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Protecting Children in Substance-Abusing Families
User Manual Series (1994)

Author(s):  U.S. Department of Health and Human Services Kropenske, Howard, Breitenbach, Dembo, et al.

Year Published:  1994

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You are in section: Table of Contents Preface Acknowledgments 1 - Introduction 2 - Identifying Alcohol and/or… 3 - Chemically Involved Parents:… 4 - Children of Chemically… 5 - Reporting Child Maltreatment… 6 - Comprehensive Family… 7 - Juvenile Court Involvement… 8 - Innovative Approaches to… Conclusion Appendix I - The Nature of… Appendix II - Sample Medical… Appendix III - Sample Interagency… Notes Glossary of Terms Selected Bibliography Other Resources Table 1 - Hospital Form For… Table 2 - Sample Interagency… Table 3 - Assessment/Intervention… Table 4 - Assessment/Intervention… Table 5 - Assessment/Intervention… Table 6 - Major Substances of…

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Conclusion

In order to effectively use the information presented in this manual, the professional should proceed with a basic understanding of substance abuse as a serious health disorder:

• The problem of substance abuse is no respecter of persons. Alcohol and other drug abuse can occur in any family, rich or poor, educated or uneducated, across the entire ethnic and cultural spectrum.
  
  
• Denial is an inherent part of a substance abuse problem, often making identification of a substance-involved family member a complicated process. Denial also can seriously interfere with the process of rehabilitation and recovery.
  
  
• Because society tends to view alcohol and other drug abuse problems differently from other health disorders, professionals need to be aware of their own feelings and attitudes about addiction in order to effectively assess and intervene with substance-abusing populations.

Bearing this in mind, this manual has presented information about alcohol and other drug abuse in families with children because many of these families first become "visible" to professionals as their children become involved in the health and educational systems. Although Chapter 1 describes methods for identifying substance abuse (through client history, behaviors, and diagnostic tests), professionals need to be mindful of the limitations of such measures. Identification is often a more extensive process that requires ongoing contacts with family members.

Chapter 2 focuses on substance abuse among adults of child-bearing age and the impact of alcohol and other drugs on parenting ability. In working with chemically involved families, it is important to remember that parental substance abuse is rarely an isolated phenomenon. Individuals who abuse alcohol and/or other drugs themselves often come from abusive, traumatic, or substance-abusing backgrounds, and their own substance abuse, in turn, has a profound effect on their children. Not only does the intermittent altered mental status associated with chemical involvement affect parenting abilities, but such parents also often lack models for effective parenting. Underlying mental health issues as well as basic survival issues may also need to be addressed. Thus, professionals commonly must focus on a wide range of problems that require intervention in order to help substance-abusing parents meet their own needs as well as the ongoing needs of their children.

Fathers and mothers who abuse alcohol and/or other drugs often fail to seek nonemergency health care and other needed services for themselves and their preschool-aged children, and this often makes identification difficult. However, when a pregnant substance abuser delivers a child, health care professionals often become alerted to problems within the family. Newborns who were exposed to alcohol and/or other drugs in utero may present with a range of medical complications related to their parents' substance abuse and lifestyle. Lack of prenatal care, poor maternal nutrition, and infectious diseases (including sexually transmitted diseases and human immunodeficiency virus) are common health risks to drug-exposed neonates. Chapter 3 focuses on these risks as well as on developmental patterns that have been observed in children from substance-involved families.

All of the characteristics described above (the mind-altering effects of alcohol and other drugs; the lifestyle associated with substance abuse; a parental history of abuse, family violence, low self-esteem, or mental health problems; and medical and developmental problems in children) can increase the risk of child maltreatment in substance-involved families. Although specific regulations regarding the reporting of suspected child abuse and neglect lie beyond the scope of this manual, Chapter 4 contains a discussion of general reporting issues in cases of prenatal alcohol and/or other abuse.

In any case of parental substance abuse–whether or not child maltreatment is suspected and reported–a comprehensive assessment of the family is essential. Ideally, such an assessment, as described in Chapter 5, should be made by members of an interdisciplinary team and should encompass the health and behaviors of children and parents as well as an evaluation of the home environment, family support systems, and cultural beliefs. In cases in which the birth parents are not the primary caregivers, professionals must also evaluate the individuals who are responsible for providing care (i.e., relative caregivers or foster parents). The goal of such an assessment is to identify family strengths as well as needs so that an appropriate service plan can be developed.

This assessment information also can be helpful to the juvenile court in cases when professionals have reported suspected child abuse or neglect, and Chapter 6 describes the special issues that the court must consider in evaluating cases of parental alcohol and/or other drug abuse. Such court involvement does not need to be viewed as an isolated event for substance-involved families, but, rather, the court can be viewed as one of many service providers assisting the family. Professionals can contribute valuable information to the court regarding family strengths and needs, aiding in the development of appropriate plans. Further, besides helping to protect the safety of the child, court involvement often can provide clout to help other service providers urge parents to enter and remain in treatment or obtain other needed services for themselves and their children.

Although the ultimate goal of identification, assessment, and in some cases, court involvement with substance-involved families is to obtan appropriate services that can help parents and children, this represents a relatively new area of service provision. Only during the last few years have we had access to information describing programs that serve substance-abusing parents and their children. We now recognize that a family-oriented and culturally sensitive treatment approach is necessary for many parents, and that the more traditional, primarily male-oriented strategies (e.g., Alcoholics Anonymous) do not always work for everyone. Although the specifics of various treatment methodologies (e.g., preferred practices, problems encountered during the course of treatment, relapse prevention strategies, and factors that affect recovery) would encompass a manual in themselves, Chapter 7 highlights some of the more innovative approaches that have been implemented to serve substance-abusing families.

Over the past years, our professional knowledge base across all the disciplines that are involved with substance abuse and with families has grown enormously. There is no doubt that services have become more comprehensive and sensitive to family needs, and as professionals continue to work together in the field over time, we will see more families benefitting from these efforts.

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You are in section: Table of Contents Preface Acknowledgments 1 - Introduction 2 - Identifying Alcohol and/or… 3 - Chemically Involved Parents:… 4 - Children of Chemically… 5 - Reporting Child Maltreatment… 6 - Comprehensive Family… 7 - Juvenile Court Involvement… 8 - Innovative Approaches to… Conclusion Appendix I - The Nature of… Appendix II - Sample Medical… Appendix III - Sample Interagency… Notes Glossary of Terms Selected Bibliography Other Resources Table 1 - Hospital Form For… Table 2 - Sample Interagency… Table 3 - Assessment/Intervention… Table 4 - Assessment/Intervention… Table 5 - Assessment/Intervention… Table 6 - Major Substances of…

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Updated on December 10, 2007