependent mothers who themselves had an upbringing disturbed by parental substance-abuse problems, are at particular high risk of adverse childhood experiences, dysfunctional family life, and to develop psychological problems, including substance dependence. There is a need to develop more knowledge on helpful interventions for these vulnerable pregnant women and families. In Norway, use of coercion against pregnant substance-abusing women to prevent drug exposure for the unborn child, was legalized in 1996. Despite promising experiences no other country has adopted a similar Act.
Aims: 1) To explore how substance-dependent mothers describe the association between childhood experiences with substance-abusing parents and their own role as caregivers. 2) To explore the social support available for these families 3) How do the professionals at this family-ward describe the aims and interventions in the treatment and their therapeutic roles? 4) How does coercion influence pregnant women’s attachment to the unborn child?
Methods: Using purposeful sampling, 17 pregnant women and mothers, admitted to in-patient substance abuse treatment, were in-depth interviewed, eight of them in involuntary treatment. Nine of the mothers’ significant, others were interviewed to explore the characteristics of the social support available. Then focus-group interviews with 15 professionals were included. Data were analyzed using systematic text condensation and thematic analysis.
Findings: The substance-dependent pregnant women were satisfied with being incarcerated and expressed that this helped them stay abstinent and start an attachment process. Mothers from families with substance abuse described having lived their whole lives on ‘the edge of society’, and were facing a complex rehabilitation process. All mothers worked to abstain from substances, process traumatic experiences, build supportive social networks and to establish safe family environments for themselves and their children. The significant others’ relationships with the mothers were close, consistent and reliable although they were themselves exposed to adverse experiences and cumulative psychosocial and socioeconomic risk factors. Dual treatment of families with parental substance dependence appeared to be complex and challenging, but in-patient treatment was described as well suited for using present-moment situations therapeutically. Some professionals found it challenging to embrace the whole family and concentrated their attention mainly on the parent, or on the well-being of the child. This work seemed to be an area of low prestige, and some professionals had problems staying emotionally balanced. Consequently they needed to take care of their own emotion regulation and time to improve cooperation and support each other.