How pregnant and parenting women in integrated substance use programs feel about their care

Research Snapshot

What you need to know

Substance use is on the rise for women.  Many plan to become or already are parents. Women who use substances and are pregnant and/or parenting have complex needs and require more comprehensive treatment than standard care typically offers. Treatment services provided need to consider these complex needs, for example, by providing mental health services, parenting support, and childcare, and covering their basic needs and transportation.

This Research Snapshot looks at the article, “Integrated treatment programs for pregnant and parenting women with problematic substance use: Service descriptions and client perceptions of care,” published in Journal of Substance Abuse Treatment. Read it below or download the PDF.

Research Snapshots are brief, clear language summaries of research articles, presented in a user-friendly format.

What is this research about?

Substance use rates are increasing among women of childbearing age, who often have more complex needs than other groups. For example, they are more likely than men to have mental health challenges, less social support, and experiences of physical and sexual abuse and trauma.

Recommended service models for women take a holistic and integrated approach. For example, they combine substance use treatment with mental health services, parenting support, primary and pre-natal care, child welfare services, and other services that attend to the psychosocial and basic needs of women and their children.

Female counsellor comforting female clientWhat did the researchers do?

Researchers interviewed 15 front-line staff and 22 managers at 12 integrated treatment programs in Ontario to see what kind of services they offered. They then met with 105 women at these programs, to investigate their opinions of the care they received and compared these to those of 207 women attending standard programs. This information was gathered from their responses to the Ontario Perception of Care for Mental Health and Addictions questionnaire.

What did the researchers find?

Services were variable across the 12 programs. All the integrated programs offered individual and group substance use treatment, mental health services, parenting support, and case coordination with child welfare services. Some offered on-site prenatal and primary care, life skills training, and food security and transportation. Treatment of maternal mental health disorders and supports for child mental health and development, direct intervention with the mother-child relationship, and housing were least common.

Women attending integrated treatment programs had more positive feelings about the care they received compared to those receiving standard treatment. Women in integrated programs commented that treatment increased their confidence and improved their mental health, decreased substance use, and helped them reconnect with their children.

Service components that women in integrated programs found to be particularly helpful included:

  • Group treatment
  • Parenting supports
  • Child-minding
  • Home visits
  • Referral support to other services
  • Non-judgemental, therapeutic bonds with staff/therapists
  • Women-only treatment spaces 


As integrated programs continue to develop, creative solutions for addressing and enhancing child care, transportation, and continuity of care will be important to consider. Given the needs of women and children, enhancing partnerships to support the mental health, child mental health and development, and the mother-child relationship are also priorities.

How can you use this research?

This research may be useful to substance use treatment providers, systems planners, and policymakers. While integrated treatment programs are associated with positive client perception of care, recommendations from clients could further enhance service delivery. Aspects of treatment that are perceived to be most helpful, but implemented the least, may be the best areas for service improvement.

About the researchers

Lesley Tarasoff is a PhD candidate at the Dalla Lana School of Public Health, University of Toronto. Dr. Karen Milligan has a PhD in Clinical Child Psychology from the University of Toronto.  She is an Associate Professor at Ryerson University.  Dr. Amelia Usher received her PhD in Psychology from Ryerson University. She is now a Research Advisor with Ontario’s Ministry of Community and Social Services. Dr. Karen Urbanoski is currently a Canada Research Chair in Substance Use, Addictions and Health Services Research, a Scientist at the Canadian Institute for Substance Use Research, and an Assistant Professor at the School of Public Health and Social Policy at the University of Victoria.


Substance use, perceptions of care, integrated treatment, pregnant, parenting, women

This Research Snapshot is based on their article, “Integrated treatment programs for pregnant and parenting women with problematic substance use: Service descriptions and client perceptions of care,” published in Journal of Substance Abuse  This summary was written by Brandon Hey.