SAN DIEGO (FRONTLINE MEDICAL NEWS) – A tailored version of the mindfulness-based stress reduction ( MBSR ) program benefited mothers in treatment for opioid addiction, according to a small qualitative analysis presented at the annual meeting of the American Academy of Pediatrics.

The intervention was the first in the United States to teach mindfulness-based parenting techniques to mothers with opioid addiction, lead investigator Diane J. Abatemarco , Ph.D., M.S.W., said in an interview.

“Mindfulness-based parenting is an effective method to enhance parenting, increase bonding and attachment, and reduce parental anxiety, stress, and reactivity,” added Dr. Abatemarco of the department of pediatrics and director of pediatric population health research at Nemours/Alfred I. duPont Hospital for Children and Thomas Jefferson University in Philadelphia.

Parents with substance-use disorders tend to suffer more stress than do other parents, and stress increases the risk of relapse among former users, Dr. Abatemarco and her associates noted. Mindfulness-based stress reduction – which focuses on compassion, nonjudgment, emotional awareness, and self-regulation – has been explored in studies of addiction and parenting , but rarely as combined approach for both stressors, said the researchers.

Therefore, they conducted a single-arm study of 34 mothers of infants or young children who were in outpatient treatment for opioid addiction, they said. Participants averaged 30 years of age, most were white and unmarried, and about half had a high school education or less, they reported.

As in traditional MBSR, the mothers attended 12 weekly group sessions to learn sitting meditation and loving-kindness techniques, said the investigators. But because of participants’ past substance abuse and high rates of childhood trauma – including family violence, sexual assault, and emotional mistreatment – they struggled with the loving-kindness techniques that are typically used in MBSR courses, said Dr. Abatemarco. “Loving-kindness is difficult for those of us who have had adverse childhood exposure or trauma as a result of abuse and neglect,” she added. “We need to realize this and ensure that the program is trauma-informed, so that we come to kindness in different ways. “The researchers therefore introduced terms such as ‘caring for yourself,’ and ‘being gentle to yourself,’ and added loving-kindness practice only after participants had begun learning sitting meditation, she said.

Mothers said two techniques particularly helped them feel more compassion toward themselves, pay more attention to their children, and elicit their children’s cooperation more often, Dr. Abatemarco and her associates reported. These included the STOP practice – which is used in some MBSR courses and stands for “stop, take a breath, observe, proceed” – and the “settle your glitter” approach, in which participants filled a globe of water with three different colors of glitter to symbolize emotions, physical sensations, and thoughts, the investigators said. The mothers then carried the sealed globes around with them and, when stressed, shook them and watched the glitter settle, symbolizing the mental effects of breathing and allowing thoughts and sensations to pass, they reported. “Moms say that just looking at the globe after it is shaken reminds them that they can easily get to a place of peace and that better decisions are available to them,” added Dr. Abatemarco.

The investigators are planning another study to test the intervention’s effects on substance use, parenting, and childhood outcomes, said Dr. Abatemarco. They also are starting a mindfulness-based parenting and childbirth course for inner-city black women who are pregnant and at risk for preterm birth, she added.

The Children’s Bureau of the Administration for Children and Families funded the study. The researchers declared no relevant conflicts of interest.


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