Connections and Breaking the Cycle (BTC)

Type of Approach:

  • Group

Provider Education Level:

  • Unspecified


  • Less than 12 weeks

Trauma Type:

  • Domestic Violence
  • Substance Abusing Caregiver

Trauma Symptom:

  • Anxiety
  • Attachment
  • Depression


  • Other
  • Other Community Settings


Type of services:

Domestic violence intervention for substance-involved mothers and children that uses a manualized group curriculum to address the impact of domestic violence on child development, parenting, and substance use recovery. Designed to be delivered concurrently with other interventions including substance use treatment, mental health counselling, child care, early intervention services, parenting services, advocacy, and instrumental supports.

Program setting:

Delivered within the context of Mothercraft`s Breaking the Cycle program. Breaking the Cycle (BTC), funded by the Public health Agency of Canada, is a comprehensive early intervention program designed to reduce risk and enhance development of substance-exposed children by addressing maternal substance use problems and strengthening the mother-child relationship.

Number of sessions:

6 sessions

Type(s) of trauma addressed:

Emotional, verbal, sexual and physical abuse

Additional Information:

In addition to substance use and exposure, women and children at BTC experience a host of complex conditions of risk including poverty, mental health problems, health vulnerabilities, and maltreatment.
In response to evaluation findings identifying high rates of domestic violence in the lives of women and children at BTC, Connections was developed and tested as a pilot intervention in 2005 andhas been funded by the Ministry of Children and Youth Services Community Capacity Building Fund since 2006.

Unique/Innovative Characteristics

Connections provides a unique framework for mothers/parents to explore the inter-relationship of domestic violence/victimization, parenting, substance abuse and recovery, and their children’s development.
This intervention illustrates the importance of delivering integrated services within the context of an intensive and comprehensive program which takes into account the complex needs of the mother and child.

Date Added/Updated:



  • 0-5 (Early Childhood)


  • English
  • French

Ethnic Racial Group:

  • American Indian, Alaska Native, Other Indigenous
  • White

Caregivers Included:

  • Mother

Population Adaptations:

Age range of children:

0-6 years

Parent/adult caregiver included in intervention:

Yes, mothers (the non-offending partner) are included. In earlier evaluations of BTC, it was clear that domestic violence was a salient issue for the majority of women and children in the program (Pepler, et al., 2001). This was of particular concern given the risk of domestic violence on mothers’ substance use recovery and parenting processes, and the impact of exposure to domestic violence on children. Of additional concern for BTC mothers, more than 80% of whom report a history of experiencing domestic violence and child maltreatment themselves (Pepler et al., 2002), was the recognition that they are often still coping with unhealed emotional wounds from their own childhoods. Parenting their own children may trigger long dormant issues particularly if they are working on their own recovery from substance abuse and no longer using drugs or alcohol to numb the emotions that are generated. Substance abuse may also be a coping strategy used to manage domestic violence (Baker et al., 2005).

Ethnic/racial and other groups serve

d: Aboriginal groups

Cultural adaptations:

Adapted for use by Aboriginal groups

Languages available:

English and French.


Theoretical basis:

BTC’s priorities, philosophy, and programs reflect the fact that both mother and child are affected by maternal substance use and domestic violence. The care of substance-involved mothers and their young children requires attention to both of these issues and the relationship between them. BTC draws on a number of theoretical frameworks including attachment theory, relational theory, feminist theory, harm reduction theory, developmental theory, the trans-theoretical model of the stages of change, and motivational interviewing.

Outcome indicators:
  1. Increased maternal knowledge regarding the impact of domestic violence on substance abuse recovery, child development and maltreatment, and parenting processes
  2. Enhanced capacity for mothers to address co-existing problems of substance abuse, domestic violence and parenting problems in a comprehensive maternal-child service model
  3. Early identification and planning for young children affected by maternal substance abuse, domestic violence, and parenting problems
  4. Increased community capacity to deliver a domestic violence intervention within an integrated service model that acknowledges and addresses co-existing conditions of risk for women and children, including substance abuse, child maltreatment, and parenting problems

Evaluation Studies:

Connections was evaluated within the context of a larger evaluation of Mothercraft’s Breaking the Cycle program. A longitudinal study was conducted over a two year-period with data collected at baseline, 12 months, and 24 months after the intervention. The unpublished results of the evaluation confirmed positive outcomes for mothers and children. The outcomes included:

  1. increased maternal confidence in mothers’ ability to resist relapse to substance use
  2. decreased reports of depression and anxiety symptomatology from Time 1 to Time 2
  3. enhanced maternal relationship capacity, including an increase in mothers` comfort with closeness and intimacy in relationships and an increased sense of social support from family and friends
  4. more empathy and more appropriate expectations in the parenting role
  5. improvements on measures of parenting distress over time
  6. scores on standardized measures of child development were all within the average range

Qualitative data gathered through focus groups confirmed that mothers were able to use Connections to reflect on their past experiences in order to make changes in their current relationships. Mothers reported that they gained an understanding of the cycle of unhealthy relationships and an increased understanding of the impact of unhealthy relationships on their children and on their parenting. Mothers linked their capacity to make changes to their participation in Connections.

Publication of Evaluation Results:

The evaluation report has not yet been submitted for publication.

Other publications:

Leslie, M. (ed.). 2007. Substance use, violence and mothering: BTC’s Connections Project. In The Breaking the Cycle Compendium Vol. 1: The Roots of Relationship (pp 101-112).Toronto: Mothercraft Press. Available on-line at
. Mary Motz, C. Psych; Stacey Espinet, M.Sc.; Nicole Racine, B.Sc.; Dr. Debra Pepler, C. Evaluating “Connections”: Assessing the links that mothers make between domestic violence, substance use, parenting, and child development by Dr. Psych – submitted to the Ministry of Children and Youth Services in March 2009 in compliance with evaluation requirements of the Ministry.

Rated/Reviewed by Evidence Based Registries:

This intervention was not rated by the registries/databases we reviewed.

Training Contact:

Margaret Leslie at 416-364-7373,

Training Notes:

Training manuals:

Yes; Download at
Connections: A Group Intervention for Mothers and Children Experiencing Violence in Relationships.
Connections: Un groupe d’intervention pour les mères et les enfants vivant de la violence dans leurs relations

Training available:


Languages resource:

English, French

Program Contact