Alcoholism and the Parental Role
Every alcoholic has a direct effect on several people, the majority of whom will be spouses, children, and parents. Although disagreement exists on a definition for
alcoholism
, there is general agreement that the term must be understood in context. As such, the most immediate and basic context is that of the family.
According to the Substance Abuse and Mental Health Services Administration, an average of 7.5 million children under the age of eighteen years were living in households with an alcoholic parent or parents by 2012. When a parent is an alcoholic, the result is often destructive, evidenced by higher rates of domestic violence, child neglect, health problems, and alcohol-related death. Families with an alcoholic parent are more likely to experience conflict and to face financial challenges.
Many persons, however, have coped effectively with the trauma of growing up with an alcoholic parent and have become competent adults. Longitudinal studies have noted that such persons relied on significantly more sources of support in their childhood and youth than was true of children of alcoholics who demonstrated coping problems. This notes the importance of environmental and individual resilience factors that can assist in both prevention and adaptation.
Many substance abuse therapists and organizations accept the premise that a biological vulnerability exists for alcoholism. Others disagree with the importance given to the genetic influence and prefer to focus on individual behaviors and environmental influences. Research has illustrated the importance of the home atmosphere; for example, families who ate dinner together (even families with one alcoholic parent) were less likely to pass alcoholism from parent to child. The sense of structure and of being cared for was assumed to be a contributing factor. In another longitudinal study, mothers who were warm and supportive were less likely to have children who grow up to become alcoholics.
Parents Who Abuse Alcohol
Over time, parental patterns of behavior and communication are affected as a result of alcohol abuse, and these patterns often keep families from dealing with general parental and child problems because alcoholic behavior becomes the primary focus. In the recovery process, a parent becoming sober is a necessary but insufficient goal. Also needing to be addressed are the distorted behavioral and communication patterns that have developed in the family. Treatment is essential if the abstinence is to be maintained.
Research shows a link between substance abuse and child maltreatment. In effect, children of alcoholics are more likely to have behavioral problems and conduct disorders, and to report higher levels of depression, anxiety, and stress.
Alcoholism in the family is not just about one person affecting others. All family members and persons in close relationship with the alcoholic are affected. Possibly the ones most vulnerable are younger children, because of their small physical size and their dependent status. How effectively a family with an alcoholic will function depends on the degree to which that family provides for the physical, social, emotional, and psychological well-being of family members.
When a parent is an alcoholic, the family system becomes organized around the alcohol abuse. Therefore, an effective recovery process requires change in the system itself, referred to as second-order change in family therapy, so that the family can develop patterns based on strengths, resiliency, and coping mechanisms.
Intervention
Fifteen years after Bill Wilson founded Alcoholics Anonymous, his wife, Lois Wilson, founded Al-Anon to help family and friends recover from the effects of someone else’s drinking. The preamble for Al-Anon Family Groups, as the organization is known officially, states that alcoholism is a family illness and that recovery is assisted by changed attitudes. Other organizations and approaches may state their purpose somewhat differently, but they all generally agree that the entire family benefits from inclusion in the recovery process.
The focus on adult children of alcoholics started as a grassroots movement, initiated primarily by those who had experienced living with one or more family members who abused alcohol. Their desire to receive assistance for themselves was often overlooked by helping professionals who concentrated on the alcoholic.
Although family therapy as a form of treatment has not been commonly utilized for families of alcoholics, related intervention programs have shown effectiveness in the treatment of families affected by alcohol abuse. One approach in particular, multidimensional family therapy (MDFT), has combined resources to treat issues related both to substance abuse and to conduct disorders. The effectiveness of this therapeutic model lies in its careful design, which considers the chemical-dependent issue as being both family-based and multisystemic.
Parenting Children Who Abuse Alcohol
Viewed from the parental role, concern over a child’s alcohol abuse usually begins with adolescents and includes early adult years, especially the time when children are in college. In most family settings, the parental role will be more hands-on with adolescents and more distant with college students. Over the years, studies have been conducted to determine whether parenting styles have a direct effect on whether children become alcohol or other substance abusers as adults. The increasing number of young adults who return home after leaving the home for the first time also increases the likelihood that parents will extend their time of direct involvement. In such cases, the parent and the returning young adult may disagree over what constitutes alcohol abuse.
By the time young adults who drink alcohol reach their late twenties, many will have reduced their use of alcohol, often without clinical help or focused dialogue with their parents. These adult children often do not abstain from alcohol entirely but are not likely to abuse alcohol. Those who do not emerge from this phase of alcohol use are more likely to be at serious risk because they have family members who are or who have been addicted to some substance, including alcohol.
Intervention Strategies for Parents
Parents should learn how to detect a true alcohol abuse problem with their teens and young adult children. The American Psychiatric Association’s fourth edition of the
Diagnostic and Statistical Manual of Mental Disorders
distinguished between alcoholic behaviors as abuse disorders and the more severe diagnosis, dependence disorders. However, in the DSM-5, published in 2013, these two disorders were combined as a single disorder called alcohol use disorder (AUD).
Research shows that some types of treatment for alcohol abuse by adolescents and young adults are more effective than others. Intervention strategies identified as more effective are those that provide motivation, tools, and support to produce change. Effective treatments draw upon strengths, motivation, and existing support networks. Young people possess many assets that assist them in making the necessary changes. By recognizing and using the resources available, changes are more likely. A parent is a primary resource.
Two treatment strategies that are effective with young people are MDFT and motivational interviewing (MI). The MDFT model considers multiple areas of an adolescent’s life, including emotional and cognitive functioning and family and peer relationships. A carefully designed, family-based model will focus on the adolescent’s particular developmental stages and his or her position within the family system.
MI is designed for therapy in general but has been especially effective for working with adolescents who abuse alcohol. MI is based on the premise that motivation to change should be elicited from the patient-client. Although MI does seek to “confront” clients with the reality of alcoholism, the technique differs substantially from more aggressive styles of confrontation over abusive behaviors.
Bibliography
Brown, Stephanie, and Virginia Lewis. The Alcoholic Family in Recovery: A Developmental Model. New York: Guilford, 1999. Print.
Jay, Jeff, and Debra Jay. Love First. 2nd ed. Center City: Hazelden, 2008. Print.
Miller, W. R., and S. Rollnick, eds. Motivational Interviewing: Preparing People for Change. 2nd ed. New York: Guilford, 2002. Print.
Peele, Stanton. Addiction-Proof Your Child. New York: Three Rivers, 2007. Print.
Tirumala, Shreyas. "Parenting Style Linked to Alcohol Use." Yale Daily News. Yale Daily News, 14 Oct. 2015. Web. 30 Oct. 2015.
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