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Children of Substance Abusers in the Child Welfare System

Children of Substance Abusers in the Child Welfare System. Naomi Weinstein, MPH, Director, Phoenix House Children of Alcoholics Foundation 646-505-2061 nweinstein@phoenixhouse.org. Assumptions. Child affected by parent’s use COA/COSA – lifelong status

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Children of Substance Abusers in the Child Welfare System

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  1. Children of Substance Abusers in the Child Welfare System Naomi Weinstein, MPH, Director, Phoenix House Children of Alcoholics Foundation 646-505-2061 nweinstein@phoenixhouse.org

  2. Assumptions • Child affected by parent’s use • COA/COSA – lifelong status • Children not “cured” when parent enters recovery • Lots of ways to support and help

  3. CriticalFactors • Parent’s use of drugs • Child’s experience • Family dynamics • Relational issues • Protective factors • Systems involvement • Environment

  4. Parent’s Use • Pattern of use • Drug of choice • Rate of addiction • Parent’s gender and role • Age of child • Duration of addiction • Family living situation

  5. Parent Behavior and Illicit Drugs • Drug subculture • “counter” values • “beat the system” • Disdain for authority • Focus on money and materialism • Exposure to drug sales, violence, theft, prostitution • High stakes consequences • Systems involvement

  6. Continuum of Addiction • Use • Dependence/addiction • Treatment • Recovery • Relapse

  7. Centrality of AOD Secrecy and denial Broken promises, no trust Lowered inhibitions Higher aggression Neglect Shame, blame and guilt Conflict Parent-focused parenting Social isolation Dependence/AddictionFamily Dynamics

  8. Dependence/AddictionFamily Rules • 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

  9. Ignored Pulled into conflicts Can’t study Abused and neglected Parentified Afraid to bring friends home No access to emergency services Chaotic family structure Lack good role models Domestic violence exposure Dependence/AddictionConsequences for Children

  10. Sad Afraid Lonely, invisible Traumatized Angry Worried Love parent Ashamed Guilty, responsible Embarrassed Parental Confused Depressed Anxious Loyal to parent Hopeful Dependence/AddictionHow COAs/COSAs Feel

  11. Experiment w/ AOD School problems Social problems Run away Withdraw/ignore Perfectionism Alternative relationships Doesn’t trust Hypervigilant Hoards Psychosomatic problems Anxious/depressed Comedy Aggression/anger Dependence/AddictionHow COAs/COSAs Behave

  12. Dependence/AddictionWhen Children are Removed • Eating and sleeping disorders • Depression • Emotional withdrawal • Physical aggression and disruptive behaviors • Academic problems • Truancy • Harder for kids 8+ yrs • Symptoms often misdiagnosed

  13. Dependence/AddictionSeparation/Removal • Loss and abandonment • Fearful re: parent • May live with AOD caregiver/family member • Possibility of multiple placements • No pause button

  14. BehaviorResiliency • Successful adaptation despite challenges • Personality traits + environment • Contextual • Dynamic process • Enhanced by protective factors

  15. Behavior: ResiliencyWolins’ 7 Areas of Resiliency • Insight • Independence • Relationships • Initiative • Morality • Creativity • Humor

  16. Behavior: ResiliencySurvival Skillsof COAs/COSAs • 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

  17. Treatment • Parental apologies • Fantasies and expectations • Separation • Limited visits with parent • Not sure of parent’s whereabouts • Fear re:parent’s well-being • “Broken promises” – tx issues

  18. TreatmentIntervention for COAs/COSAs • 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

  19. Recovery • New homeostasis • Recovery the parent’s #1 priority • Fantasies – unrealized • Denial of family issues • No AOD as a buffer • Relapse potential • Reunification issues

  20. ReunificationWhen Families Reunify • Honeymoon period • Testing behavior = parental surprise • Tantrums • Defiance • Jealousy • Nightmares • Clinging behavior • Hypervigilence

  21. ReunificationOther Issues • 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 • doubts sobriety potential • renegotiate roles and boundaries

  22. Relapse • Dashed hopes • Child may re-enter care • Renewed separation – erodes attachment • Pre-recovery state for child • Further cements lack of trust

  23. Long-term Consequences • Suicidal ideation • Hyperactivity • AOD use • Child abuse and neglect • Domestic violence • Depression and anxiety • Somatic problems • Workplace, parenting and other relational issues for adults

  24. How to Help • Access community-based services (Alateen, support groups, special counseling) • 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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