When Birth Parents Struggle with Addiction, Mental Health, or Intellectual Disabilities

Are your child's birth parents struggling with addiction, mental illness, or intellectual disability? If so, join us for this discussion with Teresa Bradley, a psychotherapist with over 17 years of experience in addiction counseling and mental health. She is a Master Addiction Counselor, Trauma-Focused Cognitive Behavioral Therapist, and clinical trainer at Amerigroup.

In this episode, we discuss:

Substance Abuse Disorders

• What are some of the challenges that adoptive or foster parents might expect to see when a birth parent is struggling with a substance abuse disorder (SAD) and not able to raise this child?
  • How are those issues different for relative caregivers, like grandparents raising grandchildren? 
• At what age should we start talking to the kids in our care about their parents’ challenges with substance abuse? How do we bring it up? How do we decide what to share and when?
• How can parents address that emotional fallout and deal with their own expectations, triggers, or negative feelings about the birth parents’ SAD?
  • For relative caregivers, especially grandparents raising grandchildren, adding layers of guilt, shame, and disappointment.
• How might an open adoption relationship change across a birth parents’ journey through SAD? How should adoptive parents approach openness in their adoption when SAD is a known issue?
• What do you suggest parents or relatives do to process their feelings? 

Mental Health Challenges or Intellectual Disabilities

• What are some of the specific challenges that adoptive or foster parents might expect when they are trying to support a child of parents with mental illness or intellectual difficulties?
• How can parents explain a birth parent’s challenges to children? When? How?
• What are some of the questions kids might have but cannot voice?  
• How do we address a child’s concern that they will “get” this mental illness without scaring the child?
• Is this a good reason to limit contact with birth parents?
• How might an adoptive or foster parent talk to children and youth about the birth parents’ ability to connect or maintain a relationship? 
• When a kinship caregiver has a pre-existing relationship with this birth parent, how do they talk about the challenges and how their relationship changes in light of their struggles? 
• What other issues do we need to consider to maintain a relationship with the birth parents while keeping the child safe and feeling cherished and supported?

Resources:

• How Do You Manage Relationships with Birth Parents with Substance Use Disorders? 
• Open Adoption

Transcript

Please pardon any error, this is an automated transcript.
Unknown Speaker  0:00  
This is Creating a Family. Talk about foster, adoptive and kinship care. Welcome back to our regulars. We are so glad to have you back and a special shout out. Welcome to our newbies. We're really glad to have you guys. I'm Dawn Davenport. I am the host of this show, as well as the director of the nonprofit creating a family.org,

Unknown Speaker  0:20  
today, we're going to be talking about what to do when birth parents struggle with addiction, mental health or intellectual disabilities. This is a topic that when we send out a survey every year about topics that our audience wants us to cover. This was a topic that we received multiple requests on, so we're glad to be able to offer you this. I'm going to be joined today by Tracy Whitney, who has been with creating a family for nine years, and you're going to be hearing more from Tracy. Tracy is going to be joining me more often because I have announced my retirement from creating a family, and Tracy is going to be my replacement. It's not anything is going to happen anytime soon. It's going to be a slow process. And I can't wait for you guys to get to know Tracy. She is terrific. She is the voice behind many of the art, not many, almost all the articles that you're seeing written and published on creating a family, and she is the heart behind our online support group. So many of you probably already know her, and by the way, the online support group facebook.com/groups/creating,

Unknown Speaker  1:32  
a family. So join us over there. So as I mentioned today, we're going to be talking about birth parents struggling with addiction, mental health or intellectual disabilities, and we'll be talking with Teresa Bradley. She is a psychotherapist based in Georgia with over 17 years of experience in Human Services, addiction counseling and mental health. She is a master addiction counselor and a trauma focused cognitive behavioral therapist, and she is currently a clinical trainer at Amerigroup, so welcome Teresa to Creating a Family. Thank you. I'm glad to be here, and now I will turn it over to Tracy to get us started.

