Don’t Talk, Don’t Trust, Don’t Fee l :

1. Don’t Talk, Don’t Trust,Don’t Feel: Supporting Children of Alcoholics/Addicts Stephanie Roy, Center for Safe Schools Center for Safe Schools www.safeschools.info

2. Learning Objectives • Participants will: • Examine characteristics of dysfunctional/struggling families • Identify strategies for working with children in dysfunctional homes • Identify resources for pregnant women and families struggling with substance abuse • Examine approaches for communicating about substance use/abuse Center for Safe Schools www.safeschools.info

3. Alcoholism in the United States • 17 million children in the U.S. live with alcoholism in their homes • Four times as likely to develop alcoholism • Genetic factors and family interactions affect risk of alcohol abuse • Alcohol related violence • 68% manslaughters • 62% assaults • 54% murders/attempted murder • 48% robberies • 44% burglaries National Association for Children of Alcoholics Center for Safe Schools www.safeschools.info

4. Characteristics: Children of Alcoholics • Targets of physical abuse • Witness of family violence • Demonstrate poor problem-solving • Increased family conflict and poor communication • Disruptive behavior problems • Attention-seeking, aggression, impulsive • Anxiety and depression • Physical and mental health problems National Association for Children of Alcoholics Center for Safe Schools www.safeschools.info

5. Characteristics: Children of Alcoholics • Score lower on tests that measure cognitive and verbal skills • View themselves as unsuccessful • Pre-school aged- poorer language and reasoning skillsand performance • Truancy, drop-out, repeat grades, referrals • Abstract and conceptual reasoning National Association for Children of Alcoholics Center for Safe Schools www.safeschools.info

6. Alcoholism and Child Development • Developmental gaps due to familial stressors affect: • Family cohesion • Independence • Intellectual-cultural orientation • Active-recreational orientation National Association for Children of Alcoholics • Many children may appear to be developing normally Center for Safe Schools www.safeschools.info

7. Characteristics: Young COA • Depression • Anxiety • Crying • Bedwetting • Trouble making friends • Afraid of going to school • Nightmares *National Association for Children of Alcoholics Center for Safe Schools www.safeschools.info

8. Pregnancy and Alcohol • Support groups, self-help, MH and or D&A counseling, outpatient, residential • Motivation • Treatment assistance • Alternative to incarceration • Child care and support • Stressors after birth Center for Safe Schools www.safeschools.info

9. Pregnancy and Alcohol Abuse • Report if abuse or neglect of newborn is suspected • Report if mother is unable to care for newborn due to substance use/abuse and there is no indication of another adult who can care for the newborn Bridges to Care Resource Guide www.cchealth.org/groups/alcohol_and_drugs/ Center for Safe Schools www.safeschools.info

10. Pregnancy and Alcohol • No amount of alcohol is safe during pregnancy • Cognitive performance less affected if drinking is stopped early in pregnancy • Second trimester exposure-lower academic achievement • Fetal Alcohol Syndrome (FAS) affects approximately 6% of children born to alcoholic women Fetal Alcohol Spectrum Disorders Center for Excellence Center for Safe Schools www.safeschools.info

11. Fetal Alcohol Spectrum Disorder (FASD): Physical Characteristics • Brain damage • Facial abnormalities • Growth deficiencies • Defects of heart, liver, kidneys • Vision and hearing problems • Skeletal defects • Dental abnormalities Fetal Alcohol Spectrum Disorders Center for Excellence Center for Safe Schools www.safeschools.info

12. FASD Fetal Alcohol Spectrum Disorders Center for Excellence • Behavioral Characteristics: • Visual and auditory processing problems • Difficulty with reading comprehension • Memory problems • Sensitivity to sensory input • Attention deficits • Problems with social behaviors • Problems following multiple directions or rules • Difficulty with math or abstract reasoning • Inability to understand cause and effect • Difficulty organizing tasks and materials Center for Safe Schools www.safeschools.info

13. Working with Families Affected by Alcoholism • Understanding addiction • Stages of change • Enabling • Working effectively with the children • Seeking help/assistance Center for Safe Schools www.safeschools.info

14. Addiction • Chronic • Often relapsing brain disease • Compulsive • Harmful consequences • Changes the brain • Impulsive • Treatable Center for Safe Schools www.safeschools.info

