With the discussion coming to a close, Donny had a final comment. Taking a deep breath, this bright and perceptive 11-year-old shared, “Addiction turns the people we love into strangers.”

I have spent my adult life working with the youngest victims in families with addiction. These children live with the emotionally painful, and sometimes, debilitating consequences of alcoholism and/or other drug addiction, not because they made a conscious choice, but because the adults entrusted with their care inadvertently passed this burden on to them.

Many of the children who have come to programs over the years were living with active addicts or alcoholics; others were referred to me because one or both parents are in treatment or are recovering from an addiction. They all bear the scars of living with addiction in their families — the secrets and shame, the guilt, the feelings of worthlessness and helplessness. Fortunately, they are also capable of being resilient, honest, wise and trusting. In time, many are able to express their worries, problems and feelings, as we help them develop coping skills, care for themselves and stay safe. These children can and do heal from the adverse impact of family addiction by initiating and deepening the healing process through supportive educational group programs and counseling, as needed.

An important lesson learned through the years is to include the adults in children’s programs. Helping the adults learn effective parenting skills is beneficial to both them and their children. When parents and adult caregivers also participate, this healing process transcends the children and has a dramatic impact on the entire family system — especially the parents. The love and care these kids feel as they safely confront their parents’ disease often stops adults in their tracks and gives them a new, deeper commitment to breaking the multigenerational legacy of addiction. It is so rewarding to see a frightened, confused child grow into a confident, resilient, capable young adult.

From risk to potential

Children who are raised in families where addiction is present are at risk for a variety of behavioral, emotional, physical and psychological problems as they grow up. They are the most at-risk group for developing alcoholism, drug addiction and other compulsive behaviors. Due to a powerful combination of genetics and environmental factors, all too often, addiction becomes a family legacy that is passed from generation to generation to generation.

Children of Addiction (COAs) are also youth with great potential. Prevention and early intervention support group programs, whether offered in community or school settings, can provide children help, hope and healing, whether their loved ones find recovery from addiction, or not. Such programs — offered at treatment centers, family service agencies, through the faith community and in student assistance programs in schools — empower kids with essential messages, skills and strategies to cope positively with all the challenges they face.

The research on resilience consistently points to a critical factor for individuals who were able to rise above the hardship and adversity in their lives. That factor is the presence of a caring, nurturing adult. It isn’t necessary to be a counselor to be that caring, nurturing adult. Perhaps, more than anything else, I have worked tirelessly through the years attempting to be just such an adult for every youngster I have been blessed to serve.

A paradigm shift: strengths-based approach

For many years, the work with children from addicted families utilized a damage model: determine what’s wrong and what’s missing, and then attempt to “fix” things. Unfortunately, this approach revolves around sickness and pathology. Far too many of these children already believe that something is wrong with them. Whether they get such a devastating message directly or indirectly from loved ones, or they simply tell themselves this, it weighs heavily on their hearts and dampens their spirit. This model may often reinforce the message that they are just not good enough. Some youngsters get inappropriately labeled with a mental health diagnosis so a therapist can work individually with the child to “fix” the damage. While some truly need and benefit from such individual therapy, my personal belief, developed through the years, is that there is great value in educational support groups, helping most of these youngsters to learn, grow and heal.

These boys and girls are survivors. Somehow, some way, they make it through highly chaotic, unpredictable environments where the rules often change and one never knows what will happen next. It often borders on the miraculous how they simply make it to school on a daily basis with all they contend with and handle.

A strengths-based perspective helps kids realize they are special. I often hold up a “big mirror” in group to help children see the strengths, gifts and tools with which they have been blessed. The objective is to help kids see these qualities, accept them and deepen them to move toward a life of health and wellness. Such a paradigm shift, from a damage model to a strengths-based model, lets children also focus on what’s right and develop pride in how they have made it through tough times in their lives. Hope stems from these children being able to switch their focus from all that is wrong, to realize they have skills, tools and caring adults to help them.

A road map

Children embrace, accept and celebrate diversity better than anyone on the planet. While the kids and their families are so diverse in many different ways and each program is shaped by this, there are a number of constants throughout the process. The first is to teach children about alcoholism and other drug addiction in an accurate, age-appropriate way. It is a tremendous relief for young people to learn that the addiction is not their fault, and they are not to blame for their parents’ behavior. By creating a safe and supportive environment, children begin to identify and express their thoughts, feelings and concerns. In group sessions, they get in touch with their pain and learn a variety of ways to work through it.

