Abstract
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. EFT may be particularly well-suited for
dissemination in a residential SUD setting because it is brief, flexible, and can be delivered by peer recovery
coaches (PRCs), individuals with lived substance use and recovery experiences. Utilizing PRCs, who are
already widely employed in SUD treatment settings, increases the scalability, acceptability and cost-
effectiveness of this approach and may reduce stigma, a critical barrier to participation in parenting programs
among individuals with SUD. Following a deployment-focused model, we will conduct a small case-series trial
and collect data regarding critical implementation outcomes (including acceptability, tolerability, and dosage).
Results from this aim will inform manual adaptation. We will then recruit 72 parents of children between the
ages of 6 and 10 receiving inpatient substance use treatment in the low resource, majority-minority, city of
Flint, Michigan. Participants will be randomized to receive EFT or a comparison intervention. Findings from this
study will be used to plan a large-scale (R01) intervention trial and will inform public health approaches for
reducing child maltreatment and preventing intergenerational cycles of addiction.
