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Family & Corrections Network |
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October 10-12, 1993 Quebec City, Quebec, Canada
THE ROLE OF THE CHILD IN MOM'S RECOVERY FROM ADDICTION/ L'influence de l'enfant sur sa mere aux prises avec une dependance Margot Kaplan-Sanoff, Ed.D. Director, Steps For Kids Outreach Training Project Boston University School of Medicine , Boston, MASS Carol Seval, R.N. L.M.H.C. Director, Women and Infants Clinic Boston City Hospital, Boston, MASS Cet atelier a permis de souligner l'importance de l'intervention axee sur la famille par rapport a l'intervention axee sur l'individu dans le processus de retablissement. Les meres ayant un probleme de pharmacodependance ont constate que leurs enfants peuvent representer une motivation puissante dans leurs tentatives pour devenir sobres. Faire face a la perte possible d'un enfant ou reconnaitre les effets de la toxicomanie sur un enfant a naitre peuvent etre des aspects essentiels du processus. Evaluer les besoins et de la mere et de l'enfant est essentiel au traitement. Considerer attentivement les besoins des enfants pendant le traitement de leur mere peut etre complexe et exiger beaucoup de temps. Ce type de traitement amene ceux qui donnent des soins et ceux qui ont des decisions a prendre a considerer le role de mere de la femme comme element possible de soutien dans le processus de retablissement. "This baby has put everything into perspective". Two months into her recovery from years of cocaine abuse, Ida describes how the birth of her child helped her find the strength to acknowledge her addiction and seek help. Children can be a powerful motivating force for women in their struggle towards sobriety. The birth of a child born prenatally exposed to alcohol and/or other substances can be a window of opportunity, a chance for a woman to examine her substance use and enter treatment, perhaps initially for her child and then later, for herself. "If I give up my recovery and go out there and use, I'm going to lose myself and I'm going to lose my child." The potential loss of her child precipitated a crisis for Patty, a crisis that also provided a powerful motivating force for her to consider treatment for her alcoholism. "I was afraid to come in because I didn't want to leave my kids. My kids were my life; they were always there and they always loved me." For Debbie, concern about the care of her children prevented her from seeking treatment for years. Because she had no one that she trusted to care for her children while she was in a residential program, she avoided all forms of treatment until she finally hit bottom. For all of these women, their children played a significant role in their recovery. There were valuable lessons to be learned from these women, lessons which can shape approaches to intervention for both women and children. Family-focused intervention for substance-abusing women and their young children requires a balancing act, one which delicately weighs and considers the needs of the mother and those of her children. Treatment which focuses only on the mother or the child ignores the advantages of changing the family system. In the long run, the best way to help a child is to help the mother recover and retain her sobriety. Family-focused intervention is not a new strategy; Head Start and early intervention programs have been providing mother-child programs for many years. But family-focused intervention with substance abusing woman is extremely challenging, frustrating work. Substance abuse treatment providers must learn to cope with the "messes" which a baby brings to a traditional adult-treatment program. Giving careful thought to the children's needs during their mothers' treatment can be complicated and time-consuming. On the other hand, early childhood providers and pediatricians need to acknowledge and deal with their anger at substance abusing women and their desire to "rescue" their children. They must learn to develop supportive relationships with these families and to set limits and boundaries within the context of those relationships. They must also shift their focus and view the family as the client rather than the individual identified child and to consider the mother's issues and concerns as well as the child's when planning intervention approaches. Most early childhood educators and pediatricians have not been trained to support women in recovery; similarly, substance abuse treatment providers have not been trained to consider a woman's role as a mother and tend to focus solely on her substance use. Finally, public policy, often guided by the media portrayal of prenatally exposed children as innocent victims of their mothers' use, has also prevented providers from seeing the role which children can play as a part of the recovery process. Yet children are a vital part of recovery - they provide the motivation to begin treatment and the reinforcement to maintain sobriety. The value of family-focused intervention can be seen at each level of treatment. At the onset of treatment, the mother-child relationship can be the focus of intervention for the mother; the baby's behavior and development can help providers to reach the mother and to begin to establish a therapeutic relationships with her around her concerns for her child. Secondly, children can serve as a vehicle for examining a woman's life choices and decisions. Simply asking a woman why she has chosen a particular name for her child can provide tremendous insight into her life experiences and family history. Children can be a significant source of pride and self-esteem for their mothers, but they can also be triggers for anger, repressed memories, depression and relapse. Teaching women about basic child development can better their understanding of why their child behaves in certain ways. For example, when a one year old cries as her mother leaves the room and the mother gets angry, calling the child spoiled and bad, that behavior can be re-framed for the mother. She can come to understand that the child is responding to a scary and painful separation from her because she is so central to the child's life. Issues of abandonment are often pivotal to the lives of addicted women; helping them see their role in supporting their child's growth towards individuation can place new meaning on their own lives, on how they interact and understand their children, and how they respond to their own losses, pain and anger. Finally, children offer hope for the future in which the mother plays a critical role. If she can envision a drug-free life for herself and her children, then she can begin to change the chaos and crisis which frequently characterize addiction. Success measured in small steps - "one day at a time", can help the mother sustain a vision for a better life through sobriety and a sense of pride in her accomplishments and those of her children. |
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