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This prospective longitudinal study examined how maternal prenatal substance use disorder (SUD) and early mother-infant interaction quality are associated with child social cognition (emotion recognition and mentalization) at school age. A sample of 52 poly-substance-using mothers receiving early interventions and 50 non-users, along with their children, was followed from pregnancy to school age. First-year mother-infant interaction quality was measured with EA scales. At school age, child facial emotion recognition was measured with DANVA and mentalization with LEAS-C. SUD group children did not differ from comparison children in social cognition, but higher severity of maternal prenatal addiction predicted emotion recognition problems. High early mother-infant interaction quality predicted better emotion recognition and mentalization, and mother-infant interaction quality mediated the effect of prenatal SUD on emotion recognition. The results highlight the need for early treatments targeting both parenting and addiction, as well as long-term developmental support for these children.

In this article we present a novel method of outpatient care: brief, dynamic mother-infant group psychotherapy with mothers who have substance use problems. In this therapy, substance abuse treatment is part of mental health and parenting interventions. The focus is on preventing disturbance in the mother-infant relationship in this high-risk group. The clinical material is taken from 16 mother-infant dyads from six psychotherapy groups, which met weekly over six months from pregnancy to post-partum. The therapy process consists of 20-24 three-hour sessions. The basis of the therapy is to offer mothers experience of care, which they, in turn, can give to their infants. In this paper we analyse the core therapeutic elements that may contribute to better mothering and child development. They involve: the group providing a symbolic maternal lap, and the meeting of the mothers' and the infants' needs. It is hoped that this may offer the mothers a new experience within which to reappraise their early memories. This may help prevent them from projecting traumatic past experiences onto their infants. Our analyses show that in the therapy, mothers, feeling safe within the group, gradually experienced pleasure with their infants and their peers. These effects, according to the mothers, were the most noticeable. Brief dynamic mother-infant group psychotherapy seems to be a promising form of treatment for those substance-abusing women able to commit to outpatient care and examine the causes of their drug dependence. The groups may also be used as a diagnostic tool to detect problems in early mother-baby interaction.