Preschool children’s coping and caregiver support in families with maternal substance misuse: A qualitative study

Maternal substance misuse affects caregiving, which influences children’s coping skills. However, little is known about how children of mothers with substance misuse describe their coping in stressful situations. We studied coping and caregiver support among 29 children 4 years of age recruited from a children’s health clinic serving families with maternal substance misuse in Finland. Children completed a revised Attachment Story Completion Task that we examined with qualitative content analysis. We identified children’s experiences with coping in stressful situations with optimal and non-optimal caregiver support. Experiences with optimal caregiver support included (a) empathy, (b) solicitude, (c) intimacy, (d) reassurance, (e) being a role model, (f) concrete help, and (g) shared joy. Ones with non-optimal caregiver support included (a) punishment, (b) abandonment, (c) unresponsiveness, (d) physical aggression, (e) aggressive protection, and (f) parentification. Children’s strategies for coping without caregiver involvement were (a) magic, (b) avoidance, (c) inappropriate laughing, (d) self-reliance, or (e) a lack of strategy. Our findings highlight that preschool children of mothers with substance misuse employ various coping strategies in stressful situations that either include caregiver support or indicate non-optimal support. Children also tended to use maladaptive coping strategies when a caregiver was not involved. Understanding children’s coping with stress in families with maternal substance misuse is essential to supporting their socioemotional development and providing adequate interventions.