In every children’s program I’ve developed, kids also learn a variety of coping and self-care strategies. They are introduced to the important concepts of safe people and safe places. Every attempt is made to empower youngsters with healthy living skills and to use group as a safety net to assist them in developing and deepening these tools.  Many develop specific safety plans and learn new, healthy ways to handle the stress in their lives. Lastly, children get in touch with their intrinsic beauty, goodness and worth. Counselors/group facilitators reflect back to kids all their strengths and gifts, as well as lead activities that allow children to begin to heal and to thrive. Most importantly, children are given an opportunity simply to be kids. Play is an essential ingredient in the healing process.
This work is exhilarating, demanding, joyful and exhausting, all in the same breath.  Through the years I’ve learned many important lessons to enhance the depth, quality and effectiveness in serving these children, adults and their families.  Here are a few of these lessons.  

Enter their world. Perhaps the best thing to do with children who come from addicted families is to develop a healthy, nurturing relationship with them. Kids don’t care about how much you know until they know about how much you care. This requires counselors/group facilitators to truly “show up” each time they work with children and to pour their heart and soul into all their efforts. It’s often the counselor/group facilitator who is the first adult in a child’s life who consistently treats them with dignity and respect.

It is time to stop making children fit programs, and make programs fit children. Historically, many COA programs took adult concepts and learning styles and tried to make youngsters adapt to them. Therein lies part of the problem. Many of these kids already grow up way too fast, so let them be kids, and love them by giving them focused attention at every opportunity. Really get to know them as individuals, and repeat important information they have shared with you, at appropriate times, to demonstrate that you are truly listening. Encourage them to ask questions, and when they need something, do your best to follow through. Don’t just tell them they are important, but consistently show them just how much they matter.

I’ll never forget the little boy who had to have a green folder when we had run out of them.  In the beginning, he didn’t want to be in the program, so this was really the frosting on the cake. One of the staff, who wasn’t working with this particular group, was heading out to purchase supplies for an upcoming retreat.  I told her, “Whatever you do, come back with a green folder.”  I promised this eight-year-old I’d have a green folder for him by lunchtime.  His only response was to declare, “Yeah, right.” I couldn’t help but wonder how many promises had been broken in his short life. When I later gave him his green folder, and watched the smile spread across his face, I knew that this simple act was a turning point for him.  

Often the only difference between the children and the adults we encounter is that the adults never had a program to attend when they were kids. Many of the adults are still wounded children inside — they want and need to be loved, valued, protected and respected. We show these parents and grandparents the same kindness, dignity and caring the children receive. I have great admiration and affection for them because of their courage and strength in asking for help for their children and for themselves. They are often giving their kids the gift they never received as a child — a safe place to grow, learn, play and heal. The overwhelming majority of these adults know firsthand the pain and confusion of growing up in a family challenged by addiction.

Create a safe place. In her landmark book It Will Never Happen to Me, Claudia Black outlined the Family Laws of Addiction: Don’t Talk; Don’t Trust; Don’t Feel.

Youngsters strictly adhere to these rules as a means of survival, and when children come to a program, I ask them to do the exact opposite of what has allowed them to survive: trust me; talk to me; tell me how you feel.

These kids actually do it, and it’s always amazing how quickly this process unfolds for most. The key is to create a safe place for the kids to express themselves. Structure and consistency breed safety. Many of these children survive by always being a step ahead as they go through life. They pay a huge price in not simply being in the here and now.

Throughout the day, it is important to review the group schedule and announce what will be next. Children begin to trust more fully as they witness that what the facilitators say and what actually transpires match. The effective counselor walks a tightrope of consistency and flexibility in the same breath, always willing to throw out the planned activity if something else comes along that is important and must be taken care of first. The key is letting the group know the change of plans. Positive group rules and consistently enforced consequences let the children know that their safety and well-being are paramount, and that you take this very seriously.