15. Stages of Change • Pre-contemplation • Contemplation • Preparation • Action • Maintenance *James Prochaska and Carlo DiClemente Center for Safe Schools www.safeschools.info

16. Enabling • Helping: doing something for someone that they are not capable of doing for themselves. • Enabling: doing something for someone that they could and should be doing for themselves. Center for Safe Schools www.safeschools.info

17. Adverse Childhood Experiences Study (ACE Study) • 63% experienced one category • 22% experienced three or more categories • 27% grew up with someone in the household using alcohol and/or drugs • 28% physical abuse • 21% sexual abuse • 11% emotional abuse • 13% witnessed their mothers being treated violently • 10% experienced physical neglect • 19% grew up with a mentally-ill person in the household Felitti,V. Center for Safe Schools www.safeschools.info

18. Identified Roles in Dysfunctional Families • The perfect child or hero • The rebel or scapegoat • The clown or mascot • The loner or adjuster • The caretaker Claudia Black and Sharon Wegscheider-Cruse Center for Safe Schools www.safeschools.info

19. Unspoken Rules in Dysfunctional Families • Hero Child: “If I don’t do this, no one will. I must stay in control of my feelings.” • Rebel/Scapegoat: “If I scream loudly enough, someone may notice me. Take what you want, No one is going to give you anything. I am angry about it, whatever it is.” • Clown/Mascot: “If I make people laugh there is no pain. It is my job to make people laugh.” Robert Ackerman Center for Safe Schools www.safeschools.info

20. Unspoken Rules in Dysfunctional Families • Loner: “If I don’t get emotionally involved, I won’t get hurt. I can’t make a difference anyway. It is best to not draw attention to yourself. Why should I feel? It’s better if I don’t.” • Caretaker: “If I am nice, people will like me. If I focus on someone else, the focus won’t be on me and that is good. If I take care of you, you won’t leave me or reject me. I must take care of other’s feelings.” R.Ackerman Center for Safe Schools www.safeschools.info

21. Behaviors to Avoid • Hero: focusing only on their achievements, always letting them be first/volunteer, etc. • Scapegoat/Rebel: feeling sorry for them, taking it personally • Clown/Mascot: laughing with them, use sarcasm • Loner/Adjusting: allow them to remain silent or allow others to answer for them • Caretaker/Playcater: call on them to focus on other people’s emotional pain Center for Safe Schools www.safeschools.info

22. Behaviors that Help • Hero: teach them that mistakes are normal and necessary growth experiences, validate intrinsic worth • Scapegoat: set clear expectations, limits and boundaries, give positive encouragement when they show responsibility • Clown: Hold the child accountable, encourage responsible behavior, encourage appropriate use of humor and insist on eye contact Center for Safe Schools www.safeschools.info

23. Behaviors that Help • Loner: small group work, encourage the child’s strengths, talents and creativity • Caretaker: encourage them to play, ask them about their wants for themselves and help them to focus on themselves Center for Safe Schools www.safeschools.info

24. Emotional and Behavioral Impact on Children Living in High Risk Families R.Ackerman • Response to trauma: • Emotionally unavailable isolated, maladaptive, climates of futility, self-fulfilling prophecy • Children Taking on adult roles, inability to effectively solve problems tension and confusion among family members, feelings of distrust, inconsistency, suppression of self, stress on entire family Center for Safe Schools www.safeschools.info

25. Unspoken Rules for Troubled Families R. Ackerman • Be in control • Be right, do right • Blame someone or yourself • Deny feelings (fear, anxiety, loneliness, grief, rejection, need) • Don’t expect reliability or consistency • Don’t expect resolution • Don’t talk about embarrassing things Center for Safe Schools www.safeschools.info

26. Problem Areas for Troubled Youth • Destructive relationships • Climates of futility • Learned irresponsibility • Loss of purpose Center for Safe Schools www.safeschools.info

27. Negative Coping Strategies Children Use to Avoid Stress • Denial • Regression • Withdrawal • Impulsiveness • Acting out Center for Safe Schools www.safeschools.info

28. Helping Children Cope • Remove at least one stressor • Teach new coping skills • Teach self-soothing strategies • Transfer coping strategies to other life situations Ackerman Center for Safe Schools www.safeschools.info

