1. Supporting Families and Promoting Recovery
Alcohol and Drug Dependence and Its Impact on Family and Community: Seizing the Opportunity
Supporting Families and Promoting Recovery
Steve Hornberger and Doug Ronsheim
Bloomfield, CT
June 2, 2010

2. Supporting Families and Promoting Recovery
Why in the Faith Community?

3. So Help Me God: Substance Abuse, Religion and Spirituality
CASA’s Surveys of Clergy and Schools of Theology
Presidents of 230 multi-denominational Christian seminaries and 6 Rabbinical Schools
Sample of 1,200 clergy from New York, Florida, Iowa, Washington
Denomination groups: Catholic, Protestant, Jewish, Christian, Orthodox, other (independent and non-denominational)

4. So Help Me God: Substance Abuse, Religion and Spirituality
The Great Disconnects
- Clergy’s recognition of problem of substance abuse in their congregations vs. lack of training on how to deal with it
- Importance of spirituality and religion to substance abuse prevention and treatment vs. failure of healthcare providers to take advantage of this

5. So Help Me God: Substance Abuse, Religion and Spirituality
The Clergy Disconnect
percent of clergy and 97.6 percent of theology school presidents consider substance abuse an important problem in congregations
- Only 12.5 percent of clergy get any substance abuse training

6. So Help Me God: Substance Abuse, Religion and Spirituality
Engage the Clergy
Schools of Theology should:
Train clergy to recognize substance abuse and know how to respond
Clergy should:
Address substance abuse in their ministries
Develop relationships with treatment professionals
Connect members of congregations to treatment

7. The Clergy Education and Training Project®
Phase I – Seminary Training Expert Panel
November, 2001
Phase II – Development of Core Competencies
February, 2003
Phase III – Dissemination
Step One: Release at CADCA, January 2004
Step Two: Publication of articles in journals
Step Three: Incorporate into AAPC and ACPE credentials,
standards, and training
Step Four: Engaging the Faith Communities to help
Step Five: Developing Seminary Curricula Modules
Phase IV – Implementation of Clergy and Pastoral
Minister Training – Pre- and Post- Ordination

8. Core Competencies for Clergy
Guide to the core knowledge, attitudes, and skills essential to the ability of clergy and pastoral ministers to meet the needs of persons with alcohol or drug dependence and their family members
Focus on:
Addicted person
Family system
Affected children

9. Clergy Core Competencies
1. Be aware of the:
Generally accepted definition of alcohol and other drug dependence
Societal stigma attached to alcohol and other drug dependence
2. Be knowledgeable about the:
Signs of alcohol and drug dependence
Characteristics of withdrawal
Effects on the individual and the family
Characteristics of the stages of recovery
3. Be aware that possible indicator of the disease my include, among others:
marital conflict, suicide, family violence (physical, emotional, and verbal), hospitalization , or encounters with criminal justice system.

10. Clergy Core Competencies
4. Understand that addiction erodes and blocks religious and spiritual development; and be able to effectively communicate the importance of spirituality and the practice of religion in recovery, using scripture, traditions, and rituals of the faith community.
5. Be aware of the potential benefits of early intervention to the:
Addicted person
Family system
Affected children
6. Be aware of appropriate interactions with the:

11. Clergy Core Competencies
7. Be able to communicate and sustain:
An appropriate level of concern
Messages of hope and caring
8. Be familiar with and utilize available community resources to ensure continuum of care for the:
Addicted person
Family system Affected children
9. Have a general knowledge of and, where possible, exposure to:
12 Step Programs: AA, NA, Al-Anon, Nar-Anon, Alateen, ACOA, etc.
Other groups

12. Clergy Core Competencies
10. Be able to acknowledge and address values, issues, and attitudes regarding alcohol and other drug use and dependence in:
Oneself
One’s Own Family
11. Be able to shape, form, and educate a caring congregation that welcomes and supports persons and families affected by alcohol and drug dependence.
12. Be aware of how prevention strategies can benefit the larger community.

13. AOD 101 – Basic Information
To understand how to help congregants affected by alcohol and drug problems requires that we must understand the disease and its impact on family members.

