ALCOHOLISM TREATMENT TECHNIQUES AND APPROACHES: CHILDREN IN THE ALCOHOLIC FAMILY

A few words are in order on behalf of older children in an alcoholic family. In many cases, children’s problems are related to stress in the parents. Children may easily become weapons in parental battles. With alcoholism, children may think their behavior is the cause of the drinking. A child needs to be told that this is not the case. In instances where the counselor knows that physical or severe emotional abuse has occurred, child welfare authorities must be notified. In working with the family, additional parenting persons may be brought into the picture. Going to a nursery school or day-care center may help the child from a chaotic home.What cannot be emphasized too strongly is that children not be “forgotten” or left out of treatment. Sometimes parents consider a child too young to understand, or feel the children need to be “protected.” What this can easily lead to is the child’s feeling even more isolated, vulnerable, and frightened. Children in family sessions tend to define an appropriate level of participation for themselves. Sometimes the presence of children is problematic for adults not because they won’t understand, but because of their uncanny ability to see things exactly as they are: for example, without self-consciousness the child may say what the rest are only hinting at, or may ask the most provocative questions. Along the same line, while a parent is actively drinking, the inevitable concerns and questions of the child must be addressed. Children may not need all the details, but pretense by adults that everything is okay is destructive. When initially involving the family, consider the children’s needs in building a treatment plan. Many child welfare agencies or mental health centers conduct group sessions for children around issues of concern to children, such as a death in the family, divorce, or alcoholism. Usually these groups are set up for children of roughly the same age, and run for a set period, such as 6 weeks. The goal is to provide basic information, support, and the chance to express feelings the child is uncomfortable with or cannot bring up at home. The subliminal message of such groups is that the parents’ problems are not the child’s fault, and talking about it is okay. In family sessions you can make that message clear, too. You can provide time for the child to ask questions and also provide children with pamphlets that may be helpful for them.Occasionally a child may seem to be “doing well.” In fact, the child may reject efforts by others to be involved in alcohol discussions or treatment efforts. If the alcoholic parent is actively drinking, the resistance on the child’s part may be part of the child’s way of coping. Seeing you may be perceived by the child as taking sides; it may force the child to look at things he is trying to pretend are not there. (Resistance also may surface to joining the family treatment when the alcoholic has become sober, for many of the same reasons.) Listen to the child’s objections for clues to the child’s concerns. Feel free to seek advice from a child therapist if you feel you are in danger of getting in over your head. What is important here is not to let a child’s assertion that “everything is fine” pass without some question.*133\331\2*

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