Family functioning of perinatal substance abusers in treatment

This prospective study examined family characteristics of perinatal substance abusers enrolled in an intensive outpatient treatment program both during and after treatment. Data is provided on family functioning in three areas: current family, family of origin, and love/partner relationship, and at six time points up to 24 months postdischarge. Standard family assessment measures, including the Self-Report Family Inventory (SFI) and Family-of-Origin Scale (FOS) were utilized to measure current family functioning and family of origin health, respectively. A new instrument, the Relationship Assessment Form (RAF), was used to measure the level of unhealthy, codependent behaviors in the subject's love/partner relationship. A mixed models repeated measures ANOVA was used to determine if subjects' family functioning changed over time. Multivariate and univariate methods examined differences between the subjects in the current study and previously reported means for the SFI and FOS. Results were that perinatal substance abusers' perception of the overall health of their families of origin remained stable over time. Subjects rated their families of origin as more pathological than community adults, but similarly to adults presenting for psychotherapy. Although current family functioning was relatively stable, SFI scores that changed worsened over time after treatment. Perinatal substance abusers scored more pathologically at intake than normal, nonclinic families, but were similar to families presenting for family therapy on the SFI. In contrast, enduring changes of greater magnitude occurred in the subjects' self-reported codependent behavior over time. All RAF scores that changed moved in the direction of healthier, more autonomous functioning. Change and stability in aspects of family functioning may be due to specific factors of the treatment program, which are discussed. Standard family measures may need further refinement for use in this population. Recommendations for clinical programs and future research are provided.