14. Terminology Can Provide Hope or Deepen Misunderstanding and Shame
Alcoholism
Addiction
Chemical Dependency
Brain-Based Illness
Substance Use Disorder
“Substance Abuse”

15. Learning about addiction includes learning about its children
1 in 4 children under the age of 18 has a family member who abuses alcohol or has alcoholism. Countless others live with parental drug use.
Addiction is a treatable disease, not a moral weakness, and living with it is emotionally and developmentally harmful to children.
Clergy and other pastoral ministers can offer hope and help to addicted individuals and affected children and spouses in their congregations.
We all have more than enough to screen for, diagnose and treat in general pediatrics practice without adding one more thing. Why might you want to learn more about this group of children, whose greatest risk factor is that they have a parent who is abusing substances? Is it because the AAP, in conjuction with other disiciplines has developed core competencies in this area? The first pages of your handout outline these competencies. The national association of COAs estimates that there are 28.6 million children of alcoholics and substance abusers in the US, 11 million children under age l8 living in these families, and 1 in 4 children have some experience with this disease through contact with family members or care givers. 38% of Americans have a family member with alcoholism.This is a prevelent problem that knows no socioeconomic boundaries. C. Any child living with a parent with a chronic disease may be at risk as the medical problem affects the family system.Alcoholism and substance abuse is now seen as a chronic, relapsing disease, that waxes and wanes, and requires management for the rest of an affected person’s life. Or d. the child in your office displaying emotional or behavioral problems may be the presenting patient, but the family needs treatment for substance abuse if the child is to return to good health. I think these are all good reasons to learn about this issue and look for it in your patient population.

16. Why Include an Emphasis on the Children?
Numbers are so great
Chronic confusion, fear, stress, emotional and - sometimes - physical abuse
Developmental and emotional impact from the toxic family environment
Greater risk for neglect, for mental health problems, for addiction and for entering the juvenile justice system

17. Family interaction is defined by alcoholism or addiction.
Problems clergy see that are frequently associated with addiction in the family:
Increased… Decreased…
Family conflict Family cohesion
Emotional or physical violence Family organization
Family isolation Family stress, e.g.: work problems, illness, marital strain, finances,
and frequent relocations

18. What Makes the Family Toxic?
Don’t talk
Don’t feel
Don’t trust

19. Addicted Family Defense Mechanisms
Delusion
Denial
Minimizing
Projection
Rationalization

20. A Parent who is abusing alcohol or other drugs
May be less attentive to the child while drunk or high
May be unable to fulfill their role as a parent, including providing medical treatment
Is more likely to be diagnosed with a co- morbid psychological problem
May be less attentive to the child while drunk or high
May be unable to fulfill their role as a parent, including providing medical treatment
Is more likely to be diagnosed with a co morbid psychological problem

21. A Parent who is abusing alcohol or other drugs
May be chronically physically ill from using drugs or alcohol
Spends times procuring, using, and recovering from the alcohol or drug use instead of parenting
May be engaged in illegal activities
Places financial stress on the family system
A Parent who is using drugs and alcohol affects the children around him or her in many ways.
May be chronically physically ill from using drugs or alcohol
Spends times procuring, using, and recovering from use of the chemical
May be engaged in illegal activities to obtain their substances
Places financial stress on the family system

22. Consequences for Children of Addicted Parents
More absenteeism from school, less help with homework
Daughters more likely to connect to/marry addicted men
More depression and suicide in adolescents
More illness, injuries, poisonings, substance abuse, hospitalizations

23. Children of Addicted Parents
Often lack consistency, stability, and needed emotional support due to the chaotic family environment
May be physically and emotionally traumatized by accidental injury or verbal, physical or sexual abuse due to parental drinking/drug use
May encounter permissiveness, neglect, violence, poor communication, under-socialization

24. Adverse Child Experiences Study

25. Addressing Family Addiction
Interventions need to be comprehensive and continual – and include age-appropriate child services.
Children benefit from educational support programs, including Alateen, whether they live in birth home or in foster care, and whether or not their parents get well.
Spouses benefit from Al-Anon

26. Recovery Does Happen Intervention and treatment work Families heal
Spiritual health is possible again
Money is saved
Life gets better
People in recovery give back
Everyone wins!
Recovery from alcoholism and other drug addiction happens frequently across a broad spectrum of society: rich and poor, old and young, doctorate and high school drop-out, women and men, black and white, and country or city dweller. Achieving a stable, productive, chemical-free life is, in fact, a normal expectation when proven solutions are applied. When proven solutions are applied to appropriately diagnosed cases of addiction illness, a number of happy outcomes occur:
Recovery happens. Families heal. Money is saved. Life gets better. Recovering people give back. Everyone wins!
So often and so frequent are these experiences of recovery attained that it can be said with complete scientific authority that the chronic illnesses of alcoholism and drug addiction have been conquered.

27. Emerging Recovery Trends
Recovery from alcohol and drug problems is a process of change through which an individual achieves abstinence and improved health, wellness, and quality of life.
Recovery-Oriented Systems of Care shift the question from “How do we get the client into treatment?” to “How do we support the process of recovery within the person’s environment?”

