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Children of Substance Abusers: Intergenerational Substance Abuse and Resiliency

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Title: Children of Substance Abusers: Intergenerational Substance Abuse and Resiliency


1
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

2
Critical Factors
  • Parents use of drugs
  • Childs experience
  • Family dynamics
  • Relational issues
  • Protective factors
  • Systems involvement
  • Environment

3
Parents Use
  • Pattern of use
  • Drug of choice
  • Rate of addiction
  • Parents gender and role
  • Age of child
  • Duration of addiction
  • Family living situation

4
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

5
Continuum of Addiction
  • Use
  • Dependence/addiction
  • Treatment
  • Recovery
  • Relapse

6
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

7
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

8
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

9
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

10
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

11
Dependence/AddictionSeparation/Removal
  • Loss and abandonment
  • Fearful re parent
  • May live with AOD caregiver/family member
  • Possibility of multiple placements
  • No pause button

12
Treatment
  • Parental apologies
  • Fantasies and expectations
  • Separation
  • Limited visits with parent
  • Not sure of parents whereabouts
  • Fear reparents well-being
  • Broken promises tx issues

13
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

14
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

15
Relapse
  • Dashed hopes
  • Child may re-enter care
  • Renewed separation erodes attachment
  • Pre-recovery state for child
  • Further cements lack of trust

16
BehaviorResiliency
  • Successful adaptation despite challenges
  • Personality traits environment
  • Contextual
  • Dynamic process
  • Enhanced by protective factors

17
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

18
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
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