Monday, March 26, 2012

More on parenting and addiction.... while I'm on the topic (parenting and addiction, see previous post), I'm going to keep rolling with a thought that has plagued me for awhile. We are in treatment program number 3 right now, since we've been at this substance abuse thing for over two years, with various ups and downs. And for the third time, I am struck that the treatment model is ill-suited to foster/adoptive situations.

How so?

First, although I recognize that all kids struggling with substance abuse have underlying complexities, I feel safe in saying that kids who've been a long time in foster care tend to have an extra layer of complexity in their histories. Many have been exposed to drugs and alcohol before birth and face serious cognitive and learning disabilities. Almost by definition, they have been abandoned and sexually and/or physically abused, which is how they came to be in foster care in the first place. If they now have foster or adoptive parents attending treatment with them, those parents usually have a very thorough grasp of the child's unique needs and struggles. We have yet to work with a substance abuse counselor who takes the time to absorb that history. In fact, in two out of our three substance abuse program intake meetings, the intake counselor began to cry when I answered questions about T's early history, then cut me off, as if needing to know no more. I wasn't impressed that they were so moved, I was annoyed and alarmed that they weren't able to take a complete medical history, especially given that these are so-called "dual diagnosis" facilities who are administering psychiatric medication in some cases.

Second, it's been our experience that the substance abuse treatment programs in which we've participated have used a model for family therapy that presumes that the child has been with you since birth, and that the family dynamics are in some way contributing to the child's substance use. Of course, right? Except that in an older child adoption, whenever you're doing "family therapy", at least in our case, there might as well be a dozen people in the room. Who are T's parents? Over his lifetime, there have been five of us primary parents, and that doesn't count the 14 other foster parents with whom he spent time. It's complicated. The group family sessions are awkward for us, because when the conversation turns to family history, we all three struggle to fit our situation into the presumed model.

Third...well, I hope readers of this blog will forgive me for this one, because it might sound conceited. But: we are not your average parents. We aren't any BETTER, as people, by any stretch. But we do have a LOT of training, and we focused our training on parenting adolescents, so we aren't your average parents of a teenager, taken aback by the recent changes in our child. We are in that strange quasi-professional parent category that all foster/adoptive parents ascend to, by virtue of the seemingly endless mandatory trainings one must undergo in order to adopt from foster care. In order to be T's parents, we've been through 60 hours of county-mandated parenting training, plus annual re-certification trainings especially for parents of "extremely emotionally disturbed children", because T's social worker required it. We've also been in continuous family therapy for the entirety of our time with him, and we've worked with social workers, Department of Mental Health crisis teams, DCFS "resource" teams, special education advisors...the list goes on. Parenting a child who comes from county custody is like that - you are swept up in an enormous parenting bureaucracy. The family sessions in these substance abuse programs don't account for parents like us. They are geared toward more typical adolescent struggles.

The other night in a family session about "open communication", even T was struck by the mismatch. He turned to me and whispered "You have fat sausage toes. Also, we are WAY past this. We've had a lot more classes than everybody else. We already know all about open communication. We don't need to be here." Of course, that's not entirely true, and I told him that our issues are just like everyone else's - there can be benefits to being in a peer group. But it can be alienating to be the only family of our sort in the room, and I did appreciate his sense that we're ready for the advanced class, thank you very much.

So I'd just like to say: let's get real. Let's have child welfare agencies admit that the problem of addiction and substance abuse amongst kids with abuse histories and long engagements with foster care is HUGE. Let's not skirt the issue and leave foster and adoptive parents to traditional family group therapy. Let's meet the problem head on with specialized services that support families like ours. Then providers would have a place to refer families like us, and we wouldn't have to squeeze ourselves into a model that just isn't a good fit.


Gab said...

It's striking that although the intake counselors are overwhelmed by T's history, they have also booted him from programs (unless I have misunderstood the history). I would think they might be moved to go the extra mile to make things work.

Also, I would hope for T that he finds a program that resonates with him, that doesn't feel like busywork. You are not the first adoptive parents to have a teen with a complex history and substance abuse issues (right?), and yet it feels like you're in undiscovered territory.

You remind me that it's a triathlon, not a sprint.

lauren said...

I found your blog through the international adoption community where we also often need to parent kids from trauma. I just read it ALL this week; I was transfixed. You inspire me to be a better parent, to remain calm in a storm and to stay focused on the goal of helping our children to reach their potential. I wish you, your partner and T the best.

You are an excellent writer, so introspective and reflective. Also great traits in a parent. Thank you for sharing.

Bible Belt Betty said...

As always, I admire all the work you've done to be such great parents.

T's problems are a bit more unique than most that deal with substance disorders/co-morbid disorders and because you are quite experienced with effective communication have you thought about starting your own group? Specifically for adolescents dealing with substance abuse and long term foster care. You could find a facilitator (a therapist or social worker)to help form the group but the families would lead. Just a thought. I hope everything goes well for you all.

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