Abstract
This presentation will consist of an overview of successful measures addressing the inclusion needs of children with Attention Deficit Disorders, Foetal Alcohol Syndrome, and Cognitive Deficits. It begins by addressing the needs of the parent by providing services that break the cycle of physical, mental, and sexual abuse, and criminal and addictive behaviour that have caused and/or contributed to the exceptional needs of their children. Alpha Home offers guidance to help parents renew and stabilize families, reduce the need for public assistance, acquire a high school diploma, gain employment and avoid criminal behaviour, thus, generalizing the end results into mainstream society and implementing a cycle of success for the next and future generations. Program criteria including an overview of program components and procedures to meet the needs of parents and their children in a residential setting will be discussed. To illustrate the specific needs being addressed and the effectiveness of the overall program outcomes, actual programme footage will be shown via video production. Handouts of program models and intervention strategies to meet the needs of the whole family will be discussed and presented to provide avenues of intervention and implementation strategies for other community resources, educational services systems and schools to consider when meeting inclusive holistic family needs.
The purpose of this paper is two-fold. First to inform educators, professionals, paraprofessionals, parents and caregivers alike concerning the impact of substance abuse upon the lives and behaviors of women, children and the systemic family dynamics. Secondly, to introduce strategies providing a foundation for congress participants to begin to replicate successful interventions for children from substance abusing environments worldwide. We believe by addressing addiction, we can impact a significant change in the lives of not only the women, but their children. Many of these children present with Attention-Deficit Hyperactivity Disorder, Attention-Deficit Disorder, Fetal Alcohol Syndrome, Fetal Alcohol Effect, Learning Disorder, Communication Disorder, Disruptive Behavior Disorder, and overall suppressed intellectual ability. Alpha Home, Inc., is a non-profit residential and outpatient center for women who are recovering from substance abuse. We believe by working with the women, their children and family systems as a whole, we can disrupt the cycle of addiction. Women can learn to be nurturing and effective parents and children can develop resiliency and coping strategies in this interim of suspending the dysfunctional family system. Our program's mission is to provide and increase the availability of services that decrease the prevalence of drug and alcohol dependency among pregnant and parenting women. It is our belief that by helping women become healthy, drug free, self-sufficient and effective parents, they will impact a cycle of success for future generations.
According to current statistics at least 10% of the general population experience some problem with substance abuse or dependence (Comer, 1995). One county in point, Bexar County Texas, with a population of over 500,000 adult women, has at least 50,000 women in need of substance abuse treatment. These women average three children each, indicating there are an average of 150,000 children who are being impacted by substance abuse in this one county alone.
Social characteristics in this population include lack of parenting skills, dysfunctional family systems, cultural issues, and domestic violence including emotional, physical and sexual abuse. Medical issues include pregnancy, lack of pre and post natal care, HIV/Aids issues, sexually transmitted diseases, and general deteriorating physical and dental health. Many women have additional mental health issues such as depression, manic-depression, and borderline intellectual functioning.
In 1999 Alpha Home treated 387 substance-abusing women who had 902 children. These children had many medical and social issues such as needing immunizations, lack of adequate shelter, food, and clothing. Many of the children resided in the dysfunctional system from which the addicted woman came. The children lacked basic communication skills and had numerous behavioral problems. They were in need of specialized counseling to address educational and developmental needs and many had sexual and physical abuse and neglect issues.
The adult family members and significant others are often in need of services. Many have drug and alcohol problems and need to be educated and referred for treatment. Often spouses and significant others have anger management issues and are perpetrators of domestic violence and sexual abuse. At the other end of the spectrum are families who have spent years enabling the addict. The majority of clients and their families' present with multigenerational histories of welfare dependence, drug addiction and criminal justice involvement. Unless the women receive treatment, children and family problems remain unidentified and untreated.
In an effort to help women stop using drugs and alcohol, Alpha Home provides a safe, drug free environment where women can participate in drug and alcohol education, relapse prevention, individual counseling, group counseling, and exposure to the 12 step philosophy. Women gain knowledge about the disease of addiction, it's progression, and identify the impact on their life. They learn to cope with feelings and life stressors. They also develop trusting relationships where they are able to establish life goals and develop a plan for achieving them. They are required to obtain and maintain employment or education. They attend Job Readiness Training to learn appropriate dress, job ethics, work search skills, resume preparation, and interviewing skills. They learn to manage their money and become financially responsible.