Unknown Speaker  2:15  
Thanks for the kind words. Don I'm excited to talk about this topic today, because I know a lot of adoptive, foster and kinship caregivers are in relationships with birth parents who struggle with substance abuse or with mental illness or intellectual or cognitive disabilities, and it can prove to be very challenging when they're trying to manage some degree of openness or contact For the children or with the children. These challenges are across all the types of adoption, international, domestic and foster and they also exist for grandparents who are raising grandkids or aunts and uncles raising nieces and nephews. I think it's sometimes very tempting for the adoptive or foster parents or even the kinship caregivers to just want to shut all contact down, especially if a birth parent is actively struggling with an addiction or mental health battles, or if their behavior is pretty erratic or unpredictable for the kids. But as we'll talk about later in the show, that doesn't always solve the problem, and in fact, it can actually create other issues for the adoptive parents, for the children, for the relationships. Moving forward, Dawn's going to get us started on the topic today by talking about birth parents who struggle with substance abuse disorders first and then later, after we've worked through some of those issues, I'll jump in to discuss the issues around mental illness and intellectual disabilities, and then, as we try to do with all of our shows, we'll wrap up at the end with some specific questions and practical tips that will help parents and caregivers support both the children and the birth parents through This relationship. Thanks. Tracy, talking about addiction is something that we have to do a lot when what we do in supporting foster adoptive and kin families, because many of the families, certainly not all, but many of the families, the birth families of the kids we support, are struggling with substance abuse disorder. So Theresa, what are some of the challenges that adoptive or foster parents might expect to see when a birth parent is struggling with substance abuse disorder and is thus not able to raise the child,

Unknown Speaker  4:31  
there could be a variety of things, and so some of the issues that they may struggle with could be attachment issues. A lot of time children may experience difficulties forming secure attachments due to instability in their early environment. We also see trust and safety concerns. Previous experiences of inconsistency can lead to difficulty trusting their caregivers. They also can experience mixed feelings about their birth parents.

Unknown Speaker  5:00  
Parents, sometimes they can feel very loyal to those birth parents, and it could bring about some confusion and anger towards birth parents. That's very common. I see it a lot with foster youth that are aging out of care, especially when there has been substance use involved. They more than likely a very high percentage of them want to reunite with their family. So when they do reach that age where they can make that decision, they oftentimes go back home and find out that the situation has not changed, and so it leads to extending that lack of choice that they've been dealing with. It's also hard for their parents, their foster parents at that point, absolutely, because they see them going back into and then fear that that instability and the role models that they're being presented with will be challenging for them. So it's a it's hard for their foster parents as well. Are there in this case, it could be relative caregivers as well, who are absolutely children going back? Yeah, absolutely. These are children that often have difficulties in school, and they oftentimes have difficulty regulating their emotions, and so you can get a lot of outbursts, a lot of anger, those behaviors that sometimes can be difficult to manage, and they generally struggle with low self esteem and identity issues. So it's really important to make sure that you're building positive self esteem. If you are working with a child whose birth parents struggle with an addiction,

Unknown Speaker  6:29  
if you are the aunt or uncle or parent of the birth parent who is raising the child, are any of these issues? I would imagine there's additional complexity, because you are emotionally connected in a ways that a foster or adoptive parent would not be to the parent. So how do the issues differ if you're a relative caregiver, like a grandparent or or a sister to the birth parent? Oh, definitely. So one of the biggest things that I oftentimes see is that struggle with those boundaries. Right? When it's a relative, relative foster placement, they face some unique challenges. They really do. You know, I had a conversation with a colleague very recently during a supervision where the mother and father of a young lady has custody of her child, and she is struggling with severe substance use disorder, and it creates a little bit of chaos in that relationship, because mom wants to allow her to come into the home, you know, she wants to still care for her if she needs food, things of that nature, whereas the Father is very firm in his boundaries, because that exposure to their grandchild, he does not want her to see the mom that way. And so it creates challenges in their own relationship, because they're on different sides of the table when it comes to allowing her to be involved those emotional dynamics that come into play, you know, just that emotional support that usually you would give to a family member, making the tough decision to set those firm boundaries can be difficult for a lot of families, and they oftentimes it actually adds to the trauma that the child is experiencing. And most people don't realize that, yeah, yeah, talking about the trauma to the child that brings up the issue of it. At what age should we start talking to the kids in our care about their parents, challenges with substances? How do we bring it up? And how much do we share? What do we share? So when you're talking about speaking with the kids, you can start as early as four, believe it or not. So at that age, children can understand, they can understand those very simple concepts, but they may not be able to grasp the full complexity of the substitutes, right? And so you can start by explaining that mom or dad is not feeling well. You know, you want to make sure that you keep that language very simple for that child. And so this is anywhere between age four seven, and when we get to the middle school, those middle ages anywhere between eight and 12, they can handle a little bit more detailed information. So talk about, you know, how the parents may use substances in an unhealthy way, you know, that affects their behavior, and emphasize that the parent is receiving some help. And then, of course, as they get older, from ages 13 and up, they can definitely understand the complexities of substance use. So that's an opportunity to just be completely honest with them, because they may have noticed some changes in their parents. You know, at that age, kids, all kids are observing. But when you think of teenagers, they're in the community, and they see things in the community, they hear about things from their friends. And so it's important to have an honest conversation. You know, acknowledging what they've observed, what their concerns may be, it can also be beneficial to involve them in a discussion.