Experiential learning

Learning by doing is the best way to reach and teach children from addicted families. Every person has a predominant learning style. Some learn best visually, some auditorily, others kinesthetically, and still others creatively through the arts. Effective counselors/facilitators always try to gauge each individual’s best learning style and adjust accordingly.

For COAs words often have no meaning, as they have usually heard a myriad of excuses from their loved ones. In group, move beyond words. Experiential activities can get people out of their heads and into their hearts, which allows for deeper levels of insight, understanding and access to feelings and emotions. Rich and varied activities, such as stories, television game shows, art, puppets, role plays, music and games lend themselves to this process. Create opportunities for kids to be active participants in their healing and discovery. Then, always allow ample time for discussion, as every child will have a unique perspective on each activity; and the group is enriched when they all share. Tools exist today to carry out this mission, especially the Children’s Program Kit developed by the National Association for Children of Alcoholics (www.nacoa.org) for the Substance Abuse Mental Health Services Administration (SAMHSA). This kit contains everything necessary to facilitate programs for COAs, K-12.

The Addiction game teaches children in powerful ways. Here, you take the abstract concept of the disease process and make it very concrete by personifying addiction. A facilitator plays the role of the disease so kids can hear it, watch it, react to it, and have feelings about it. Youngsters get to hear “Addiction” tell all the lies and set the trap to take control of the addicted person’s life. Here, kids experience a powerful visual as they come to separate the person they love from the disease that consumes them. Slowly, they understand that it’s not their fault, and they also begin to develop ways to avoid the trap of addiction as they get older.

In an effort to build upon hope, we introduce children to “Treatment” and “Recovery.” T & R are the arch-nemeses of addiction. They help people get better, and they come in many forms, including: treatment, counseling, 12-Step meetings, therapy, and a turn to faith. Once the alcoholic/addict asks for help or accepts it through a form of intervention, T & R come to the rescue and provide a safe haven to ward off the disease.  Children can learn many important lessons from these games and have fun at the same time.

Flexibility

It is an arduous task, but essential, to be willing to throw your whole plan out the window, change course midstream, and develop a new avenue to best meet the needs of the group at any given session. Remember, we are making programs fit children; we are not making children fit programs. Always have a backup activity or two ready to go.  

Picking the “right” activity for group can be humbling, particularly with continuing care groups, as these youngsters have already acquired a common base of knowledge and skill sets in the program. Sometimes, even when I think I know exactly what will work well in a group, I find myself in the middle of an activity with seven- and eight-year-olds when that little voice echoes in my head with a resounding, “It’s not working!”

I keep deluding myself and proceed. Finally, “Mayday, mayday, crash and burn; bail out, get out, stay out,” goes off in my brain. I’m often the last to know (or accept) that the activity isn’t working, as the kids have usually realized this eight minutes ago. Stop and switch gears. Let the group know you’re going in a different direction. Change course whenever necessary. This will be a huge asset in reaching the kids and families you serve.

Have fun and play

An important goal is to engage children so they want to come back to group to continue growing and healing. There has to be something there that intrigues and excites them, something that they are not consistently getting from other people and places in their lives. A child-centered focus, based on dignity and respect, goes a long way toward creating such an atmosphere, but it isn’t quite enough in and of itself. A balanced blend of fun is essential to seal the deal.

In its 2007 report on the importance of play, the American Academy of Pediatrics (AAP) details how free and unstructured play is healthy and essential for helping children reach important social, emotional and cognitive developmental milestones, as well as helping them manage stress and become resilient.  Many COAs get devoured by grown-up worries, problems and secrets, sending the typical hurried lifestyle most American youth already face through the stratosphere.

When it comes to working with children from addicted families, play typically gets short shrift. Play provides excellent opportunities for children, in a safe environment, to actually practice and deepen the very skills they’re learning in group: communicating, problem solving, setting boundaries, and asking for help. It teaches youngsters a great self-care skill and stress management technique. Make the time to let the children play.

Many COAs have lost the ability to embrace fun, joy and silliness in their lives. Some never had this ability, as trauma, loss and pain at a young age made it impossible to develop such skills. Counselors need to let their passion and enthusiasm run loose. There have been innumerable times where youngsters have gone from joy and laughter to tears and pain in a heartbeat. Let the children play, and be playful with them along the way. Simply creating a safe place where these precious children get to be kids for just a little while can foster bonding, trust and closeness that can’t be fully developed in any other way.