As an agency focused on specialized female issues, we have accomplished our expertise through formal education and hands-on experience. Our thirty-four years of experience has confirmed that women returning to untreated families do not remain clean and sober. Our knowledge and demands from the community have made it imperative that we expand our focus and qualifications to provide educational and supportive services for the children and families of our clients. Alpha Home has become proficient in the field of specialized female substance abuse treatment encompassing the whole family.
The majority of women we serve have several children and will be returning to their home to assume parental responsibilities. The average number of children per woman was three and 78% of these mothers were single parents. Ninety-three percent of these families lived below federal poverty levels. In working with these women we have become painfully aware of the intense and unmet needs of their children. In our attempt to assist in establishing healthy families, we have implemented a curriculum created by Rainbow Days, Inc. This curriculum, titled "Kids & Youth Connection" is designed to establish a foundation for nurturing resiliency. Resiliency here in is defined as the ability of an individual to recovery from or adjust easily to misfortune or change. Through continuous exposure to dysfunctional and deteriorating environments, many children have learned to adapt either appropriately or inappropriately to the situation at hand. In the Training on Pregnant and Post Partum Substance Abusing Women, conducted by Dr. Ira J. Chasnoff (1998), one of the nation's leading experts in drug and alcohol effected children, stated "Behavioral patterns they display include: aggression, anxiety, depression, cognitive problems, attention problems, as well as, delinquent behavior" (1998). Dr. Chasnoff goes on to say that prenatal exposure to cocaine and other drugs has a significant impact on the behavioral patterns of affected children until the age of six (1998). Chasnoff further reports that prenatal exposure to cocaine and other drugs is not directly related to later IQ scores, but the indirect effect is mediated through the quality of the home environment (1998).
We are aware that many caregivers working with these children have minimal training or education pertaining to drug and alcohol addicted families. As a result, teachers, daycare workers, and medical personnel view these children as non-compliant or cognitively impaired. Addicted parents, in denial of their disease, attempt to divert attention from themselves and their addiction by blaming the schools, teachers, absent parents, or the children. The mothers acknowledged, when questioned about their children's excessive school absences, that they responded by blaming their own mental illness or the irresponsibility of the other parent. Furthermore, when questioned about aggressive tendencies of their child, they frequently blamed the other parent, neighborhood children, or violence on TV. In addressing the views of the caregivers, we have found that it often is difficult for them to separate the child's behaviors from the child. We are concerned that caregivers may convey unspoken negative messages that the children internalize as blame, shame, and guilt.
The most important strategies when working with these children include: teaching resiliency, identifying their coping adaptations and modifying the curriculum with the notion of flexibility based upon the specific overt behavior exhibited by the child at any given time. In addition, one must consider the highly significant impact of a nurturing, non-distracting and predictable environment. The children's adaptations often results in the development of responses that dictate their actions, making it imperative for facilitators to continually assess their emotional state and mood. Due to the child's past experience with empty promises and disparity, consistency is the primary element for the children's groups. Non-distracting environments affect the ability of the children to stay on task and to focus. Typically, children enjoy bright environments, posters, and live animals. In fact, teachers are often judged upon their ability to create such environments whereas administrators should be more in tune with the needs of these types of children in inclusive environments. Such environments may be tremendously distracting for children already struggling with attending skills.
Resiliency is a focal point of the "Rainbow Days" curriculum and is implemented via a fourteen week cycle of lesson plans. "Celebration of Me" is a lesson plan which assists the child in identifying their internal positive traits. "Feelings" is a lesson plan that teaches children how to identify and express feelings helping children to identify their goals and the possibility of achieving them . "Dream/Goal Setting" is a lesson plan where regardless of environmental limitations children are encouraged to set goals. In "Healthy Choices" children differentiate between healthy choices and unhealthy choices resulting in negative consequences and in "Self-Control" children are assisted in identifying signals of anger and consequences of actions. In conjunction with the children's group the mothers participate in a parallel curriculum to address parenting skills. Titled the Parent Connection it teaches similar messages providing the women with new skills and allowing them to reinforce what their children are learning.
