Substance Abuse and Child Welfare
Intervention to Break Cycles of Abuse and Addiction in Families
Shirley N. Sparks, MS and Rosemary Tisch, MA
The societal burden of child abuse is exorbitant and it is of vital importance to find effective interventions to prevent its recurrence. Children living with caregivers dealing with substance use disorder (SUD) are more likely to experience lengthier stays in out-of-home placement, recurrent involvement with child welfare services, and lower rates of family reunification than other child welfare-involved children (Brook & McDonald, 2007; Traube, He, Zhu, Scalise, & Richardson, 2015).
Caregiver SUD can have long-term impacts on children’s mental and physical health and affects every member of the family, often impacting multiple generations. Children of parents with SUD are four times more likely than other children to develop problems with addiction (Substance Abuse and Mental Health Services Administration [SAMHSA], 2009). However, these children are not predestined to develop problems with substance abuse, and family-focused treatment can be an effective prevention strategy.
There is much evidence that family skills training programs decrease the risk of child abuse and decrease the time children spend in out-of-home placement by providing interventions for parents/caregivers and preventing the cycle of addiction for children. They do this by strengthening protective factors in families, thereby reducing the probability of risks. Celebrating Families!™ is one of the few family skills training programs that engages family members in learning healthy living skills while addressing child maltreatment, family violence, and substance use disorders. The program utilizes a multi-family skill-building model that engages every member of the family (age birth through adult).
Several aspects of the program make it distinctive: It uses strength-based, trauma-informed strategies to increase healthy living skills; it adapts teaching to be appropriate for families dealing with (or at risk for) substance use, learning differences, and mental health challenges; and it addresses substance use and mental health challenges in every session, helping parents/caregivers comprehend the critical importance of basic healthy behaviors.
Sessions are provided weekly for 16 weeks. Each two-and-a-half-hour session begins with a family meal served by group leaders followed by separate 90-minute, age-appropriate instructional sessions for children age birth-17, and another for parents and caregivers. Session topics cover substance use; education facts about alcohol, tobacco, and other drugs; addiction as a disease; the effects of addiction on the whole family; and the impact of in-utero exposure to alcohol and other drugs. Other subjects include well-being related topics such as healthy living, nutrition, communication, feelings and defenses, anger management, goal setting, and healthy friendships and relationships. Parents then reunite with their children for a 30-minute family activity.
Parents of children age 0-3 have a half-hour session preceding the meal that focuses on parent-child interaction. Transportation to the site can be a barrier, but trained and dedicated staff members are ready to help with solutions. Attendance is usually excellent because families are motivated to participate by being reunited with their children when they graduate. Appropriate sites must have enough space for the separate groups and facilities to serve the meal.
Celebrating Families impacts families in three ways. First, it gives parents/caregivers skills to stay sober, to heal, and to build healthy, non-violent relationships with their children. Second, it decreases risks of child abuse and repeated family cycles of addiction. Lastly, the program serves as an intervention for parents/caregivers who are in early recovery and focuses on prevention for children.
Celebrating Families is provided throughout the United States by over 100 organizations and serves approximately 4,000 families each year. The curriculum is effective with diverse cultural, racial, and socio-economic populations (Coleman, 2006; Sparks, Tisch, & Gardener, 2013). It has been adapted for Spanish-speaking families (Celebrando Familias), Native American families, and women in residential treatment facilities with young children. Evaluation outcomes from multiple studies show significant positive results with very large effect sizes. Independent evaluators have documented that the curriculum:
Doubles the rate of family reunification, while decreasing reunification time for families in Dependency Drug Court (Quittan, 2004; Brook, Akin, Lloyd, & Yan, 2015).
Significantly increases family cohesion, communication, strengths, resilience, and organization, and impacts positive parent involvement, supervision, efficacy, and positive parenting style (LutraGroup, 2007).
Significantly increases positive growth for youth in knowledge and use of resources, coping skills, and ability to avoid delinquency involvement (Jrapko, Ward, Hazelton, & Foster, 2003).
Agencies serving families dealing with (or at risk for) child welfare involvement and SUD can reduce out-of-home placement of children and help families to prevent children’s future SUD by providing family-skills training programs, such as Celebrating Families. Programs should emphasize strengthening protective factors such as healthy attachments between caregivers and children. Programs can decrease risk factors by educating caregivers about the importance of relationships and decreasing substance use, violence, and abuse in the home. Family drug courts may order it as an alternative to incarceration and child removal. However, any institution that serves families is appropriate, such as schools, churches, community centers, and rehabilitation facilities.
Shirley N. Sparks, MS, is associate professor emerita, Western Michigan University. She is a member of the Advisory Board for Celebrating Families!™.
Rosemary Tisch, MA, is the director of Prevention Partnership International. She is co-author of Celebrating Families!™. Contact: firstname.lastname@example.org