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Sheway is well-known in Canada for its success in providing wrap-around services for pregnant and newly parenting women who are dealing with complex personal and social circumstances. It is trauma-informed, women-centred, culturally responsive and uses a harm reduction approach with a focus on connection with self and others. Women and their children can remain in the program up to 18 months post-partum. Last December, Lenora Marcellus, University of Victoria, and Sheway published findings to their study on how women make the transition from Sheway to living on their own – Supporting Families at Sheway and Beyond. Additionally, Dr. Marcellus has published a journal article:

Marcellus, L. (2017). A grounded theory of mothering in the early years for women recovering from substance use. Journal of Family Nursing. E-print ahead of press. 

In order to learn what elements of a positive transition could be identified and built upon, they followed 18 women for 3 years after leaving Sheway. These women faced multiple obstacles in this transition process with the overarching theme being “holding it together.” Their daily efforts are explored in these 3 ways:

Download Sheway Report

Restoring Self: gaining recovery and taking care of self, reconnecting with self and others, and rebuilding trust and credibility.

Centering Family: parenting their children, preserving a routine, dealing with partners, and handling custody issues.

Creating  Home: “chasing housing”, having to take whatever housing is available even if inadequate, and maintaining not only a physical space but a feeling of home for the family

While acknowledging the value for pregnancy and postpartum support as most often provided in maternity programs, their findings underscore that secure housing is a key component to a successful transition for women and their families. Yet, although housing is important to the overall health of women and their families, the choices they must make often result in a double bind. For example, women often are faced with choosing between affordable housing that is far from supports versus more expensive housing that is near supports. Some women must choose between staying in an unsafe relationship or losing housing. As well, some women must accept inadequate housing because of their substance use history, which serves to undermine their recovery and their maintaining custody of their children.

“Poor housing was identified by women as a potential trigger to relapse in their recovery.” – [1] p. 39

Complete findings are detailed within the report and recommendations are framed within the Levels of Prevention model developed by this prevention network.  Among the research team recommendations is to extend the time women can stay in the program in order to solidify recovery, supports and resources. As well, they stress that housing needs to be a core component of intensive, integrated maternity programs.


For more on these topics, see earlier posts:

HOLISTIC AND SPECIALIZED SUPPORT FOR PREGNANT WOMEN: LEVEL 3 PREVENTION, November 21, 2016
THE MOTHER-CHILD STUDY: EVALUATING TREATMENTS FOR SUBSTANCE-USING WOMEN, MARCH 18, 2015
SUPPORTING PREGNANT AND PARENTING WOMEN WHO USE SUBSTANCES: WHAT COMMUNITIES ARE DOING TO HELP, OCTOBER 1, 2012
HERWAY HOME ‘ONE-STOP ACCESS’ PROGRAM IN VICTORIA SET TO OPEN, MAY 20, 2012
“NEW CHOICES” FOR PREGNANT AND PARENTING WOMEN WITH ADDICTIONS, JANUARY 9, 2012
TORONTO CENTRE FOR SUBSTANCE USE IN PREGNANCY (T-CUP), DECEMBER 19, 2011
CLINICAL WEBCAST ON BREAKING THE CYCLE PROGRAM: SEPTEMBER 20, 2011, AUGUST 2, 2011

  1. Marcellus, L., Supporting families at Sheway and beyond: Self, recovery, family home. 2016, Sheway: Vancouver, BC.

 

For the last four years, HerWay Home in Victoria, BC, has been providing outreach, medical and social services to pregnant and parenting women with difficult lives in a one-stop supportive environment. On June 23 from 9:00-10:00 a.m. PST, there will be a free webinar to share the results of a first-phase evaluation of HerWay.

Deborah Rutman and Carol Hubberstey of Nota Bene Consulting, and Nancy Poole of BC Centre of Excellence for Women’s Health will discuss lessons learned and promising practices, and lead a discussion on working with pregnant and parenting women affected by substance use, violence and mental health issues. With its child-focused, women-centred and family focused approach, HerWay Home encourages positive parenting and healthy outcomes for children and women.

Click here for more information and register by June 20th at http://fluidsurveys.com/surveys/bccewh/herway-home-evaluation-webinar/

To learn more about HerWay home and similar programs, see these previous postings:

 

Cover Mother-Child-Study_Report_2014

Mothercraft’s Breaking the Cycle (BTC) in Toronto is one of Canada’s first prevention and early intervention programs for pregnant women and mothers who are substance-involved and their young children.

The program’s goal is to reduce risk and enhance the development of substance-exposed children by addressing maternal substance use problems and the mother-child relationship.

