Best Practice

BRIGHT Intervention (Building Resilience through Intervention: Growing Healthier Together)

State/Jurisdiction: Massachusetts
Setting: Clinical Home
Population: Children Infant Women & Maternal
Topic Area: Safe and Connected Communities Mental Health & Substance Use Injury Prevention & Hospitalization
NPMs:

The global epidemic of substance use disorders and opioid use disorders (SUDs/OUDs) (WHO, 2014) is significant for infant mental health professionals as mothers and caregivers with substance use and often co-occurring mental health disorders can exhibit problematic parenting, putting their young children at-risk for maltreatment and poor developmental outcomes (SAMHSA, 2018). Few interventions address the complexities of parenting while in recovery, particularly with an attachment focus. The BRIGHT intervention (Building Resilience through Intervention: Growing Healthier Together) was developed to address the needs of children from birth to age six and their mothers with SUD/OUD. BRIGHT includes weekly sessions to encourage parental attunement and reflective functioning, play and relationship activities between parent and child, emotion regulation, and recovery maintenance. BRIGHT is rooted in the principles of Child-Parent Psychotherapy (Lieberman, Ghosh Ippen & Van Horn, 2015) and attachment-informed parenting interventions for mothers with SUDs (Suchman, et al., 2013). It utilizes mother-child dyadic techniques to improve maternal reflective functioning, mother-child attachment, and child social-emotional development, and to reduce child maltreatment. BRIGHT has now been successfully implemented in five different settings.

The Institute for Health and Recovery (IHR), Jewish Family and Children’s Service (JF&CS, collaborator from 2009-2016) and Boston University School of Social Work (BUSSW) have offered BRIGHT as an enhancement to addiction treatment and medical care for over 15 years with funding support from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration (HRSA). By addressing the dangers of opioid and substance misuse, maternal and child mental health symptoms, and focusing on the parent-child relationship, this intervention addresses the Maternal and Child Health Bureau (MCHB) National Performance Domain of injury prevention – specifically aiming to prevent injury from child maltreatment by improving parenting. Rarely do parenting programs address the specific challenges of these parent-infant dyads by offering interventions that recognize the dual impact of opioid or substance misuse and maternal mental health symptoms on parenting practices and child health and development (Mirick & Steenrod, 2016). For these reasons, identifying effective pragmatic therapeutic parenting interventions for mothers with SUD/OUD and their infants or young children is urgently needed.

The intended population for BRIGHT is mothers with SUD/OUD and their young children. More specifically, women who are pregnant and parenting and in SUD/OUD treatment often did not have their own nurturance needs addressed when they were children potentially affecting their own nurturing parenting abilities. Additionally, many of these parents have experienced many challenges as children and adults. The infants born to them are frequently at high-risk for maltreatment, a long-term health risk that can lead to compromised social, emotional, and cognitive development. BRIGHT benefits these families by supporting the parent’s SUD/OUD treatment, screening for and focusing on caregiver mental health, and encouraging best parenting practices.

The Perinatal Substance Use Disorder Implementation & Policy Hub project is supported by the Foundation for Opioid Response Efforts (FORE) and Perigee Fund. The content presented is the responsibility of the featured practices and policies and does not necessarily reflect the views of FORE, Perigee Fund, or AMCHP.

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CONTACT INFORMATION
Boston University
Ruth Paris
rparis@bu.edu



For more information about this practice, please email evidence@amchp.org