28. Definition of Addiction in Relationship to God
Addiction is a systemic de-construction that estranges, alienates and sedates the self-in-relation toward the Ultimate with outcomes of disenchantment and loss of meaning for life-experiences.
Paraphrased from James E. Royce, S..J., Ph.D.
The Effects of Alcoholism and Recovery, 1995
from Spirituality and Chemical Dependency

29. Long term effects within family system: applications to spiritual development. (McIvyn C. Raider, Ph.D. –1992, Assessing the role of religion in Family Functioning)
Tangled relationships
“God” as the image of mom or dad
Co-dependent behaviors
Poor self-image
Instability of religious commitment
Underdeveloped intrinsic values
Overcompensated with rigid behaviors or beliefs
Under-utilization of religious formation and support systems
Inconsistent modeling and mentoring for children

30. COAs Need Spiritual Help
“I don’t know if I can ever forgive him …”
COAs must learn to walk the path of progress, not perfection.
Support by clergy and faith–community for family therapy or individual counseling
Spiritual direction and mentoring
The journey of forgiveness is not made in one’s feelings but in one’s surrender to faith.
One day at a time …

31. COAs Need Spiritual Help (cont.)
COAs need to appreciate their goodness and individual gifts.
“We cannot forget but we can know where we want to be and always seek out new, fresh, holy ground as a restless pilgrim. We may not want to go home – but we can build a new house and make it our home.”
Spiritual maxim (Ronald Rolheiser 2001: Against an Infinite Horizon)

32. Small Efforts Can Help Deliver the messages that break the silence
In sermons
In “Did You Know” Factoids
In casual conversations
In your congregational education programs
In your youth programs
In your pamphlet racks and with posters

33. Affected Spouses and Children Need a Framework for What They are Experiencing
- Information about addiction as a family disease
- Information about the hope of treatment and the process of recovery
- Information on community-based supports such as Al-Anon and Alateen
- Validation of their experiences
- Reassurance that affected children and spouses need and deserve support and help…whether or not the addicted family member recovers

34. Addicted Families Need Clergy
To Break the Family “no talk” rule:
Use “teachable moments” in sermons to inform about the disease and invite hurting congregants to healing.
Include addiction and family impact information in your educational programs.
Leave 12-Step literature in your materials racks
Leave this project’s free pamphlets in your counseling offices and youth centers for children and teens; hang project poster.
Remember: doing nothing and saying nothing is not neutral.

35. Talking Helps to Break the Silence
Talk TO the children of alcoholics and drug addicts and talk ABOUT them; explain the disease and 7 Cs
I didn’t Cause it
I can’t Cure it
I can’t Control it
I can take better Care of myself:
by Communicating my feelings
making healthy Choices
by Celebrating myself.

36. Other Messages Children Need
You’re Not Alone.
It’s Not Your Fault.
You deserve help, and there are safe people who can help you.
Addiction is a health problem.
It’s OK to feel our feelings.
It’s important to talk.
Treatment helps, and recovery happens.

37. There are Many Message Delivery Systems
Health Care Systems
Treatment Systems
FAITH COMMUNITIES
Courts
Community Coalitions
Schools
Workplace Programs
Knowledgeable and caring family members

38. Help for the Children
There is great value in educational support group activities –
Provide beneficial education for all children and youth
Especially helpful for children living with alcoholism or drug dependence in the family
A tool to help:
SAMHSA’s Children’s Program Kit

39. Group Work is the Preferred Strategy Because:
Kids learn they are not alone.
Group work increases the likelihood of breaking denial.
Group work provides safety and protection.
Kids experience healthy social interactions.
Group work builds trust in social situations.
Group work provides opportunities for group validation.
Group work allows kids to try out new approaches to old problems.

40. COA Groups Let them know they are not alone!
Validate their perceptions and interpretations
Help them gain some perspective
Absolve them of blame
Help them separate parent from parental behavior
Offer hope, self-care skills and help to cope
Provide a safe outlet for anger
Explain risks of behavior, and how to identify safe
people in their lives
Help build self-esteem

41. What happens if adults don’t help?
Children are at greater risk for:
Physical, verbal or emotional abuse
Poor school performance
Lacking of trust in others, including God
Diminished spiritual life
Truancy or trouble with the law
Poor choice of life partners
Diminished economic opportunities

42. Clergy Need to Understand Family Intervention
Engages the most significant people in the addicted person’s life to:
present a loving, structured, supportive and coherent message of concern to an addicted loved one;
convince the person that alcohol/drug use is creating painful problems for all involved;
request that the person get help so that all can recover and heal.

43. Family Intervention Is...
Carefully pre-planned
Facilitated by a professional interventionist
Includes key family members – spouses,
children, and other significant persons
Uses loving, supportive language
Includes “What if…?” bottom lines
Would seldom include clergy or other
pastoral ministers

44. The Vision
A faith community environment where all members of a family affected by addiction know there are knowledgeable and caring clergy and other pastoral ministers who:
understand what they are experiencing
care about them and are available to them
can help them find emotional and physical safety and
can support their healing and spiritual growth

45. To Contact Us: National Association for Children of Alcoholics
Steve Hornberger
American Association of Pastoral Counselors
Doug Ronsheim