Connections and Breaking the Cycle (BTC)

Programs

Connections and Breaking the Cycle (BTC)

Overview

Delivery Approach:

Group

Delivery Format:

In-Person

Provider Requirements:

Licensed/Certified Professional Led

Type of Experiences Addressed:

Domestic Violence
Child Abuse
Community Violence
Neglect
Family Separation
Substance Abusing Caregiver
Homelessness
Verbal/Emotional Abuse
Mental Health Issues/Concerns
Historical Traumas
Other Types of Experiences Addressed (Current Traumas)

Engagement Methods:

Culturally-Grounded
Talk based
Other Engagement Methods (see Program Details)

Level of Intervention:

Intervention
Primary Prevention

Length:

Less than 12 weeks

Setting:

School
Domestic Violence Shelter
Correctional
Homeless Shelter
Headstart and Early Education Programs
Day Care
Family Service Agencies
Mental Health Setting
Community Based Agency

Program Details:

Type of services:

Connections is an interpersonal 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. Connections is 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:

This intervention is 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:

6-8 sessions

Type(s) of trauma addressed:

Emotional, verbal, sexual and physical abuse, historical and ongoing traumas

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 and has been funded by the Ministry of Children and Youth Services Community Capacity Building Fund since 2006. More recently (2016-2021), Connections has been replicated through a nation-wide initiative in 34 communities across Canada. Results have confirmed the efficacy of Connections in diverse community settings and that the intervention can be delivered with fidelity following a certified training.

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:

07/14/2022

Population Served

Age:

Pre-natal
0-5 (Early Childhood)
18-25 Years (Young Adult)
25 and up (Adult)

Population Language:

English

Ethnic Racial Group:

Asian
Black or African American
Hispanic or Latino
Indigenous People – American Indian/Native American, Alaskan Native
White

Client/Audience

Child
Child and Non-abusive Parent/Caregiver
Survivor parent
Community

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

The Connections intervention was not designed for any specific racial group, but our evaluation suggests that it can be effective across a wide range of communities.

Cultural adaptations:

There is a version of the Connections intervention manual that has been adapted for use in Canadian Indigenous communities.

Languages available:

English and French.

Evaluation

Foundation:

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:

Increased maternal knowledge regarding the impact of domestic violence on substance abuse recovery, child development and maltreatment, and parenting processes
Enhanced capacity for mothers to address co-existing problems of substance abuse, domestic violence and parenting problems in a comprehensive maternal-child service model
Early identification and planning for young children affected by maternal substance abuse, domestic violence, and parenting problems
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:

An early evaluation of Connections delivered in the context of Mothercraft’s Breaking the Cycle program confirmed positive outcomes for the mother, the child, and the mother-child relationship. Findings from quantitative data included increased maternal confidence to resist substance use, decreased reports of maternal anxiety and depression symptomatology, enhanced maternal relationship capacity, increased social support, more appropriate expectations in the parenting role, increased empathy, decreased parenting stress, and child development within the average range as measured on standardized assessment. Qualitative data confirmed that, as a result of Connections, mothers: a) enhanced their capacity to reflect on their past experiences in order to make changes in their current relationships, b) gained an understanding of the cycle of unhealthy relationships, c) increased their understanding of the impact of unhealthy relationships on their children and on their parenting (Motz, et al., 2009).

Connections was evaluated more recently with a national sample of 400 participants through the Building Connections project. Preliminary evaluation findings confirmed the fidelity of the replication of the intervention in communities across Canada. Certified facilitators identified changes in four key areas related to trauma-informed practice: awareness (e.g. attitudes toward interpersonal violence), competency (e.g. application of trauma-informed knowledge), collaboration (e.g. working with other organizations to provide service to children and families), and safety (e.g. organizational policies to ensure safe, welcoming spaces (Singh et al., 2020). Preliminary evaluation of outcomes for mothers in this sample confirmed significant increases in maternal self-esteem, self-efficacy, ability to feel closeness in relationships, ability to depend on others in relationship, knowledge of community services, and understanding of Connections concepts. Significant decreases were found on measures of anxiety in relationships and parenting stress (Andrews, et al., 2020a).

