Monday, March 1, 2010

Breaking the Cycle of Substance Abuse

Breaking the Cycle of Substance Abuse: Relapse Prevention Teaching Parents in Recovery Nurturing Parenting Skills

M. Kay Keller, M.P.A., S.S.W., C.I.M.I., All Family Solutions

One Day At A Time

Parents in recovery focus on their sobriety one-day at a time. At first minute to minute, hour to hour, one day at a time seems insurmountable, as each moment becomes the stepping stone to a successful day in recovery. The success of each day builds the bridge to discharge from treatment and rejoining the family unit. However, even this milestone is a landmine in disguise for relapse potential. Sending parents back home without new tools for dealing with their children while sober is a set up for failure. New beginnings deserve the best possible education supports available especially when dealing with the most vulnerable of our society, our children.


Substance abuse has long been known to be a factor in child neglect and/or abuse cases (more than 80of substantiated cases of child neglect and abuse indicate poverty and substance abuse as the two primary contributing factors to abuse and neglect of children). Children of parents who abuse substances are three times more likely to abuse substances themselves. More than 70of people in substance abuse treatment have been neglected and abused as children it doesn't take a quantum leap in logical thinking to determine there is a cycle of child neglect and/or abuse in the majority of families suffering with addiction disorders.

The Facts
Research conducted with parents involved with aftercare programs discovered inappropriate parental expectations of the child, lack of empathy towards their children's needs, parental value of physical punishment and parent child role reversal (Gallant, 1998). The most common characteristic of people suffering from addiction disorders is a narcissistic personality disorder. Traits of this personality disorder are (1.) an exaggerated sense of their own importance, (2.) a perspective of what they can obtain from their own importance, (3) a perspective of what they can obtain from the people they make contact with, a sense of entitlement, and expectation of special treatment by others, and are highly sensitive to criticism or negative feedback (Sandler, 1991). Rather than focusing on the needs of children or others in their relationships, people in recovery are focused upon what other can do for them, what they can receive from the relationships rather than what they can provide.

In a "Neurological approach to understanding anger, rage, trauma and addiction," Dr. Cardwell Nuckols discusses the vulnerability of young children to delays in emotional and cognitive development. Children are susceptible to the affects of substance abuse in the family because the brain is still developing after birth and is not fully developed until the child is approximately twenty years of age. Research has indicated children who were exposed to family addiction disorders showed an inability to empathize with others, are more likely to develop conduct disorders, ADHD, affective disorders, schizoprhenia and obsessive-compulsive disorders.

Parents who suffer from addiction disorders show an inability to empathize with others, children who are exposed to family addiction disorders show an inability to empathize with others and the cycle continues from one generation to the next. The absolute strongest argument for parenting intervention in families with substance abuse disorders is, how children are raised is how they will ultimately raise their own children. Children learn best from the examples set by their caregivers not by what they are told to do (Bavolek, 2000).

Reducing The Impact
What intervention will reduce the impact of children exposed to family addiction and intervene in the cycle of substance abuse/ child neglect and abuse? Educating parents in recovery on: realistic expectations, how to use positive discipline tools, building up their child(ren)'s self-esteem and learning problem solving skills increases chances of a more balanced or appropriate parenting experience for parents endeavoring to empathetically understand their [children's] needs and lower the chance of abusive parenting (Gallant, 1998). Nurturing, positive, empathetic supportive communication combined with problem solving skills supports recovery and increases resiliency factors. Building up the family system is prevention of substance abuse addiction disorders in the next generation.

Effective Intervention and Prevention
An effective parenting education program found in Florida is the Nurturing Parenting Program. Evaluated by the State of Florida's Department of Children and Families showed a completion rate of 86 more than 40above any other parent education program in the state. The nurturing program validation studies showed significant (page 1) change of parental beliefs of age appropriate expectations of children's behaviors, empathic awareness of the needs of children, decreased the belief of corporal punishment as a discipline tool and decreased parent-child role reversal (Bavolek, 2001) (www.nurturingparenting.com).

The Nurturing Parenting Program for families in substance abuse treatment and recovery both group-based and in-home curriculums assisted parents in strengthening their own recovery, facilitating recovery within their families, and building a nurturing family lifestyle. The goal of the program is nurturing parents, which enhances their ability to nurture their children and as a result enhances the richness of experiences of recovery. The Nurturing Parenting program focuses on parenting as a relationship. Mutually building attachments between parents and their children, authentically being worthy of their children's trust, and building empathy in parent to child interactions. Parents develop self-awareness and build nurturing skills by using a variety of techniques and hands on activities accommodated to different learning styles. Parents explore their childhood experiences, their fears and their strengths, and the effects of substance abuse on themselves and their families. These parents build skills to strengthen their recovery, explore their own development as adults in recovery, and examine similarities and differences in the development of their children. Partners of parenting adults in treatment and recovery and extended family members who parent children of substance abusing adults find the Nurturing Parenting program beneficial as well (Bavolek, 2000).

Additional Recovery Support
Families with infants and toddlers exposed to substances pre- or post-natal and experienced attachment and bonding processes interruption (due to residential treatment placement of a parent or experienced neglectful parenting due to substance abuse use), increase opportunities for successful nurturing parenting when infant massage is included in the educational program.

Infant massage instruction includes asking permission to touch infants, matching verbal expressions, developing engagement cues, positive eye contact, supports bonding and attachment by gentle touch, smell, and hearing. Additional benefits include positive parenting interaction, brain development education and age appropriate expectations of infants and toddlers. Combined infant massage and nurturing parenting provides clarification of physical and emotional boundaries, supports and enhances resiliency in families as they face an every changing world and continue sobriety on a path to healthier lives and leave family legacies for future generations.

1The narcissistic personality was first addressed by Havelock Ellis (1859-1939), described by five specific characteristics in the 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III): 1. Inflated self image; 2. Exploitative; 3. Cognitive expansiveness; 4. Insouciant temperament; and 5. Deficient social conscience. It is not uncommon for people who have this personality disorder to feel entitled to undue praise, attention and special treatment by others and have a lack of understanding or acknowledgement for the needs of others. The person suffering from narcissistic personality disorder has no patience with personal interactions in relationships or otherwise loses interest in any situation where attention is not focused upon them (Westen, 1985).

Infant Massage and Nurturing Parenting Education provided for parents in substance abuse recovery as a method of developing empathy for their children. Florida State University Department of Family and Child Sciences Program of Family Relations. Doctoral Seminar on Parenting. November 2003.

Infant Massage for Infants with Fetal Alcohol Syndrome Women's 2003 Substance Abuse Conference. Tampa, Florida

Infant Massage-Loving Touch. International Association of Infant Massage - U.S. Chapter Annual Educational Conference. May, 1998. Orlando Florida.