Treatment recommendations for Aboriginal mothers with substance use issues

In brief

Women with substance use issues who are pregnant or parenting have needs that are not being met by traditional addiction services. Aboriginal mothers are up against even more challenges. In Canada, Aboriginal women face disproportional rates of poverty, discrimination, harassment, violence, inadequate housing, mental health issues, loss of child custody, and difficulty in accessing appropriate treatment.

Researchers reviewed the evidence on integrated and Aboriginal treatment programs. They found that many of the programs for Aboriginal women are not culturally-sensitive, are not gender specific, require women to travel far away to get treatment so they end up relapsing when they return home, and don’t offer enough aftercare.

EENet is pleased to feature a Research Snapshot on the article, “Treatment Issues for Aboriginal Mothers with Substance Use Problems and Their Children,” by Alison Niccols, Colleen Anne Dell, and Sharon Clarke. The article appeared in the International Journal of Mental Health and Addiction, vol. 8 (2010).

Research Snapshots are brief, clear language summaries of research articles, presented in a user-friendly format.

Read it below or download the PDF.

What you need to know

There is an urgent need for women-only, culturally-sensitive, one-stop shop treatment programs that:

  • Address trauma;
  • Include prenatal care or therapeutic child care;
  • Help women reclaim their identity as Aboriginal women; and
  • Focus on the resiliency and strengths found within each woman, her family, and her community. 

What is this research about?

Women with substance use issues who are pregnant or parenting have needs that are not being met by traditional addiction services. Aboriginal mothers are up against even more challenges. In Canada, Aboriginal women face disproportional rates of poverty, discrimination, harassment, violence, inadequate housing, mental health issues, loss of child custody, and difficulty in accessing appropriate treatment.

There is an urgent need for integrated, women-only, culturally-appropriate treatments that are welcoming and flexible, and that aim to reduce the harmful effects of substance use on women and their children. An example of an integrated treatment program is New Choices in Hamilton, which offers a one-stop shop for women-only services related to pregnancy, parenting, child development, and childcare. Sheway, in Vancouver, is similar but emphasizes Aboriginal culture and healing practices.

Studies suggest these types of programs are helpful in improving engagement and health outcomes, but more rigorous research needs to be done. 

What did the researchers do?

Researchers in Hamilton and Saskatchewan reviewed the evidence on integrated treatment programs and Aboriginal treatment programs, and offered recommendations for future research and practice.

What did the researchers find?

Concerns with current treatment programs for Aboriginal women include:

  • There is limited access to culturallysensitive services;
  • There aren’t any gender-specific treatment services in northern Canada or the territories;
  • All too often, women are referred to residential programs that are far away from their families. They end up relapsing after returning home, and they don’t receive any/enough aftercare.

How can you use this research?

Clinicians and healthcare providers may want to consider the following when striving to improve existing treatment programs or develop new ones.

Treatment programs for Aboriginal women with substance use issues need to help them reclaim their identity as Aboriginal women by:

  • Providing access to traditional healing practices and ceremonies, such as sacred dances, sweat lodges, talking circles, four circles, etc.
  • Finding connections between women’s present-day lives and the roles that Aboriginal women are traditionally honoured for: life-giver, care-giver, observer, teacher.

Treatment programs also need to ensure that clinicians:

  • Recognize the impacts of trauma;
  • Are empathetic, especially regarding the loss of child custody;
  • Communicate openly;
  • Support the link to Aboriginal culture;
  • Are non-judgmental, especially regarding prostitution and mothering practices;
  • Can act as positive role models; and
  • Acknowledge the past and help their clients move forward with healthier relationships, skills, and ties to their community

Limitations and next steps

The available studies that were reviewed by the authors are of limited quality in terms of design and methodology. Researchers may be interested in contributing to the evaluation and outcome data of existing Aboriginal community-based treatment programs.  

About the researchers

Alison Niccols is the Clinical Director of the Infant-Parent Program at McMaster Children’s Hospital. She is also an Associate Professor in the Department of Psychiatry & Behavioural Neurosciences at McMaster University.
Colleen Anne Dell is a Research Chair in Substance Abuse at the University of Saskatchewan; she is a Professor for both the Department of Sociology and the School of Public Health; and she is a Senior Research Associate at the Canadian Centre on Substance Abuse.
Sharon Clarke is the past Executive Director of the National Native Addictions Partnership Foundation.

This Research Snapshot is based on their article: “Treatment Issues for Aboriginal Mothers with Substance Use Problems and Their Children,” which was published in the International Journal of Mental Health and Addiction, vol 8 (2010): 320-335.


Aboriginal, women, substance use, children, treatment, pregnancy, parenting. This Research Snapshot is based on an article that has been critically appraised for quality and susceptibility to bias. 

EENet has partnered with the Knowledge Mobilization Unit at York University to produce Research Snapshots in the field of mental health and addictions in Ontario. 

This summary was written by Lindsay Kochen. 

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