Unknown Speaker  10:00  
About treatment and support options for the parent, it's important for them to know

Unknown Speaker  10:05  
it fits perfectly with what we always recommend, which is lay the groundwork for the hard issue. Be it whatever the hard issue is, in this case, it's that your parent has a substance abuse disorder, and then start young lay the groundwork. The advantage there is that they're usually children's books that you can use that help. And then the idea is to add more detail with every telling. Add gradually more detail, so that before the child reaches adolescence, they know the information that you are struggling with. I will say that we have some great books on our website, creating a family.org hover over either adoption or foster and click on suggested books. It's a strong resource. There many parents, and I would say, myself included, we want to protect our kids. We don't want them to know the hard truth. So the idea is that let's just wait. We won't tell them we don't want to ruin their childhood. What would you say to those parents feeling that normal, protective feelings that they have towards the child? Well, I think each child is different, and I think it's important we oftentimes work extremely hard to protect our kids from things and later regret it, because you have that, you know, they may become angry when they find out later. Well, you know, you've could have talked to me about this, and I think it should be something that's very individual. You know, what is that child's emotional intelligence? What does that look like? What is the ability for them to actually grasp the information? I think the best thing that any parent could do for a child is just be completely honest with them, as we talked about previous depending on the age, determines how much information or what details that you share with them. But I honestly think moving forward from an honest place is the best way to go. So how do parents cope with their own emotions? I mean, foster parents and adoptive parents can often feel anger at the parents because they're erratic. They don't show up for visits. They act weird, you know, high. When they're around the kids or the child, they may have suspicion that the child was exposed prenatally to alcohol or drugs, and they they see the child dealing with the long term ramifications of that. So frustration, certainly anger, and then if you're a grandparent or others, then there's the whole added layers of guilt, shame, disappointment, just all that. So how do how do the adults deal with their own feelings? Well, I think the first thing they should do is just actually make sure that they understand what substance use disorder is. Educate themselves, right? Most people look at it as a moral issue. Most people take the blame for why their child may be experienced this, but understanding the disease model of substance use it is chronic, it is recurring. That's the basics. Educate yourself on what substance use disorder looks like, and the more you know about it, the easier it is to look at it from a position of, I'm not to blame. And so taking care of themselves their support groups, right? So for people that are suffering from substance use disorder, you have narcotics, anonymous, alcoholic, anonymous, well, guess what? They have support groups for the family members as well. You have Nara nine. You have Al Anon. You have Alateen. So when you have those teenagers who don't understand what their parents are going through, the benefit of lived experience or support from someone that is going through the same thing you are, is amazing. It has been proven to be very effective when working with people with substance use and mental health disorders, just like with mental health, you have Nami and so that's one way that they could receive that additional support to talk through their emotions, to have an outlet when they're angry. You know, someone that's been through it can understand it, and the benefit of that is, hey, I felt the exact same way you felt when I came here two months ago. And here's what I've been doing. I take walks, I meditate, I read, I research to learn more and understand I come to these meetings, I get with people that are going through the exact same thing, and it helps me to get through my day One day at a time.