Publication of Evaluation Results:

Andrews, N., Motz, M., Zuberi, S., Singh, C., Leslie, M., & Pepler, D.J. (2021). Building Connections to Support Mothers and Young Children Affected by Interpersonal Violence: The Evaluation Report. Toronto: Mothercraft Press.

https://mothercraft.ca/assets/site/docs/connections/BC-TechEvalRpt_2021.pdf

Andrews, N., Reynolds, W., Leslie, M., Motz, M., Zuberi, S., Singh, C., & Pepler, D. J. (2021). Building Connections for Healthy Relationships: What We Learned. Toronto: Mothercraft Press.

https://mothercraft.ca/assets/site/docs/connections/BC-PlainLanguageRpt_2021.pdf

Andrews, N. C. Z., Motz, M., & Pepler, D. J. (2020a). A national implementation of a community based intervention for mothers experiencing violence in relationships. Journal of Family Psychology. http://doi.org/10.1037/fam0000810

Andrews, N. C., Motz, M., & Pepler, D. J. (2020b). Developing and testing a readiness tool for interpersonal violence prevention partnerships with community‐based projects. Journal of Community Psychology. https://doi.org/10.1002/jcop.22361

Singh, C. D., Andrews, N. C. Z., Motz, M., Pepler, D. J., Leslie, M., & Zuberi, S. (2020). Trauma-informed and relational approaches to service provision: Building community-based project capacity to respond to interpersonal violence through a national initiative. BMC Public Health, 20 (1833), 1-13. https://doi.org/10.1186/s12889-020-09960-3

Andrews, N. C. Z., Pepler, D. J., & Motz, M. (2019). Research and evaluation with community-based projects: Approaches, considerations, and strategies. American Journal of Evaluation, Vol 40(4), 548-561. https://doi.org/10.1177/1098214019835821

Zuberi, S., Motz, M., Leslie, M., & Pepler, D.J. (2018, November). Building Connections: Supporting the readiness and capacity of community-based projects to deliver a trauma-informed intervention. Zero to Three, 39(2), 21-25.

Other publications:

Leslie, M., Reynolds, W., Motz, M., Pepler, D.J. (2016). Building Connections: Supporting Community-Based Programs to Address Interpersonal Violence and Child Maltreatment. Toronto: Mothercraft Press. (Available in English and French)

https://mothercraft.ca/assets/site/docs/connections/Building-Connections-Manual-ENG.pdf

https://mothercraft.ca/assets/site/docs/connections/Building-Connections-Manual-FRE.pdf

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.

Motz, M., Espinet, S.D., Racine, N.M., & Pepler, D.J. (May 2009). Evaluating Connections: Assessing the links that mothers make between domestic violence, substance use, parenting and child development. Prepared for the Ministry of Children and Youth Services, Toronto: Mothercraft Press.

https://mothercraft.ca/assets/site/docs/connections/EvaluatingConnections2009.pdf

Motz, M., Reynolds, W., Leslie, M. (2020) The Breaking the Cycle Compendium Volume 2 – Healing Through Relationships. Toronto: Mothercraft Press

https://mothercraft.ca/assets/site/docs/resource-library/Publications/BTC-Compendium-Vol2-HealingThroughRelationships.pdf

Rated/Reviewed by Evidence Based Registries:

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

Training & Resources

Training Language:

English
French

Training Availability:

Training Details:

Training manuals:

Yes, available in English, French, and a version adapted for Canadian Indigenous communities.

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

https://mothercraft.ca/assets/site/docs/connections/ConnectionsManual_EN.pdf

https://mothercraft.ca/assets/site/docs/connections/ConnectionsManual_FR.pdf

https://mothercraft.ca/assets/site/docs/connections/ConnectionsManual_AB.pdf

Training Contacts:

Margaret Leslie
mleslie@mothercraft.org
416-364-7373

Program Contact