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Children of Substance Abusers: Intergenerational Substance Abuse and Resiliency. Naomi Weinstein, MPH, Director, Phoenix House Children of Alcoholics Foundation 646-505-2061 nweinstein@phoenixhouse.org. Critical Factors. Parent’s use of drugs Child’s experience Family dynamics
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Children of Substance Abusers: Intergenerational Substance Abuse and Resiliency Naomi Weinstein, MPH, Director, Phoenix House Children of Alcoholics Foundation 646-505-2061 nweinstein@phoenixhouse.org
CriticalFactors • Parent’s use of drugs • Child’s experience • Family dynamics • Relational issues • Protective factors • Systems involvement • Environment
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
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
Continuum of Addiction • Use • Dependence/addiction • Treatment • Recovery • Relapse
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
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
Sad Afraid Lonely, invisible Traumatized Angry Worried Love parent Ashamed Guilty, responsible Embarrassed Parental Confused Depressed Anxious Loyal to parent Hopeful How COAs/COSAs Feel
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
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
Dependence/AddictionSeparation/Removal • Loss and abandonment • Fearful re: parent • May live with AOD caregiver/family member • Possibility of multiple placements • No pause button
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
Recovery and Reunification • New homeostasis • Recovery the parent’s #1 priority • Fantasies – unrealized • Denial of family issues • No AOD as a buffer • Relapse potential • Reunification issues
ReunificationWhen Families Reunify • Honeymoon period • Testing behavior = parental surprise • Unification, not re-unification • Child may be stranger to parent • Reality v. fantasy • Child’s problems • Emotional baggage • Grief and loss for past home
Relapse • Dashed hopes • Child may re-enter care • Renewed separation – erodes attachment • Pre-recovery state for child • Further cements lack of trust
BehaviorResiliency • Successful adaptation despite challenges • Personality traits + environment • Contextual • Dynamic process • Enhanced by protective factors
Behavior: ResiliencySurvival Skills of 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
How to Help • Prevention services and programs • Psycho-education for kids w/ parents in tx • 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 • Reunification support • Strengthen access to protective factors • Help kids identify resiliencies • Aftercare includes family issues