Unknown Speaker  14:30  
You've talked about this a little bit, but what about the from the Children's standpoint, and we've talked about the parents having a host of different emotions, but what about the kids? Very young children, perhaps not, but older kids are also going to feel a host of different including anger or fear. Are there just so many things that kids can exist so many emotions? How do we help our kids deal with that?

Unknown Speaker  14:59  
And you.

Unknown Speaker  15:00  
And for young kids, or even the teenagers, you do have support groups for them as well, but I would say, you know, having conversations with them about what the parents are going through, maybe even offering them some therapy to work through those emotions so they can learn how to express those emotions in a healthy way, so it doesn't lead to a long term problem for them, I think it's very important people don't utilize the community resources that are available. And so there are so many community resources, especially with the younger kids. They could do play therapy with their older kids, they could do talk therapy. And I think parents, adoptive parents, or the kinship parents or the foster parents, just checking in with them, making sure that they're okay and giving them a safe space to express how they feel okay. Yeah, in adoption well, and actually in kinship care as well, and often in foster care. So we have open adoption, we have foster care, and we have kinship care. What are some of the issues you may see with a parent who is struggling with substance abuse disorder, and there is ongoing contact and ongoing openness between the adoptive family, foster family or kinship family and the person and the birth parent who is struggling. What are some of the issues that come up with navigating the relationship with a person that's in the midst of their addiction,

Unknown Speaker  16:26  
the main issues that come up is trust and consistency, right? And so generally, when someone is actively using substances, maintaining a schedule, you know, they spend most of their time seeking their drug of choice. They spend most of their time finding ways to get money to support that habit. So if they're an active addiction, that consistency won't be there. However, if they are in treatment, I've seen where those relationships have worked very well. A lot of residential treatment program, particularly for women and children, have what they call it therapeutic childcare. And each child, whether they are placed at the treatment center with the parent, or if they're in the home with a family member, or in any of these situations that we discuss, that case manager works with that child to ensure that that child's needs are being met. They sort of help put those boundaries in place. They determine when it's a good time, you know, for that parent to interact with that child. They help to determine the amount, you know, of time that the child is interacting. Because one thing about substance use disorder or addiction, that it is relapsing, is chronic, and it is relapsing. And so you don't want to put the child in a situation where they're being disappointed over and over and over again because mom or dad may have returned to use and that relationship they were building was interrupted. I think the best way to do that is to consider the child first in this we know that birth parents have their rights, but for lack of better words. It's almost like having to pass a test, right? You don't get to drive until you get your driver's license, and until we know that you are sure that this is the road that you're on the road to recovery, allowing that person in and out of that child's life can be very damaging. So it's important to set that boundary, all right? And we're gonna toward at the end, we're going to talk about some specific case issues that adoptive, foster and kinship the parents often face, such as whether or not to allow your child to do visitations if the birth parent is currently using how to handle, you know, promises that aren't kept, meetings that aren't made. We'll talk about that in a minute, but now I'll turn it back over to Tracy to talk about navigating relationships with mental health challenges or intellectual disabilities.

Unknown Speaker  18:50  
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Unknown Speaker  19:12  
and now back to this interview.

Unknown Speaker  19:15  
So I would imagine that some of the issues could be quite similar, as with a substance abuse disorder. But can we talk a little bit about some of the specific challenges that adoptive or foster parents or kinship caregivers might experience when they're trying to support a child whose parents have specific mental health challenges or intellectual disabilities? Absolutely, the foster parents or the adoptive parents that are supporting that child whose parent has intellectual disability can run into problems such as the child's learning style, right? They could be maybe behind in school because that parent that had that intellectual disability was.

