Text messaging to communicate with recovering SUD maternal patients

Substance Use Disorders (SUD) are quite common among pregnant women, affecting a number of maternal patients every year. In fact, in 2020, between 8 percent and 11 percent of pregnant women aged 15 to 44 reported using illicit drugs, tobacco products, or alcohol. This makes it all the more necessary to make use of communication methods that are reliable during this period to help support continued recovery and sobriety. 

The presence of substance use disorders (SUD) in maternal patients

The repercussions of substance use in maternal patients can manifest in numerous troubling pregnancy outcomes. For instance, exposure to substances can lead to premature birth, where babies are born too early and are not fully developed. These infants often face low birth weights leading to health complications in their initial months of life. Furthermore, developmental issues for the child can occur.

For the mother, SUD can exacerbate or lead to health issues such as gestational diabetes and hypertension, which endanger both the mother and baby during pregnancy and delivery. Recognizing and treating SUD as part of prenatal care allows healthcare providers to offer specialized support that can include therapy, medication-assisted treatment, and continuous health monitoring. This treatment should be noted to have different layers impacting its efficacy as discussed in, Moms Supporting Moms: Digital Storytelling With Peer Mentors in Recovery From Substance Use, “...the difference between being “in” recovery—going through motions by adhering to treatment protocols—versus “doing” recovery, which denoted an active commitment to not only treatment but the “inside work” of acknowledgment and self-acceptance identified by participants as critical to sustaining recovery.” This approach minimizes the risk of complications during pregnancy and childbirth as well as improves the prospects for long-term health and well-being for both mother and child. 

See also: Remote patient monitoring strategies for mental health professionals

Using text messaging strategies in the treatment of maternal patients with SUD

1. This technique involves sending personalized, motivational messages that engage patients in a dialogue intended to improve their intrinsic motivation to change. Text messages are crafted to elicit self-motivational statements and reinforce positive behaviors.
2. These messages are part of a behavior reinforcement approach where patients receive rewards (which can be communicated and tracked via text) for meeting specific treatment milestones, such as attending appointments or maintaining sobriety.
3. Using text messaging or apps to send daily or weekly prompts encourages patients to engage in cognitive behavioral therapy (CBT) exercises. These prompts help patients practice coping skills to manage triggers and stress related to SUD.
4. Communications are tailored to acknowledge and address the role of trauma in SUD, with messages designed to be sensitive to trauma and avoid re-traumatization.
5. Utilizing predictive analytics to identify patterns that may indicate a risk of relapse, followed by sending proactive supportive messages or intervention prompts to both the patient and their care team.
6. Specialized communication strategies focused on the postpartum period, providing support and resources that address both SUD management and new parenting challenges.
7. Tailoring communication content to align with the patient's cultural background and language preferences,.
8. Messaging that considers factors like housing, employment, and access to food. This strategy involves providing information and resources related to these areas as part of comprehensive SUD care.

Best practices 

1. Develop targeted HIPAA compliant text messaging campaigns based on the stage of treatment or recovery. For example, different sets of messages could be crafted for those in early recovery versus those in a maintenance phase.
2. Implement predictive analytics to customize message timing and content based on data-driven insights. For instance, analytics can identify patterns in a patient’s interaction with texts that may predict when they are most vulnerable to relapse.
3. Integrate automated response systems that can provide instant feedback or support when patients text keywords related to urgent help or advice. 
4. Use text messaging to monitor and respond to behavioral triggers. This can involve asking patients to report their mood, stress levels, or exposure to high-risk environments through texts.
5. Connect text messaging systems with wearable technology that can monitor physiological indicators of stress or craving. Text messages can be automatically triggered based on the data received from these devices.
6. Facilitate text-based peer support networks that allow for anonymous communication among peers, moderated by professionals. 
7. Automate text messages for follow-up immediately after a missed appointment to reengage the patient. The messages could offer easy rescheduling options and inquire about any barriers the patient faced in attending the appointment.
8. Link text messaging with community resources by sending information or contacts related to housing, employment, childcare, or transportation services.

See also: Navigating HIPAA requirements for mental health professionals

FAQs

What is SUD?

Substance use disorder is a medical condition characterized by the compulsive use of substances despite harmful consequences.

What is CBT?

CBT is a form of psychological treatment that helps individuals change negative thoughts and behaviors to improve mental health.

What other forms of support are necessary for SUD patient sobriety?

For SUD patient sobriety, support often includes medication assisted treatment, peer support groups, family therapy, lifestyle adjustments, and continuous access to mental health professionals.