WHAT CHILDREN NEED: Support & Education Services for Children and Youth Minnesota Children’s Justice Initiative ITV Presentation: 9/25 & 10/1, 2008 Presented by: Betty Conger LMSW CPC-R Henry Ford Behavioral Health Maplegrove Children & Family Program Coordinator

Maplegrove History of Service for Children & Families FREE Children’s Program established in 1990 Adjunct to treatment – community participation Various settings / partnerships Volunteer staffed Children’s Program Parent Component added in 1993 Teen Component added in 2005 Intensive Outpatient Treatment Program Family Education & Support Program added in 2005

Workshop Objectives To identify: Rationale for intervening with families affected by “substance abuse” Goals of intervention Intervention strategies & preferred strategy Curriculum based alternative: key messages

Experience has taught us… Need all systems to address alcohol/drug problems and impact on families Each system contributes to solution Systems help and support each other

Addiction Premise Although environmental and social factors will influence the progression and expression of the disease, they are not in any sense causes of addictive drinking. Alcoholism is caused by biochemical and neurophysiological abnormalities that are passed down from one generation to the next or in some cases acquired through heavy or prolonged drinking

Genetic Risk Prevalence rate of alcoholism is 3-4 times higher when a first degree relative is alcoholic Adoption does not eliminate genetic risk Low level of response to alcohol may explain relationship between family history and alcohol problems ** Those who begin use at age 15 are 3 times more likely to develop alcohol dependence, and are harder to treat, than those who begin drinking at the age of 21.

Environmental Impact Living in families with abuse or addiction stressful for all in family: Unhealthy ways to communicate and cope Rules (don’t talk, trust, feel) isolate members Role modeling of alcohol and drug use. Permissive attitudes toward alcohol and drug use. Note: A game, entitled High Risk Me Can’t change biological risk but can make choices that take into account this risk by choosing

Need for Education & Support Services Numbers are great: estimated that 1/5 children live with one or more adults who abuse substances. Many children live with chronic stress, confusion, fear, emotional, physical, or sexual abuse. Family environment affects development of children and youth. COA’s most likely to be tomorrow’s clients in mental health or addiction treatment, the juvenile justice system and out of home placements.

Survival Patterns: Costly to Health & Well-Being Defenses are like “ARMOR” May become life-long coping skills May interfere with opportunities and healthy relationships May increase likelihood of becoming CD

Why Prevent & Intervene? Treatment outcomes improve Relapse Prevention To improve the health — mental and physical of the entire family To break the cycle of substance abuse and associated stigma & shame Family recovery is enhanced: Potential impact on society problems

Children’s Issues Worry about health of parent Being “upset” about unpredictable and inconsistent behavior and lack of support from others Worry about fights and arguments in family Being scared and upset by possibility of violence, inappropriate sexual and/or criminal behavior Being disappointed by broken promises and feeling unloved

Common Feelings I feel ashamed I can’t talk about it I feel “different” It’s my fault I can fix it

Common Feelings (Con’t) I’m okay. Really everything’s fine I’m no good or I’m not good enough I’m confused I miss the “old family” (absent parent)

Strategies of Intervention Education Group work Family Education, Support Parent Education & Skill-building Children’s Groups Individual therapy Family Therapy

Group Work Children learn they are not alone and offers validation Group work increases the likelihood of breaking denial Group work provides safety and protection Children experience healthy social interactions Group work builds trust in social situations Group work allows children to try out new approaches to old problems.