Unknown Speaker  20:00  
Not able to properly teach them or do homework with them, they may develop some habits where, generally, in a case like that, the parent may not be able to take care of them properly, and so helping them to relearn a lot of things that they should have learned right initially, from, as we all think, from the birth parent. So it may put them in a position where they are having to reteach things or help them to get to the level where their peers are. In this case, that makes really good sense. If a parent is struggling to communicate how to brush their teeth or how to take care of themselves with daily showers, then the children would also then struggle. So when a child is in a placement home, whether it's adoption, foster or kinship care, not living with their parents, how do we as the parents and caregivers explain those kinds of challenges with mental health or intellectual disabilities to children? Well, you can talk to them about the cognitive limitations that their parents may have had. You know that difficulty with processing, making those decisions sometimes can interfere with helping them to learn those basic ADLs, right? Helping the child understand that wherever they are in their journey, they're not to blame. So if they're unable to take care of those basic activities of daily livings, I said, ADLs, and they have some like acronyms, clarifying that activities of daily living, you know, helping them to understand basic things such as problem solving, right? That can definitely limit that child's ability to learn how to problem solve if they have a parent that has intellectual disability who has not been a very good example of problem solving, but again, with the right support and education resources, you know, hopefully those parents can get to a place where they can effectively support their children. Because ultimately, when kids are in foster we are looking at reunification, right, and we want to make sure that they're getting that support as well. How about some of the big questions that kids might have but are afraid to voice or don't have the language to voice, such as, will I catch mom's illness, or will I inherit this disease at some point down the road? How do we handle some of those questions? Think you just have that conversation with them, because they they're definitely thinking about it, right? I hear that a lot, especially with you know, and I know we're talking about intellectual disability, but I've met a lot of people in my life that have never had a drink of of alcohol because they were the child of parents who were addicted. And knowing that there is a genetic component to hey, I did, you know I'm not going to drink because I, too, could become addicted because I'm born to parents that are both addicted, right? And so that's a natural thought for children with parents with intellectual disabilities. They worry that that they could be prone to it. And again, education, education, education, having those conversations, right? Meeting the children where they're at, Don talked about some of the books that you guys have. There are books out there that you can get, that are available for younger children, for older children, and so it's really important to use those resources and so you can talk to them on a level in which they can understand and just reassure them, right, right? That's a great segue into the next question, what about when a birth parents behaviors are very erratic or even frightening for a child. At what level do we talk to them about those issues?

Unknown Speaker  23:49  
When a birth parent's behaviors are erratic, I think it's important to allow the child to express how they feel. You know, if it upset them, if they're fearful, you know, we allow them to stay in that space. Oftentimes, I've seen people force relationships after, you know, situations like this, that's the one thing we don't want to do. We have to allow that child, that autonomy, to decide when they feel safe, when they want to be around that parent. Children definitely have voices, and so I think we should listen to them, you know, what makes them comfortable, and just explain to them it. I don't know if it's a situation where the parent is taking medication and maybe they've been off their meds for some time, or if they're having an outburst, and so it just depends, you know, to give a specific answer, there are a lot of factors that would be involved. If this is just erratic behavior that happens all the time, you know, maybe explaining to them that, you know, there's, they have a brain disease. There's a chemical imbalance in their brain that causes these changes.

Unknown Speaker  25:00  
To happen that causes this behavior, somewhere along those lines. So I hear you saying, first, validate what the child is feeling absolutely. Yes, it does feel scary when Mama Jane does X, Y and Z, but then also helping the kids understand what safe feels like, and giving language and words for that, and then what unsafe feels like, and giving language for that so that the kids can learn how to speak up and say what feels safe and unsafe to them, and then helping them learn how to advocate for themselves is really what I'm hearing you say, learning, helping them learn how to do that? Yes. So let's talk a little bit about how an adoptive or foster parent would be talking to a very young child about their birth parents ability to connect with them or maintain a relationship with them in the face of mental illness or intellectual disabilities,