29. Helpful Interactions • Develop: • Autonomy and independence • Social orientation and social skills • Acts of required helpfulness • Develop close relationships with others • Cope with emotionally difficult experiences • Reframe situations • Coping strategies NaCoA, Kit for Early Childhood Professionals Center for Safe Schools www.safeschools.info

30. Be Present NaCoA, Kit for Early Childhood Professionals • Listen and communicate • Assist children learn words to express their emotions • Help to translate their emotions • Teach self-soothing techniques • Communicate child’s program and performance with parent • Model appropriate adult caretaking roles Center for Safe Schools www.safeschools.info

31. Observe and Report • Excessive or constant fatigue or strain • Frequent headaches or stomachaches • High levels of confusion or anxiety • Fluctuating moods throughout the week • Compulsively responsible • Patterns for behaviors • Refer/Report NaCoA, Kit for Early Childhood Professionals Center for Safe Schools www.safeschools.info

32. Parent Under Influence? • Follow policy, procedures, guidelines • State laws, state licensing agency Center for Safe Schools www.safeschools.info

33. Resiliency Longitudinal StudyKauai, Hawaii • 698 participants from birth through midlife beginning in 1955 • Monitored at developmental stages • 30% with significant risk factors • Protective factors matter: • Within the individual • Within the family • Within the community Kauai Longitudinal Study. Portland State University www.rtc.pdx.edu Center for Safe Schools www.safeschools.info

34. Reinforce Strengths • Strong potential for resilience • Emotional and physical survival Center for Safe Schools www.safeschools.info

35. Seeking Additional Help • Speak to supervisor • Discus the value of support groups • Encourage referral to professional • Awareness and access to resources • Sensitivity to cultural differences • Non-biased reaction • Know your limits • Avoid self-disclosure NaCoA, Kit for Early Childhood Professionals Center for Safe Schools www.safeschools.info

36. Self Disclosure • Overwhelming • Inappropriate • Harmful Center for Safe Schools www.safeschools.info

37. Much Needed Messages • You are safe • You are respected • You will be taken care of • You are smart and fun to be with • You are a beautiful person • You are loveable NaCoA, Kit for Early Childhood Professionals Center for Safe Schools www.safeschools.info

38. 7 C’s • I didn’t cause it. • I can’t cure it. • I can’t control it. • I can help take care of myself by communicating my feelings, making healthy choices, and celebrating me NaCoA, Kit for Early Childhood Professionals Center for Safe Schools www.safeschools.info

39. Consistency • Consistent and safe boundaries • Consistent social skills • On-going support Center for Safe Schools www.safeschools.info

40. Children’s Book Titles • Think of Wind by Catherine Mercury • An Elephant in the Living Room by Jill Hastings • The Brown Bottle by Penny Jones • Emmy’s Question by Jeannine Auth • The House that Crack Built by Clark Taylor Center for Safe Schools www.safeschools.info

41. Help • National Association for Children of Alcoholics (NaCoA) www.nacoa.org • Alateenwww.alateen.org • Al-Anon www.al-anon.org • Caron Foundation http://www.caron.org/ • Tina George tgeorge@caron.org • Christina Getz cgetz@caron.org • Compass Mark www.compassmark.org • Amy Sechristasechrist@compassmark.org Center for Safe Schools www.safeschools.info

42. Resources • Fetal Alcohol Spectrum Disorders Center for Excellence http://fasdcenter.samhsa.gov/index.aspx • Substance Abuse Treatment for Pregnant and Parenting Women www.cchealth.org/groups/alcohol_and_drugs/ • Kit for early childhood professionals. (2011).National Association for Children of Alcoholics. Kensington, MD • Felitti, V. (2004). The origins of addiction: Evidence from the adverse childhood experiences study.San Diego, CA: Department of Preventive Medicine Kaiser Permanente Medical Care Program • Mercury, C. Think of wind. http://thinkofwind.com/purchase/ • Hastings, J., Typpo, M. (1994). An Elephant in the living room. The children’s book. Hazelden • Jones, P. (1983). The brown bottle. Hazelden Center for Safe Schools www.safeschools.info

43. Thank You Stephanie Roy, Special Projects Managing Coordinator Center for Safe Schools sroy@csc.csiu.org 717-763-1661 ext. 209 Center for Safe Schools www.safeschools.info