Transcript Children of Alcoholics and Chemically Dependent Parents

Children of Substance Abusers
in the Child Welfare System
Naomi Weinstein, MPH, Director,
Phoenix House Children of Alcoholics
Foundation
646-505-2061
[email protected]
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Assumptions
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Child affected by parent’s use
COA/COSA – lifelong status
Children not “cured” when parent enters
recovery
Lots of ways to support and help
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Critical Factors
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Parent’s use of drugs
Child’s experience
Family dynamics
Relational issues
Protective factors
Systems involvement
Environment
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Parent’s Use
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Pattern of use
Drug of choice
Rate of addiction
Parent’s gender and role
Age of child
Duration of addiction
Family living situation
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Parent Behavior and Illicit Drugs
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Drug subculture
“counter” values
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“beat the system”
Disdain for authority
Focus on money and materialism
Exposure to drug sales, violence, theft,
prostitution
High stakes consequences
Systems involvement
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Continuum of Addiction
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Use
Dependence/addiction
Treatment
Recovery
Relapse
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Dependence/Addiction
Family Dynamics
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Centrality of AOD
Secrecy and denial
Broken promises, no
trust
Lowered inhibitions
Higher aggression
Neglect
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Shame, blame and
guilt
Conflict
Parent-focused
parenting
Social isolation
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Dependence/Addiction
Family Rules
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Don’t talk, don’t trust, and don’t feel
No expectations
Stay in control
If something goes wrong, blame someone
Don’t be selfish
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Dependence/Addiction
Consequences for Children
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Ignored
Pulled into conflicts
Can’t study
Abused and
neglected
Parentified
Afraid to bring friends
home
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No access to
emergency services
Chaotic family
structure
Lack good role
models
Domestic violence
exposure
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Dependence/Addiction
How COAs/COSAs Feel
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Sad
Afraid
Lonely, invisible
Traumatized
Angry
Worried
Love parent
Ashamed
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Guilty, responsible
Embarrassed
Parental
Confused
Depressed
Anxious
Loyal to parent
Hopeful
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Dependence/Addiction
How COAs/COSAs Behave
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Experiment w/ AOD
School problems
Social problems
Run away
Withdraw/ignore
Perfectionism
Alternative
relationships
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Doesn’t trust
Hypervigilant
Hoards
Psychosomatic
problems
Anxious/depressed
Comedy
Aggression/anger
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Dependence/Addiction
When Children are Removed
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Eating and sleeping disorders
Depression
Emotional withdrawal
Physical aggression and disruptive behaviors
Academic problems
Truancy
Harder for kids 8+ yrs
Symptoms often misdiagnosed
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Dependence/Addiction
Separation/Removal
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Loss and abandonment
Fearful re: parent
May live with AOD caregiver/family
member
Possibility of multiple placements
No pause button
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Behavior
Resiliency
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Successful adaptation despite challenges
Personality traits + environment
Contextual
Dynamic process
Enhanced by protective factors
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Behavior: Resiliency
Wolins’ 7 Areas of Resiliency
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Insight
Independence
Relationships
Initiative
Morality
Creativity
Humor
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Behavior: Resiliency
Survival Skills of COAs/COSAs
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Soothe and calm unpredictable people
Negotiate peace in a “war zone”
Stretch limited resources
Find solutions to difficult problems
Prevent unavoidable disaster
Please unpleasable people
Cope in a crisis
Sense of humor
Responsibility and loyalty
Perserverence
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Treatment
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Parental apologies
Fantasies and expectations
Separation
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Limited visits with parent
Not sure of parent’s whereabouts
Fear re:parent’s well-being
“Broken promises” – tx issues
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Treatment
Intervention for COAs/COSAs
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Simultaneous program
Age appropriate
Impact of PSA on family
Changing response to family situations
Intro to addiction
Intro to self-help groups
Communication skills
Understanding of risk
Identification of resilience
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Recovery
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New homeostasis
Recovery the parent’s #1 priority
Fantasies – unrealized
Denial of family issues
No AOD as a buffer
Relapse potential
Reunification issues
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Reunification
When Families Reunify
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Honeymoon period
Testing behavior = parental surprise
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Tantrums
Defiance
Jealousy
Nightmares
Clinging behavior
Hypervigilence
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Reunification
Other Issues
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Unification, not re-unification
Child may be stranger to parent
Reality v. fantasy
Child’s problems
Emotional baggage
Grief and loss for past home
Past caregivers
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doubts sobriety potential
renegotiate roles and boundaries
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Relapse
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Dashed hopes
Child may re-enter care
Renewed separation – erodes attachment
Pre-recovery state for child
Further cements lack of trust
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Long-term Consequences
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Suicidal ideation
Hyperactivity
AOD use
Child abuse and neglect
Domestic violence
Depression and anxiety
Somatic problems
Workplace, parenting and other relational issues
for adults
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How to Help
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Access community-based services (Alateen,
support groups, special counseling)
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AOD Tx centers
Mental health centers
Schools (student assistance programs)
Family service agencies
Talking to kids
Family systems work
Reunification support
Identify resiliencies
Aftercare includes family issues
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