Clinical trial NCT05229120: Improving Delay Discounting to Decrease Harsh Parenting Among Parents Receiving Substance Use Treatment
Official title: Improving Delay Discounting to Decrease Harsh Parenting Among Parents Receiving Substance Use Treatment in Low Income Community
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Behavioral Health
Keywords: episodic future thinking
delay discounting
parent-child relations
low income
substance use treatment
Lead sponsor: Henry Ford Health System
Sponsor class: OTHER
Collaborators: name: University of Maryland, College Park
name: University of Kansas
First posted: 2022-02-08
Enrollment: 38
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: PREVENTION

Brief summary: Parents with substance use disorders are disproportionately more likely to engage in harsh physical discipline, which can lead to serious clinical outcomes, including child maltreatment and the intergenerational transmission of addictive disorders. One mechanism linking substance use and maladaptive parenting strategies is parental delay discounting, or the tendency to value smaller, immediate rewards (such as stopping children's misbehavior via physical punishment) relative to larger, but delayed rewards (like shaping adaptive child behaviors over time). This study will examine the efficacy of implementing a low-cost, brief intervention targeting the reduction of parental delay discounting to inform broader public health efforts aimed at reducing child maltreatment and interrupting intergenerational cycles of substance abuse in traditionally underserved communities.

Detailed description: Parents with substance use disorders (SUD) are significantly more likely to engage in harsh parenting practices, including spanking, hitting, and belittling their children, than parents without SUD. Punitive physical and emotional discipline is, in turn, associated with increased rates of child maltreatment and the subsequent intergenerational transmission of substance use disorders. Parents in residential substance use treatment facilities are among those at highest risk for perpetrating harsh and abusive parenting; yet most behaviorally based parenting interventions available within inpatient settings do not take into account the unique mechanisms linking parental substance use to harsh parenting. Specifically, parents with SUD may be at heightened risk for engaging in maladaptive parenting approaches given a tendency to prioritize immediate rewards (such as stopping a child's misbehavior using physical punishment) relative to larger, but delayed rewards (including shaping positive child behavior over a longer term). This behavioral tendency is known as delay discounting and recent findings suggest that rates of delay discounting predict parents' use of harsh physical discipline. Existing research also indicates a strong link between steeper (more problematic) rates of delay discounting and the severity of alcohol and illicit drug use across the lifespan. Thus, delay discounting may represent a specific vulnerability underlying both harsh parenting and disordered substance use. The current project proposes to pilot and feasibility test an adapted episodic future thinking (EFT) intervention to target the reduction of parenting-related delay discounting and examine its effects on parenting practices among families in a residential substance use treatment setting. The intervention will be delivered by peer recovery coaches who are already employed in the center.

Eligibility criteria: Inclusion Criteria:

* Parent of child between 6-10 years of age
* Able to provide informed consent and take part in all study procedures in English
* Have current diagnosis of SUD
* Currently reside with their child at least 50% of the time
* Be willing to receive daily postcards

Exclusion Criteria:

* Active suicidality/homicidally
* Active bipolar disorder, schizophrenia, or psychosis.
* Only one parent-child dyad from each family.

Primary outcomes:
measure: Change in Delay Discounting 5 Trial Adjusted Measure
timeFrame: Baseline and 4 weeks
measure: Change in Consideration of Future Consequences Scale - Parenting Adapted
timeFrame: Baseline, 4 weeks
Secondary outcomes:
measure: Change in Dyadic Parent-Child Interaction Coding System Scores
timeFrame: Baseline, 4 weeks
measure: Change in Alabama Parenting Questionnaire Scores
timeFrame: Baseline, 4 weeks
Other outcomes:
Locations:
city: Flint
country: United States
facility: Odyssey Village
state: Michigan
Study officials:
affiliation: Henry Ford Health
name: Julia Felton, PhD
role: PRINCIPAL_INVESTIGATOR
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