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The alcoholic family is armored by delusion, denial and a consistent adherence to the No-talk rule, leaving the children overwhelmed by confusion, sadness, anger and hurt as alcoholism wreaks its special brandharsh words, terror and chaos. It doesn’t have to be that way, and the National Association for Children of Alcoholics (NACoA) — a membership and affiliate organization headquartered in the Washington, D.C. area — is working to diminish the pain and confusion for the one-in-four children living in addicted families. The organization also seeks to provide information and tools to professionals.
More than 28 million people in this country have been hurt by family alcoholism and drug addiction. Over half of those admitted to addiction treatment programs are children of alcoholic parents, and over 11 million children under the age of 18 live in families suffering from the effects of parental addiction. NACoA advocates for children trapped by a family that initially denies the existence of its disease. Parents who do begin to receive treatment often continue denial by ignoring their children’s critical needs, which their treatment program may reinforce while focusing on the addicted parent. Therefore, the children believe that their needs are not important while the attention is on their parents.
Children of addicted parents may be living with confused, frightened and angry adults who are unable to function appropriately because of addiction in the family. Such children need age-appropriate information about addiction, treatment and recovery so that they can understand what is happening and can realize that it’s not their fault. They need safe ways to explore and express their anger, fear, hurt, guilt and shame, and they must learn how to cope positively with the problems at home while developing healthy self-care skills. Parental recovery, especially in the early months, does not suddenly create quality parenting; in fact, without receiving specific education and support, treatment and early recovery are often very traumatic for the children.
NACoA believes that no child of an addicted parent should grow up in isolation and without support, so the association works to bring solace and support to these children. They too are at risk for becoming addicted, developing mental health problems and becoming victims of abuse. Parental treatment and recovery is a great gift to children, but — in order to break the addiction cycle in a family — children need their own chance to heal. In addition, there is growing evidence that, when children receive age-appropriate services, recovery is enhanced for the parent client.
According to Jerry Moe, Director of the Betty Ford Center’s Children’s Program, and Dr. Claudia Black, author, trainer and therapist, specially designed games and activities can help children play their way to health and understanding. NACoA develops videos, print materials and hosts a toll-free number (1-888-55-4COAS) and a website (www.nacoa.org) to bring information and supportive materials to children and families hurt by alcoholism or other drug addictions. The association works with other groups whose members impact children’s lives — teachers, youth ministers, healthcare providers and clergy — as well as through affiliate groups and individual members throughout the country. NACoA also provides technical assistance and group-specific materials for these professionals to help them understand the immediate difference they can make.
NACoA Initiatives
The development and implementation of Core Competencies for effective involvement in helping children of addicted parents are an integral part of NACoA’s work with professional groups within each initiative. They have already been developed for several of the identified disciplines and are in development for the others. NACoA produced the May 1999 special supplement to PEDIATRICS, the official journal of the American Academy of Pediatrics. The journal featured the NACoA-developed Core Competencies for Involvement of Health Care Providers in the Care of Children and Adolescents in Families Affected by Substance Abuse and supporting research papers. A practical implementation kit for healthcare practitioners has recently been completed and will be distributed to providers in early 2001.
NACoA initiatives are directed at groups whose members have a great deal of contact with, and influence on, the health and development of all children, and who are in key positions to make a difference in the lives of children of addicted parents. Current initiatives focus on:
Primary Healthcare Professionals — Pediatricians and other primary healthcare professionals see children of alcohol- and drug-addicted parents every day. They have unique relationships with parents and families, putting them in a position to conduct brief interventions.
Faith Communities — Clergy, youth ministers, religious educators and others who work in the faith community are often the first people trusted with information about pain in families. NACoA believes it is critical that these professionals have sufficient training to reach out, listen and respond to children living in addicted homes, making referrals when necessary. A Kit for Faith Community Leaders is currently in press and will be available by late summer 2000.
Education Communities — Teachers and guidance counselors can promote the implementation of support groups for children at all developmental levels. Teachers can incorporate information about addiction and how it hurts families into school health and substance-abuse-prevention curricula, offering simple strategies for affected children to be safe and get needed help. Included in this initiative are videos and print materials for educators, parents struggling to explain the dynamics of addiction to their children and for after-school and child daycare workers. A fall 2000 meeting of key educational organization leaders is planned to review and finalize Core Competencies for involvement of educators in supporting children of addicted parents.
Social Workers — Social workers interact with families in assessment, in early treatment and at all stages of recovery. They have an opportunity to work with children of clients, run support groups for them and give them the necessary skills to change and grow.
Minority Youth and Families — Special efforts have been made by NACoA, in collaboration with the Center for Substance Abuse Prevention, to develop and disseminate Spanish language resources to help family members better understand and cope with familial alcoholism and other drug abuse. Additionally, NACoA collaborates with the Office of Minority Health, in the Substance Abuse and Mental Health Services Administration (SAMHSA), to ensure that the Core Competencies for the involvement of healthcare providers protecting children of substance abusers are appropriate for those who work with minority youth and families.
NACoA partners with national non-profit organizations, private sector groups and federal agencies to develop policies and programs in substance-abuse research, prevention and treatment. A current example is a federal partnership to develop and provide resources for effective intervention with children of adults in treatment. NACoA encourages its affiliate organizations to establish similar partnerships on a local level. These partnerships provide linkage of resources while serving to broaden and sustain the messages of all groups working for the healthy development of children.
Currently, NACoA is partnering with the Office of National Drug Control Policy’s National Youth Anti-Drug Media Campaign, providing resources and technical assistance to ensure the development and dissemination of messages targeted to those most at risk for adolescent substance abuse, children of substance abusing parents.
NACoA is a clearinghouse for research-based print video, Internet information and resources on children of alcoholics and substance abusers. It publishes a bimonthly newsletter, keeping membership and professionals informed of the latest education, prevention, treatment and research on family issues and chemical dependency.
A network of affiliate organizations from a broad cross-section of the substance abuse prevention and treatment fields is linked to NACoA. These affiliates actively disseminate materials and messages, provide training on the local and regional level and encourage the inclusion of family issues in the development of programs, policies and media outreach on the local level. They also work to support student assistance programs (SAPs) in area schools, a community resource often overlooked by treatment providers. SAPs often provide supportive educational groups in school settings for children affected by parental addiction. School-based programs complement treatment-based programs for children, and help to reduce relapse while facilitating recovery of the parents. Just as programs provide the clarity and support children need to function and grow in the educational environment, they also help to reduce the children’s confusion, isolation and stress, thus improving the family environment where the client is struggling to recover. NACoA believes that both the school and the treatment program have substantial roles to play in the healing necessary for the child of addicted parents.
Program for Treatment Centers in Development
NACoA currently is working with SAMHSA’s Center for Substance Abuse Prevention to develop a “tool kit” for treatment programs to use in the delivery of cost-effective educational support programs for children of clients in treatment. This kit will make it possible for treatment centers to help break the cycle of addiction in the families of their clients, increasing the potential for healing of the child’s tender heart, possibly preventing the devastation from staying there forever.
Sis Wenger, a child advocate for most of her life, is the Executive Director of the National Association for Children of Alcoholics, headquartered in Rockville, MD. Sis is also an Adjunct Associate Professor in Addictions Studies at the University of Detroit Mercy in Michigan and a Join Together National Fellow. Sis has received numerous honors for her professional and volunteer work, most recently the Senator Harold Hughes 2000 Memorial Award from the National Institute for Alcohol Abuse and Alcoholism. For additional information, you can e-mail NACoA at: nacoa@erols.com.
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