Nurturing Program for Families in Substance Abuse Treatment and

Nurturing Program for Families in Substance Abuse Treatment and Recovery Norma Finkelstein, Ph.D. Beth Marron, LCSW Institute for Health & Recovery

Background And Development Institute for Health & Recovery

Coalition on Addiction, Pregnancy and Parenting CSAP Demonstration Project 1989 - 1994 Institute for Health & Recovery

Two Residential Women’s Substance Abuse Treatment Programs Institute for Health & Recovery

Goal: Support Women In Their Relationships With Their Children Improve Birth And Treatment Outcomes Institute for Health & Recovery

Nurturing Program For Parents Of Children Birth To Five Years Old Stephen Bavolek, Ph.D. Institute for Health & Recovery

Rationale Well Known & Documented Aimed At Reducing Child Abuse & Neglect Evaluation Instrument - AAPI Core Domains: Appropriate Developmental Expectations Empathy Alternatives To Corporal Punishment Appropriate Roles Institute for Health & Recovery

Demonstration Project Adaptations Substantial Additional Information on Substance Abuse Increase Focus on Empathy Add Material on Self-Empathy & Mutuality Relationship Building Add Material Focused on Nurturing the Parent Create Activities Calling for More Active Participation Institute for Health & Recovery

Summary of Outcomes Program A Statistically significant improvement on all 4 domains measured (Inappropriate expectations, lack of empathy, corporal punishment, and role reversal) Program B Statistically significant improvement in lack of empathy and role reversal Increased scores in inappropriate expectations and corporal punishment Institute for Health & Recovery

Relapse Risk Reduction Follow Up on Women Who Left Treatment Survival Analysis on Relapse Rates: Completion of Nurturing Program Related to Longer Lengths of Abstinence Average Time to Relapse 14.7 months for Completers vs. 9.4 Months for Non Completers Institute for Health & Recovery

Publication of the Nurturing Program for Families In Substance Abuse Treatment and Recovery Institute for Health & Recovery

Incorporates Understanding of Factors Related to Substance Abuse Which Affect Parent-Child Relationship Childhood Experiences Parental Substance Abuse Physical / Sexual Abuse Shame & Guilt Inadequate Self-Care Skills Physical / Mental Health Recognize & Manage Emotions Calming, Self-Soothing Institute for Health & Recovery

The Relational- Cultural Model Women’s Sense of Self is Organized Around Making and Maintaining Affiliations Stresses Development Through Connections Connections - Fundamental to Psychological Growth and Healing Institute for Health & Recovery

Basic Principles Nurture the Parent Parenting is a Relationship Within a Family Not Solely a Set of Skills Maintain Nurturing Program Domains: Appropriate Developmental Expectations, Empathy, Alternatives to Corporal Punishment, Appropriate Roles Institute for Health & Recovery

Nurturing the Parent Providing Structure Encouraging Growth Physical, Mental & Spiritual Nourishment Create Opportunities to Build Connectedness Create A Safe Place for Self-Exploration & Building Self-Awareness Participation Creativity and Fun Institute for Health & Recovery

Responds To Array of Learning Styles Literacy Multiple Intelligences Exploration of Cultural Heritage Providing Opportunities to Explore & Appreciate Both Own Heritage & Heritage of Other Participants Institute for Health & Recovery

Nurturing Program Description Institute for Health & Recovery

Format 18 Sessions; 90 minutes each Each Session: Information for Group Facilitator Begins With Ice Breaker Closes With Wrap-Up Many Sessions - Additional Material on Issues or Concerns That May Come Up During That Session Institute for Health & Recovery

Topics Institute for Health & Recovery

Hope Hope Tree Exploring Cultural Values Ritual Related to New Life & New Beginnings Institute for Health & Recovery

Exploring Cultural Values and Rituals Description of Cultural Background Ways Your Culture Celebrates New Beginnings Institute for Health & Recovery

Growth and Trust Themes and Tasks of Human Development Emphasis on Development of Recovery and Parenting Institute for Health & Recovery

Families Diverse Forms of Families Biases Faced by Families Effects of Substance Abuse & Recovery on Families Institute for Health & Recovery

Feelings Explore Ways of Identifying and Expressing Feelings for Parents and Children Institute for Health & Recovery

Self-Esteem Making Connections Communication Problem Solving Body Talk What Babies Teach Us Institute for Health & Recovery

Building Structure Managing Stress Setting Boundaries Schedules and Routines Safety Institute for Health & Recovery

Guiding Behavior Self-Calming Time-Out Re-Direction Institute for Health & Recovery

Knowing Our Values Exploration of Cultural Values Value Game Institute for Health & Recovery

Recovery: Love & Loss Losses Experienced Through Substance Abuse Process of Grieving Ways of Supporting Adults and Children in Grief Loss Exercise Institute for Health & Recovery

Having Fun Importance of Play in Recovery and Family Life Play Party and Celebration Institute for Health & Recovery

Statewide Dissemination 2 statewide trainings per year (free for treatment program staff) Parent-Child Specialists co-facilitate groups and provide supervision and technical assistance to publicly funded treatment programs statewide Institute for Health & Recovery

National Dissemination IHR Parent-Child Specialists provide training on the Nurturing Program to programs and sites as requested Two full days of training is provided, utilizing a combination of didactic and interactive activities Institute for Health & Recovery

Other Study Sites (which have shown positive results) University of Miami Sstarbirth, Rhode Island Strengthening Solano Families HART House, Tewksbury, MA Harvard Street Neighborhood Health Center, Roxbury, MA Institute for Health & Recovery

States Where Nurturing Program Replicated 34 states 3 Canadian provinces Institute for Health & Recovery

Participant Evaluations Family Relationships and Parenting: “Most of what I learned had to do with ways I thought I should parent and that there really is no rulebook or manual to being a good parent. I also spent time learning about my child’s boundaries.” “I’ve learned a lot of new ways to discipline, comfort, nurture, trust, love, care.” “[I’ve learned] patience with my children; to think on their level.” “I have learned that my child will learn different skills on her own time and not mine, and that I need to be patient and loving and supportive no matter what.” “I don’t yell as much; I use time-out instead of hitting.” “I don’t have to yell or get stressed out with my kids. I have ways to relate.” Institute for Health & Recovery

Strengthening Recovery: I learned: “How to have fun as a clean and sober person, how to recognize certain feelings and situations and how I can deal with them; how to interact with other people, and how to nurture myself, my family and friends, and feel comfortable with it.” “How to handle many of life’s every day issues and problems.” “What nurturing is, how to nurture and care for myself as well as others; that I am a truly worthwhile human being who deserves safety, respect and happiness.” “To take the initiative in my recovery.” Institute for Health & Recovery

Adaptations Nurturing Families Affected by Substance Abuse, Mental Illness and Trauma Twelve Session Program (designed for outpatient programs) 60 vs 90 minute-session Format Building Family Recovery Institute for Health & Recovery

Additional Materials Family Activities to Nurture Parents and Children Institute for Health & Recovery