Educational Support Groups PURPOSE: Education about life skills and support METHOD: Curriculum-based guided activities FOCUS: Content-based LEADERS: Specially trained group facilitators RULES: Confidentiality FOLLOW UP: When problems arise, referrals made for assessment DURATION: Time-limited ENVIRONMENT: Supportive and Nurturing

Therapy Groups PURPOSE: Resolution of personal problems METHOD: Individualized treatment plan FOCUS: Process based LEADERS: Licensed Therapist RULES: Confidentiality FOLLOW UP: Ongoing assessment DURATION: May be ongoing ENVIRONMENT: Supportive, Nurturing, and Confrontive

Shifting the Balance RESILIENCE Reducing the Risks Strengthening Protective Factors

Resiliency ABILITY TO BOUNCE BACK FROM ADVERSE CIRCUMSTANCES ONE WHO WORKS WELL, PLAYS WELL, LOVES WELL, AND EXPECTS WELL CHARACTERISTICS: Social Competence Problem Solving Skills Autonomy Sense of purpose and future

Individual Intervention: What resilient adults say made a difference: Had a special relationship with an adult who cared and was nurturing, often a teacher. Latched onto another “parent” figure or family. Had somewhere other than home they felt they belonged. Had activities that were easy to participate in outside the home. Had a sense of purpose and future. Ability to make decisions and communicate feelings

SAMHSA’s Children’s Program Kit Goals: To assist treatment providers and community-based youth-serving systems to educate and support children affected by parental alcohol and drug addiction To prevent substance abuse and promote resilience in the highest risk youth population To bring the benefits of hope, healing, and recovery to children of addicted persons

Children’s Program Kit TOPIC AREA GOALS

GOALS Addiction Help children understand the disease of alcoholism and drug addiction. Help children realize that addiction is not their fault. Help children realize that they are not alone; many young people live in families with addiction. Help middle-school and high-school-age children understand that they are at increased risk for addiction because it tends to run in the family.

GOALS Feelings Help children identify and express both comfortable and uncomfortable feelings. Help children understand how feelings may affect them and how they can handle feelings in safe ways. Help children understand that there are safe people with whom they can share feelings and get support.

GOALS Treatment & Recovery Help children understand that people with addiction need help to recover. Help children realize they can’t fix their parents problems, but can work on their own self care. Help children realize that treatment and aftercare assist addicted people to get better.

GOALS Safe People Help children understand the need for and importance of always staying safe. Help children understand the characteristics that make people “safe people.” Help children realize that it’s okay to ask safe people for help.

Key Tool for Intervention 7 C’s I didn’t CAUSE it. I can’t CURE it. I can’t CONTROL it. I can take CARE of myself by: COMMUNICATING my feelings. Making healthy CHOICES CELEBRATING ME!!!

What Messages Do Families Need? You’re not alone. You deserve help, and there are safe people who can help. It’s OK to feel your feelings. Treatment helps, and recovery happens. It’s not your fault. Addiction is a disease. It’s important to talk. You can live a good life, even if your parent continues to drink. In addition to the 7C’s, children who participate in groups may come to believe that Children and parents tell us in surveys they they learned: I learned that I am not alone I didn’t cause the use, It’s a disease, It’s ok to have feelings (or be angry) and it’s ok to talk Parents specifically say: it makes a difference because it reduced stress. And they say their children are often “happier”, have more fun, and there is less conflict at home because of the group intervention.

Parents & Caregivers Need: Adult children of the addicted need support, education on addiction, skill building practice Common needs: Setting limits and reasonable consequences Knowledge of what is “normal” development Encouragement to have fun with children, share warmth, and build positive / non-critical relationships

Additional Parent / Caregiver Needs: Validation of efforts Understanding of enabling vs empowering and impact on children (and CD) Effective communication techniques Language to talk with children

Education & Skills Supportive Environment Opportunities Empowerment Hope

For More Information Betty Conger Henry Ford Health System Maplegrove Community Education Children’s Program 248.661.6170 Bconger1@hfhs.org National Association for Children of Alcoholics 1-888-554-2627 www.nacoa.org

Training Regarding Using Children’s Program Kit December 10 – 11, 2008 (9:00 a.m. to 5:00 p.m.) Crown Plaza, Brooklyn Center Registration fees, materials, breakfast and lunch will be paid by CJI; attendees must pay for lodging Registration forms will be emailed in mid-October To receive a registration form, send an email with your name, title, agency name, phone number, and email address to shannon.campbell@courts.state.mn.us Space for only 50 participants to be chosen based on application criteria