Strengthening Family Ties

Caitlin Johnson
July 1, 2002

Damon is not quite four years old. Already, he's seen his cousin sniffing gasoline. That's just what big kids do for fun, he's learning. Cara is one of many young children who regularly see their parents drunk or high—when they see them. Others have picked up glasses left on coffee tables and tasted their first drink before they're anywhere near school age.

"We see very young children who have been exposed to and seen a lot of things they shouldn't," says Judy Purcell, substance abuse resource associate at Head Start of Greater Dallas. For some of the kids in the program, parents' battles with drugs and alcohol have meant moving in with grandparents or other relatives who can provide more stability.

"When I go out to the centers and visit staff doing classes, they'll mention they've got two grandmothers and a set of eight or 10 parents," says Purcell. "It's a big enough issue that we need to address [relatives'] specific needs."

Across the country, more than 2 million children are being raised by relatives because their parents can't provide adequate care. The majority of these kids, according to the Children of Alcoholics Foundation, are there because of a parent's alcohol or drug problem. These "kinship care" arrangements are sometimes made formally through the child welfare system; more often, they're done informally within the family.

Separation is hard enough for any family, for any reason or length of time, but substance abuse adds specific difficulties for everyone involved—particularly the caregiver and the child.

Caregivers Need Help, Too

Kinship care is on the rise, but supports are not keeping pace, according to Kiki Samuels, director of Ties That Bind, a project that has published a series of guides on effective supports for kinship care families struggling with substance abuse.

The formal child welfare system is increasingly relying on kinship caregivers. The 1997 Adoption and Safe Families Act put a stronger emphasis on finding permanent family situations, and mandated that relatives be considered as the first option.

Kinship caregivers aren't a one-size-fits-all group, Samuels says. And neither are the professionals working with them. "A lot of different people touch these families, everyone from the school nurse and a child welfare worker if one's involved, to support group leaders, therapists, pediatricians. You need a number of different trainings that are specified to different populations."

Some of the issues kinship caregivers face are obvious: a financial strain, legal questions—guardianship is needed to enroll a child in school, for example, or get health insurance for a child—and emotional stresses. Anger, fatigue and frustration are bound to arise when parenting breaks the silence of what was supposed to be grandparents' "golden years."

Other issues may be harder to understand for those outside the situation. When it comes to substance abuse, the stigma can be overwhelming for caregivers. Samuels says most of the relatives she meets struggle with feelings of guilt and shame, particularly if they've had their own drug or alcohol problems in the past.

"I got an e-mail from someone who works at a halfway house and knows a lot about substance abuse. But when she started taking care of her grandchild for a crack-addicted daughter, she didn't want to tell anyone about it," Samuels says. "There's a real need to destigmatize and make it clear that substance abuse is a disease, and no one's fault. Families need to know they're not alone."

Preventing Cycles of Abuse

For the children, parents' addictions mean at best a childhood of occasional crises and struggles—problems caregivers take on when they step in. Some are physical; prenatal drug or alcohol abuse can leave kids with disabilities, medical and psychological problems, Attention Deficit-Hyperactivity Disorder or fetal alcohol syndrome. Others are emotional or behavioral. Kids are often confused have by the illegal activities they've seen, or scarred by crises they've weathered.

This confusion can lead to acting out, making the caregiver's challenges that much bigger. It can also mean modeling their parents' behavior—furthering the cycle of abuse and addiction.

Carmen A. Eisler is a counselor with the Drug Free Youth program in the largest juvenile probation center in Houston, Texas. She works with kids under age 17 who are on probation for serious crimes. Eisler isn't sure how many of the children she sees are being raised by relatives, but she suspects the number is growing.

"The hardest thing I run across is kids who don't want to express their feelings [to anyone in authority]," she says. "It's just realistic, if you talk about your parents doing this and that, chances are you'll be reported to child protective services and the family will be separated."

In her work with kids, Eisler rarely sees the parents or caregivers. That's got to change, she says. She offers the example of "Karl," 15, on probation for shoplifting and possession. He's seen his parents drink, use drugs, even steal. They try to teach him right from wrong, but he's not learning by listening, he's learning by example. "It's just not possible to help a kid unless you also address factors in the family," she says.

Another issue for caregivers is what to tell children about their parents' problems. Experts urge them to provide as much information as is appropriate for children's age, and to encourage them to express their feelings about what's happening.

Often, parents end up incarcerated for possession or related charges. "Younger children, preschoolers will be satisfied with 'Mommy or Daddy is sick and can't be here now.' Older kids have more questions, do more probing," says Purcell of Head Start of Greater Dallas. "Ultimately, you have to tell the truth."

The situation is further complicated by contact with the substance-abusing parent. By keeping it "all in the family," kinship care gives kids more frequent contact with familiar faces, including parents. This can ease the pain of separation, but create problems of its own. Parents promise things they can't deliver, children don't understand why the parent isn't going to stay and may feel re-traumatized. Caregivers' authority gets tested, their limits pushed.

When it comes to handling the reappearance of a parent, there are no easy answers. "Most professionals could argue it both ways," says Purcell, "We see both sides. The reality is that many if not most kids will end up back with their parents, so any relationship you can develop is important. But on other hand, you want to protect the child, sometimes the behavior is so erratic that it's more upsetting for the child. It's a case-by-case situation."

Ties That Bind

In 1998, the Children of Alcoholics Foundation and Phoenix House, a nonprofit substance abuse treatment and prevention organization, decided to compile resources and research on effective supports for kinship care families struggling with substance abuse. They found very little research on what works—so they set about to do it themselves.

A series of focus groups brought together diverse specialists from different sides of the issue—kinship caregivers, parents, counselors, social workers, substance abuse specialists—to come up with the Ties that Bind series.

The materials can be given to caregivers as a resource. Phoenix House also sponsors trainings for professionals working with families across the country. Since the publication of the handouts and guide for caregivers in 2001, they've done trainings or distributed materials in 35 states in a range of places—from juvenile probation centers and rehabs to grandparent support groups and community centers.

"I have found other books for professionals working with families, but this is the first one that actually addresses caregivers and is written at level that they can understand," says Purcell.

In June, just before Head Start ended for the summer, Purcell helped host a Ties That Bind training for about 20 teachers at a Dallas center. They started with the handouts, that cover topics like encouraging drug and alcohol treatment, your own use of drugs and alcohol, preserving family relationships, and finding supports.

The response was positive. The teachers, Purcell says, were eager for resources to share with caregivers. "They're on the front line, they'd seen it long before anyone else identified this as an issue," she says. "Day in, day out, they're dealing with families and children, and they know what's going on."

To help whole families heal, intervention has to come early, says Purcell. "One problem I find is that most prevention materials are aimed at junior high or high school. The field has figured out that's too late, we need to do something sooner. There are beginning to be more elementary school-age materials, but there is still very little out there for [people working with and raising] preschoolers."


Caitlin Johnson is a contributing writer to Connect for Kids. Comments about this story? E-mail Caitlin.


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Ny oldest childrens&; father has recently had a child with a woman who used meth, cocaine and god knows what else while she was pregnant with this baby.We were contacted by CPS about possible adoption. I am all for it but now CPS is claiming because I have 5 children already I cannot give the care this child needs. He has no brain damage and did very well with our visits, and social worker has not been there once to see us interact.my ex-husband wants me to raise this child and my kids are devasted knowing their little brother might be raised by strangers. Are there any studies that show how these babies do with large families?

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