Historically, treatments for substance use tended to minimize gender roles and, in particular, mothering relationships. Contemporary integrated treatments for substance use often emphasize gender-specific issues within the treatment setting, such as trauma (historical and/or present, including domestic violence), depression and other mental health concerns, and adoption of harm reduction goals with respect to substance use. Contemporary integrated treatments have also evolved to acknowledge the importance of the mothering role for women.

Profile of BTC families

This evaluation report described the findings of the Mother-Child Study. The study evaluated and compared the Breaking the Cycle program model of relationship-focused service delivery and its effects on mothers and children with a group of similar women who received a more standard contemporary integrated treatment for substance use issues.

The findings of the Mother-Child Study highlight the critical role of relational-focused interventions in supporting change for substance-involved mothers and their children.

Program features that made a difference for women’s outcomes included:

  • Supporting women to learn about relationships in a number of different ways
  • Making the focus on relationships an integral part of substance use treatment
  • Recognizing that increased relationship capacity with their children enriches the lives of women

Program features that made a difference for children’s outcomes included:

  • Providing integrated early intervention programs
  • Providing comprehensive, multimethod assessments
  • Prioritizing early intervention services which support the mother-child relationship

Importantly, the study found that children, even those exposed to substances during pregnancy, do better when mothers have relationship-focused intervention

Read the report, take a look at summary fact sheets and learn more about the Breaking the Cycle program at www.mothercraft.ca.

fact sheet 9

The Mothers’ Mental Health Toolkit was born out of a partnership between the IWK Reproductive Mental Health Service and Family Resource Centres in Nova Scotia.

IWK toolkit

It is a  collection of resources intended to support those who work with vulnerable mothers and families and includes materials for mental health promotion, education, screening, intervention, and advocacy. It includes a section on exploring substance use with women.

Visit the IWK Health Centre website to download the Toolkit, find practical worksheets for working with families, online video clips, and a manual for running an 8-week group based on the toolkit materials. There are also resources for individuals providing training on how to use the Mother’s Mental Health Toolkit.

SU

brochure

 

Challenging-Drug-Prohibition_Mothering_Susan-Boyd_May-2014

Susan Boyd from the Centre for the Study of Gender, Social Inequalities and Mental Health at Simon Fraser University is hosting a critical dialogue about the intersections of drug prohibition, women, addiction, and the regulation of reproduction and mothering with some of the leaders in the field.

The public forum will be held Saturday, May 17th, 2014 from 9:30am – 5pm at SFU Harbour Centre in Vancouver, BC. View the flyer here. The event is free but registration is required.

Speakers include several members of the Canada FASD Research Network, including Marliss Taylor from the Streetworks program in Edmonton and Lenora Marcellus from the University of Victoria.

Intergenerational Patterns, Parenting, and FASD

A paper published in the Journal of Transcultural Nursing by Suzanne Johnston and Joyceen Boyle (based on Johnston’s PhD work) explores the experiences and strengths of Aboriginal mothers raising children affected by FASD.

At a practical level, this ethnographic study aims to demonstrate what it is like for mothers to raise teenagers who have FASD, what their struggles are, how they meet challenges, what is helpful, and what is not.

The paper also explores a range of issues using a postcolonial framework (for more on this, see earlier post Postcolonial Theory for Beginners, September 1, 2010). This perspective allows the study authors to explore intergenerational patterns related to parenting and FASD. The authors connect alcohol misuse during pregnancy to colonial pressures and effects that have continued to exist after seven generations.

“…the root causes are undoubtedly related to the historical and collective emotional injury Aboriginal peoples have experienced as a result of colonialism. This injury manifests itself in various behaviors, including the abuse of alcohol, which leads to FASD, among other problems. According to the [study] participants, they have ignored and suppressed the trauma associated with FASD because there has been little support for dealing with associated feelings that remain unresolved and passed down through generations.

For example, individuals pass on unhealthy ways of behaving or coping that they use to protect themselves from their pain and trauma, such as abusing alcohol or drugs; these behaviors are modeled for their children, sometimes those involved even being aware of these dynamics.” (p. 63)

The women interviewed in this study describe feelings of blame and shame and experiences of marginalization in their lives. Yet, this study clearly works towards debunking stereotypes by demonstrating the adaptability and increasing strength of Aboriginal mothers caring for adolescents with FASD.

For more on this topic, see earlier posts:

References

 Johnston, S. and Boyle, J.S. (2013). Northern British Columbian Aboriginal Mothers: Raising Adolescents With Fetal Alcohol Spectrum Disorder. Journal of Transcultural Nursing, 24(1):60-7. DOI:10.1177/1043659612452006

Johnston, M.J. (2008). Northern British Columbia Aboriginal Mothers: Raising Adolescents with Fetal Alcohol Spectrum Disorder. (Doctoral Dissertation). Retrieved from The University of Arizona – College of Nursing.

Overview: Four Levels of FASD Prevention

Information Sheet: What Men Can Do To Prevent FASD

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