Children of Substance Abusers: Intergenerational Substance Abuse and Resiliency

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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_at_phoenixhouse.org

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Critical Factors

• Parents use of drugs
• Childs experience
• Family dynamics
• Relational issues
• Protective factors
• Systems involvement
• Environment

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Parents Use

• Pattern of use
• Drug of choice
• Rate of addiction
• Parents gender and role
• Age of child
• Duration of addiction
• Family living situation

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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

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Continuum of Addiction

• Use
• Dependence/addiction
• Treatment
• Recovery
• Relapse

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Dependence/AddictionFamily Dynamics

• 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

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Dependence/AddictionConsequences for Children

• Ignored
• Pulled into conflicts
• Cant 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

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How COAs/COSAs Feel

• Sad
• Afraid
• Lonely, invisible
• Traumatized
• Angry
• Worried
• Love parent
• Ashamed

• Guilty, responsible
• Embarrassed
• Parental
• Confused
• Depressed
• Anxious
• Loyal to parent
• Hopeful

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Dependence/AddictionHow COAs/COSAs Behave

• Experiment w/ AOD
• School problems
• Social problems
• Run away
• Withdraw/ignore
• Perfectionism
• Alternative relationships

• Doesnt trust
• Hypervigilant
• Hoards
• Psychosomatic problems
• Anxious/depressed
• Comedy
• Aggression/anger

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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

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Dependence/AddictionSeparation/Removal

• Loss and abandonment
• Fearful re parent
• May live with AOD caregiver/family member
• Possibility of multiple placements
• No pause button

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Treatment

• Parental apologies
• Fantasies and expectations
• Separation
• Limited visits with parent
• Not sure of parents whereabouts
• Fear reparents well-being
• Broken promises tx issues

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Recovery and Reunification

• New homeostasis
• Recovery the parents 1 priority
• Fantasies unrealized
• Denial of family issues
• No AOD as a buffer
• Relapse potential
• Reunification issues

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ReunificationWhen Families Reunify

• Honeymoon period
• Testing behavior parental surprise
• Unification, not re-unification
• Child may be stranger to parent
• Reality v. fantasy
• Childs problems
• Emotional baggage
• Grief and loss for past home

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Relapse

• 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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BehaviorResiliency

• Successful adaptation despite challenges
• Personality traits environment
• Contextual
• Dynamic process
• Enhanced by protective factors

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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

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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