Breathing space — less is more

Another important lesson to always remember is that less is more. These are little kids — often seven to ten years of age. Most have been through way too much in their young lives. For many, it’s more than the challenges of alcoholism and drug addiction, as some must also contend with violence, maltreatment, financial hardships, divorce or separation, a loved one’s mental health problems and parental incarceration. They can get overwhelmed by all these difficulties, and really need help to get through.

When boys and girls come through the doors, we want to give them love, education, support, tools, strategies and safety. Whether you are working with children just one hour a week; conducting a weekend retreat; facilitating a four-day or five-day process; or are running a summer camp, it often seems like there is never enough time. It is imperative not to overwhelm these awesome kids all over again by trying to accomplish too much in your programs.

Slow down. Let them breathe and bask in the environment of love and safety you have created for them. Healing is a process — give children a reasonable portion each time you meet. Provide ample opportunities for them to digest all the “goodies” you serve them. Let them ask questions, have fun and practice their new skills.

Facing challenges

Challenges are part of everyday life, and for these children, the issue of addiction is never far away. Many wonder if their loved ones will ever stop drinking or using other drugs, and if their family will tear apart. For those youngsters with a loved one in recovery, the challenges are both different and similar — they worry about relapse, and how this might affect the family. These thoughts are a constant in their lives. Add to that the challenges of making friends, fitting in, doing well in school and just being themselves.

For years we have introduced kids to the concept of safe people — adults in their lives to whom they can turn for support and guidance. The research on resilience points to the presence of a caring, nurturing adult in one’s life as a key factor in overcoming hardship and adversity in healthy, balanced ways. For lots of youngsters the relationship they develop with their group facilitator is their first such experience. Kids delight and relish in such a relationship, and many have been so emotionally hungry for this, they simply can’t get enough. From the moment counselors/
facilitators meet children, they can steadily become a bridge for them to hook up with other safe people in their lives, such as a recovering parent, relative, teacher, counselor, coach, neighbor or minister.

Every member of our children’s program staff will remain safe people, available for as long as kids want. We promise to be here for them, and we are.  They get the 800-number that they can call 24 hours a day, seven days a week, as well as e-mail and snail-mail addresses. We return every call, shoot back e-mails, write letters for every one we receive. Kids know if they send me a funny drawing, I’ll send an even funnier one back. Kids get in touch when times get tough, but also when milestones and good things happen to them.  They don’t have to be alone anymore.

Children and families can truly heal and find a life of joy, peace and love. Through educational support groups and counseling, at both community and school locations, children from addicted families can learn to be kids. They can have fun, develop new interests, and engage in a multitude of activities. They can learn new ways to help care for themselves and stay safe. They are able to communicate their thoughts and feelings to people they trust. These children can find safe people and places to help them. They can feel good about themselves and develop strengths even if their loved ones continue to be stuck in their disease. They can celebrate who they are and move forward to have good, balanced lives, despite what is happening in their families.

Jerry Moe is vice president and national director of Children’s Programs at the Betty Ford Center in Rancho Mirage, California. He is an advisory board member of the National Association for Children of Alcoholics. He also is the author of Understanding Addiction and Recovery Through a Child’s Eyes.

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Kathleen   |72.188.153.xxx |2008-06-22 06:24:10 Truthful...and even so, (gulp)FULL of hope...thankfully. As a recovering Mom who succumbed 'fast & furious' from mid-forties-age alcoholism, I must say that ed. support groups & counseling & reading have helped us all---somewhat. My 4 boys have each been 'willing to heal' to a certain extent...then, it is like, "it isn't THAT big of a deal'. Ouch! Their Dad had told me very early in my hesitant entry to AA meetings that he 'couldn't see going to meetings with all these losers for the rest of his life'[after trying Al-Anon twice], and did not/ still doesn't support our sons going to Al-Anon or even talking openly about any aspect of the several years we spent going through denial, control, blame, botched interventions, bottle-collecting, shame-inductions, anger, and ?? PAIN. Yep...lots of PAIN. So very cunning and baffling...I know clearly the difference between 'the true me' and 'the woman in the disease me'; whi... Reply 1   0

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