Children don’t motivate substance abusing moms to seek treatment

There may be a variety of reasons why a mother who abuses drugs or alcohol chooses to get treatment, but she may not do it for the sake of her children, according to surprising new results of a Florida State University study.

FSU professors Dina Wilke and Akihito Kamata and Ohio State University’s Scottye Cash found that children actually have a negative impact on a mother’s decision to enter into a treatment program. Their findings, published in the journal Child Abuse and Neglect, fly in the face of popular belief that children serve as a primary source of a mother’s treatment motivation.

“We have such a cultural expectation that children are going to be an intrinsic source of motivation for mothers,” Wilke said. “What we found was that what was going on internally with the women was more important than what was going on externally.”

Wilke, an assistant professor in the College of Social Work, Kamata, an associate professor in the College of Education, and Cash studied data of 1,371 women with custody of children under 18 who sought treatment for substance abuse. They looked at level of drug involvement, psychological functioning, children, and a desire to stop using drugs as motivators for seeking substance abuse treatment.

The researchers found that poor psychological functioning—meaning anxiety, depression, low self-esteem and poor anger management—and a desire to stop using drugs were the primary motivators for seeking treatment.

“They were just sick of their day-to-day lives,” Wilke said. “They had just had enough. They were feeling down and anxious.”

Children may actually pose barriers to mothers getting help, according to the researchers, who theorized that mothers may resist treatment because they do not have anyone to care for their children while they are in treatment or they are afraid they will lose custody of their children if they acknowledge a drug problem. Those who have already lost custody also may have little motivation to get treatment, particularly if there is little chance of regaining custody.

The findings are important because social workers and others often use the threat of removing children or the promise of reunification to coax women into treatment. Although removal may be appropriate for the safety of the children, threats or promises may not be enough to motivate mothers to get help, Wilke said, noting that just because some women may not want to get treatment doesn’t mean they don’t want to change.

“The presumption is that people who are motivated to get treatment will be more successful, so it’s important to know what motivates people,” she said. “We’ve found that we can’t overemphasize the role of children. This is an internal process, and we need to help women find their own motivation.”

For their research, Wilke, Kamata and Cash used data from the Drug Abuse Treatment Outcome Study, a national study of substance abusers entering treatment. Community-based programs, freestanding hospitals, hospital units, county-funded programs, modified therapeutic communities and criminal justice programs provided the treatment.