After completion of the residential program, women transition to outpatient treatment and are reunited with their children and families. They have gained a working knowledge of the recovery process in a controlled environment. Clients enter outpatient treatment and return home to assume many responsibilities. They begin implementing recovery principles in a new uncontrolled environment. Parenting can be a major stressor due to lack of knowledge and experience and because the children are adapting to an unfamiliar routine with the parent's new behavior. One of the primary roles of the outpatient counselor is to offer support, structure, and consistency to the woman and their families throughout this transitional period.
Alpha Home's outpatient treatment program is flexible in length based on the woman's needs and her progress. During the six month outpatient treatment program women experience the impact of their attitudes and behaviors on their daily circumstances. The program is designed to nurture self-esteem and independence and promotes accountability through responsibility in an inclusive environment of individual and group counseling, family counseling and continuation of the children's groups. The program provides integrated community resources and networks with community agencies to coordinate the client and her families treatment and support.
Therefore, the cycle of success where collaborative roles in working with children of substance abusing families is evidenced when the woman, her counselor and other involved agencies develop a personalized treatment plan which includes children and family issues. The treatment plan may be intensified in the event the treatment team and the client determine more services are needed. Treatment goals include implementing recovery skills in daily living patterns to promote long-term sobriety, improved parenting skills and family functioning.
The women's children and family members are encouraged to attend weekly groups to gain knowledge about addiction and to learn communication and coping skills. Attendance in family support groups offers support to the "new" family as they begin to implement family life skills into their daily routine. After discharge families are invited to continue attending family support group to receive ongoing support and to provide experience and hope to new incoming families.
Transition into the daily routine of life can be a difficult period for many women as they learn to participate in life without drugs or alcohol. It can also be a difficult time for her children and family as they face the adjustment of having mom and wife present in a new capacity. We anticipate the family's struggle with their new roles and thus incorporate the transformation issues of the systemic family unit into the family, parenting, and relapse prevention groups.
Two hundred and twenty women received residential treatment at Alpha Home in 1999, with 73% of these women remaining clean and sober and completing the program successfully. At the sixty-day follow-up contact, 83 % of the women who completed treatment successfully remained clean and sober. Statistics for the same period show that 167 women received outpatient treatment at Alpha Home with 63% completing treatment successfully. At the sixty-day follow-up contact, 63% of the women who completed treatment remained clean and sober.
The program also measured clients' enhanced parenting skills and knowledge gained about their family system dynamics facilitating a more healthy and stable home environment. Approximately 690 children were impacted either through attendance in groups or indirectly by their mothers improved parenting. There were 323 women who worked on enhancing their parenting skills with 93% completing this goal successfully at time of discharge from the program. We also measured the clients who were able to obtain and maintain employment, education/vocational school and/or volunteer work. This measure was critical in identifying the women's ability to return to and interact with society in a productive manner. The total number of women who were able to address this treatment issue were 195 with 87% completing this goal by completion of treatment.
In closing, we have addressed the impact of substance abuse upon the lives and behavior of women, children, and the systemic family dynamics. We also attempted to introduce strategies providing a foundation for replication to enhance successful intervention for children of substance abusing environments worldwide. Although this paper was meant as an introduction, we embrace the opportunity to provide further information to form the basis for building collaborative intervention programs to meet the needs of children of substance abusing families. Please feel free to contact Program Directors: Suzanne B. Goen at SBGoen@aol.com, Melanie Lane at alphahome@msn.com or consultant Professor Judith Amatangelo at amatangelo@prodigy.net at any time to request further information pertaining to programs and strategies listed herein. We are most interested in helping to establish similar programs and in assisting pre-established programs to further institute Best Practice Procedures for children from substance abusing environments.
References
Chasnoff, I., A. Anson, R. Hatcher, H. Stenson, K. Iaukea & L. Randolph (1998, November).
Prenatal exposure to cocaine and other drugs. In I.J Chasnoff (Chair). Training on Pregnant and Post-Partum Women to Include Training on the Brazelton Assessment Method. Symposium conducted by The Texas Commission on Alcohol and Drug Abuse in cooperation with The University of of Texas at Austin. (pp. 69-81), Austin, Texas.
Comer, R. J., (1995). Abnormal psychology(2nd Ed). (pp. 292-299). New York, NY: W.H. Freeman & Co.
Rainbow Days, Inc. (1996). In Hoff, S. P., & Mitchell, J.R. (Eds.), Kids connection.
 |
 |