Training Helps Pregnant Women with Substance Use Disorders Get the Care They Need
Jacqueline Jacobs knew she had some stigma to shatter when she decided to create a training for perinatal substance use disorders as a part of her dissertation at the University of Denver’s Graduate School of Professional Psychology (GSPP).
Mothers who are actively using substances during pregnancy and postpartum and are brave enough to seek professional help are denied treatment altogether, says Jacobs. “It’s so shaming.”
"[It’s] not only shaming but ethically and morally deficient from a ‘do no harm’ perspective,” says psychologist Tracy Vozar, a DU faculty mentor on Jacobs’ project who now works at Children’s National Hospital in Washington, D.C. “Many providers won’t even see you or provide treatment even though you are willing to trust them with the knowledge that you are using substances.”
Vozar emphasizes that providers may want to help but very likely feel they are not equipped to do so. Many providers lack formalized training in critical areas, like infancy and early childhood development, perinatal mental health, substance treatment or parenting related stress. Research in this area is lacking, too, and, as a result, so are evidence-based strategies for helping women in these circumstances.
Those who do agree to treat these women can fail if they don’t have the right tools or know how to optimize the ones they have.
“For Jacqueline to lean into this badly needed area of expertise while still a graduate student is remarkable,” Vozar says. “She is very unusual in that she really found her passion from day one in our program and has become an expert in this difficult, niche field.”
Jacobs’ program, Connecting the Dots, is a free, foundational training in perinatal substance use disorders designed for any provider working with moms or families impacted by substance misuse—from doctors to doulas. Jacobs hosted the first training in March of 2023 for a diverse audience of nearly 60 professional providers—and was humbled by the response.
“We had such amazing partners,” Jacobs says, including the Colorado Chapter of Postpartum Support International, the Colorado Department of Public Health, and the Colorado Behavioral Health Administration. “There was a remarkable amount of willingness from the community to support this work,” says Jacobs, who believes the diverse perspectives and enthusiastic participation set Connecting the Dots apart from other trainings in this field.
Connecting the Dots has grown into a collaborative network of providers who are transcending boundaries to improve outcomes for women—giving them resources and language to use when to talk to families and help mothers feel seen and supported during addiction recovery. “These are folks I am dedicated to working with for the rest of my career,” Vozar says. “We can do these great things when we work together across our partnerships.”
The training aims to be multicultural and holistic in its approach. Jennifer Yuen, DU doctoral student and co-lead, is responsible for integrating the cultural values and traditional beliefs of Asian American Pacific Islander women into the training.
“We all bring different strengths and specialties together to create a conglomerate of all our experiences,” says Yuen. She worked on the training content with Patrece Hairston-Peetz, director of the Denver-based Birth Squad and an expert in perinatal mental health, especially within the BIPOC community.
Connecting the Dots invites providers to question conventional wisdom and embrace conversations about substance misuse and how it impacts relationships between mothers and babies.
These relationships are key, says Jacobs. Research shows that when treatment centers on the child-parent relationship, “mothers are improving, sustaining recovery and showing better long-term outcomes.”
This research could lead to a significant shift in how families struggling with substance use are supported. “It’s a real set-shift for providers,” Vozar says. “Instead of thinking they can’t do the work, they can realize they have some or all of the tools they need in order to be effective in this area.”
Connecting the Dots is a free, donation-based training. “This is a crisis,” Vozar says. “We need to get this important information out to as many people as possible.” Jacobs says she would like the training to serve populations with challenges to access, like those in rural areas, as well as to see it expand globally to reduce as many barriers as possible.
“Part of the power of doing work in this space is that we are impacting intergenerational patterns of pain and psychopathology,” Jacobs says. “The impact spans past all our lifetimes.”
Connecting the Dots was hosted in collaboration with the Colorado Department of Public Health and Environment, the Behavioral Health Administration, the Postpartum Support International, UC Health, Children's National Hospital, Tough as a Mother Campaign, and GSPP.
Free trainings available to those in need:
- CO AIM SUD — A learning collaborative focused on establishing hospital guidelines and protocols for treatment of substance use disorders and perinatal mood and anxiety disorders.
- IMPACT BH — Aims to bring together hospitals, primary healthcare services, and community-based organizations to provide wrap-around support and care to perinatal individuals and families.
- Tough As A Mother — Public awareness campaign to help connect mothers with dependent children so substance use treatment and providers in their communities.
- CHoSEN QIC — An effort to increase consistency in implementation of best practice in the identification of and response to newborns prenatally exposed to substances throughout the Rocky Mountain region.
- Perinatal Navigator Pilot — A program partnering with local hospitals with a focus on keeping families together and empowering them to achieve goals and access community resources.
- Illuminate Colorado — Aims to strengthen families, organizations and communities to prevent child maltreatment.
- Parentline — A free Telebehavioral health service offering brief, strategic psychotherapy through video chat and telephone to pregnant and postpartum families with children up to age five.
- Maternal Mental Health Collaborative and Framework — A central source for Coloradans to effectively collaborate, impact action, and accelerate progress toward improved mental health and wellness of all pregnant and postpartum people in Colorado.