Perinatal Substance Abuse : Characteristics of Parents at Risk, Part 4

by Child Welfare Information Gateway

(Page 7 of 7)

Children must receive appropriate and consistent discipline so that they understand and internalize the rules of the family and of the culture. Again, this objective can be accomplished in various ways, but it must be done in a manner that builds trust, cooperation, and self-assurance. Caregivers, who themselves grew up in dysfunctional homes, often have no model of appropriate discipline and may unconsciously emulate their own inadequate parents. Consequently, these parents may use means of controlling and instructing their children that inspire fear, anger, and rebellion.

A learned pattern of inappropriate discipline may be further compounded by the effects of a parent's own drug or alcohol use. In chemically involved families, parental decisions about what is or is not acceptable behavior and judgment about what constitutes an appropriate parental response to that behavior may vary from one moment to the next. The dramatic mood swings that accompany drug use and withdrawal as well as the profound, often chronic psychiatric disorders that result from or coexist with long-term substance abuse can make it very difficult for chemically involved caregivers to exercise good judgment and respond appropriately and consistently to their children's behaviors.

Children need parents who are responsible for dealing with community agencies and major social systems, and who are capable of making the decisions that affect the well-being of all family members. Children lack the experience and the legal authority to interact successfully with school systems, housing authorities, health care providers, and other community agencies. It is the parents' responsibility to interact with these systems, deciding when and how they need to be accessed in order for family needs to be met. However, chemically involved parents often may be physically or psychologically absent when such needs arise. Consequently, many chemically involved parents do not obtain medical care or needed educational services for their children. These parents may forfeit eligibility for low-cost housing, public health services, public assistance, vocational rehabilitation, and a range of other opportunities that, if accessed, could greatly enhance the quality of life for all family members. When parents are unable to accomplish these tasks for their children, tasks that children cannot accomplish for themselves, basic family needs are not met.

Children need parents who accept the primary responsibility for home maintenance and housekeeping. Although this responsibility can and should be shared among family members, it ultimately falls to the parents to ensure that the home environment is both safe and clean. Chemically involved parents often find it difficult to accomplish the tasks associated with running a household, and basic maintenance and housekeeping tasks are either neglected or left to young children, who may lack the skills or motivation needed to accomplish them successfully. When bottles and dishes aren't washed, soiled diapers and garbage aren't disposed of properly, and plumbing isn't operable, unsafe and unhealthy conditions exist for all family members.

Children need to be free of the primary responsibility for child care. Child care is a task that can be shared, particularly within large families, but the ultimate responsibility for seeing that children's needs are met resides with the parents. Although the "parentified" child in a chemically involved family often does care for younger children, this child almost certainly lacks the judgment, experience, and maturity to care safely and properly for other siblings over time. It is destructive for older children as well as for younger siblings if the locus of child care is placed in children's hands.

Children need nurturing families. Loving and caring within families can and should flow freely in both directions between older and younger members. It is the responsibility of parents to make sure that this nurturing is available. Sober and emotionally stable parents are usually able to defer their own emotional needs or surmount obstacles such as fatigue and ill health when their children need care and attention. However, chemically involved parents may become so caught up in the cycle of alcohol and other drug abuse that they remain largely unaware of their children's need for nurturing. Children in such families often experience the pain, uncertainty, and loneliness that result from feeling a lack of caring and love.

Children need to experience appropriate roles and boundaries within the family. In healthy families, it is clear to all members precisely who are the adults and who are the children, and who is in charge of whom. Unfortunately, in families in which one or both caregivers is a substance abuser, roles and boundaries are often ill-defined. It is not unusual in chemically involved families to see a toddler "ruling the roost" with a heavy and tyrannical hand. Nor, with boundaries so blurred and roles confused, is it at all unusual for children to become victims of sexual abuse.

Summary

To begin to establish an effective treatment alliance with a substance-abusing family, it is important for professionals to acknowledge the following basic principles regarding alcohol and other drug abuse:

To work effectively with a substance-involved family, professionals must explore their own attitudes, feelings, and experiences related to alcohol and/or other drug abuse. Substance abuse is a complex problem, and objectivity can only be maintained if service providers are able to distance themselves from their own personal experiences, prejudices, and preconceptions. A basic understanding of addiction and its impact on individuals and families, therefore, is also critical. Further, an informed team approach is essential in effectively serving substance-abusing families.

An individual may become involved in the abuse of alcohol and/or other drugs for a wide variety of reasons. These issues can be ferreted out over time by professionals working with the family, and this information can help professionals and family members determine the most appropriate treatment and intervention strategies.

It is essential to recognize that parents may not be ready to engage in treatment when the professional first becomes involved with them. However, this does not mean that service providers cannot help parents become ready to consider treatment. This process is often time-consuming, but it can lead to successful intervention.

Although relapse is an inherent part of substance abuse, a failure in treatment may not necessarily be due to the disease. Rather, some treatment failures occur because the treatment program is not well suited to the individual substance abuser. Thus, professionals need to explore with the parent the possible causes of any unsuccessful treatment effort.

Professionals also need to be aware of the range and variety of treatment services that are available within their individual communities. Unfortunately, some communities offer only a limited array of substance abuse treatment services that may not address many clients' needs. (For instance, many programs will not enroll women who have children.) In such cases, professionals can become advocates to inform their communities about the need for new and expanded services.

In summary, in order to provide effective services, professionals should understand the power and tenacity of substance abuse, including its chronic and relapsing nature, the central role that it plays in the chemically involved parent's life, and the parent's attachment to the substance(s) used. Professionals also need to remember that the substance-abusing parent often has multiple, long-standing problems, some of which may not even surface until the parent has entered treatment and attained sobriety. Further, the abuse of alcohol and/or other drugs is not merely a disease of the individual, but, rather, a problem that affects the whole family. Chemically involved parents are often the victims of intergenerational substance abuse. Involving them as well as their children in treatment can be a beginning step in breaking a cycle of substance abuse, ineffective parenting, family violence, and child abuse and neglect.

About the Author

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