Unknown Speaker  26:04  
very young child, so four and under. Yeah, let's start there, yeah. Well, I like play therapy, right? And so one of the things that people don't realize is that you don't have to be a therapist to do play therapy, right? You can be a mom who's home with your kid, and you know, you get on the floor with them, and you you take the dolls, and you know, the little dolls and the toys, and you know, that's a way to start having conversations with them. And so I really, really like play therapy. I like art therapy. And again, these are things that parents can do with kiddos, the adoptive parents, the kinship parent, the foster parent, the grandparent, just taking that time, drawing with them, you know, and generally that creative space. When a child is in that creative space, they're very open, and they'll they'll definitely share a lot more, you'd be amazed at some of the things that you learn from children when they are in a creative space, by drawing or playing, and so that's definitely one way to talk with them about that, and then continuing those kinds of activities in age appropriate ways as they grow. So it would maybe more from playing or role playing into discussing different scenarios that they might face when they're, you know, later Middle School. If you've got a kid that's real into theater or dramatics, you could get the role playing because they might enjoy that, teaching them how to take a different perspective. You play the birth parent today, and I'll play you, and then we can switch roles, and I'll play the birth parent, and you play you, and talk through those different things that would help them forge a relationship and then maintain that relationship, different skill building activities like that, absolutely and art therapy is different forms. I know one thing that I've been seeing a lot of I know they do it at Youth Villages, but they do they use drums, so drumming, right? Gives the child opportunity to get their emotions out. They're making music. They're learning about culture and also dance, right? There's an agency they work with young people, particularly teenagers, right? And they work in a lot of the clubhouses around the state of Georgia, and they use dance as a form of therapy, and it's been very effective. So absolutely, to what you were saying, that sounds like an awesome resource. Yes,

Unknown Speaker  28:35  
let's talk a little bit about kinship caregivers, because in this aspect, it's a little bit unique and different in that that they've got a pre existing relationship with the birth parent, and they likely have lots of feelings and thoughts about how the relationship has changed since the child came into their home, and they're now tasked with putting the child first and putting the child At the center of all of these concerns and issues. What are some of the things that kinship caregivers can do to talk with the children, but also model for the children healthy perspectives on these relationships and how to maintain them. Absolutely, I think it's really important for them to engage in support for themselves. So I have a colleague that did a kinship support group in Clayton County, and one of the common complaints that she got, and it was a lot of grandparents, was I've raised my children, they were angry, and this was showing and so one of the things that we were very intentional about was making sure they understood that children can pick up on this energy. They can pick up on that behavior. So I always encourage them to practice self care right, to talk to someone about their feelings, you know, like I said.

Unknown Speaker  30:00  
And there were a lot of grandparents that were angry that they were raising the children prior to being a clinical trainer here at Americ group, I was also a care coordinator, so I was assigned to families of kids that were experiencing foster care. And I can't tell you how many grandparents that I talked to, and I would just give them the opportunity to express how they felt, and so being mindful of where they're at, what they're feeling right, being honest with themselves about that, and finding an outlet to express those concerns where that won't be manifested in front of the children, because ultimately, it'll continue to do harm in those relationships. So they have to be their healthiest self in order to model that behavior for the children, however they see fit to do that, whether it's walking or respite. I don't know if you guys have heard of afpac. It's a F, P, A, G, adoption families, well, they go to Jekyll Island every year. They'll be there this year, I think, around the 25th of February. And it's where foster parents, adoptive parents, there's a big conference. They get an opportunity to, for lack of better words, have a little mini vacation where they're getting training from different providers, you know, and someone else is helping with the kids, you know. So respite care is always good. So I think it's really important that they take care of themselves first. So what the children see will be the behavior that they want them to follow. If they're always angry, the children will respond that way. That's an excellent wrap up of that. I appreciate that. What are some other just in case we missed any of the other issues, what are some other things that you might think of that we would need to consider to help our children maintain a relationship with their birth parents, while prioritizing the child's safety and feeling loved and cherished by all the adults in their life, I would say, just collaborative efforts, working together with all parties that are involved. If the child is in care by way of defects, make sure that that case manager is involved. If that parent is in treatment, make sure that that treatment facility is open to maybe visits for the child, you know, at a certain point, depending on how long the program is, making sure that the the

Unknown Speaker  32:32  
placement where the child is is open to being involved with that birth parent. In spite of the fact, because I've encountered a lot of people that are adamant or not about the birth parent not being involved because of the substance use disorder, particularly substance use disorder, I'm not run into that with a birth parent with an intellectual disorder, but with substance use disorder, that has always been a big factor. So it's almost like the behavior is like isolating. And I don't think that's good. I think all parties involved in that child's life should be willing to work together as a team, just like when kids are in care, they have a treatment team, right that get together and talk about the child's need. And I think the same should apply to children with everyone involved in that child's care and also the most important person at the center of this is the child asking them, making sure that their voice is heard and what it is that they want. Because our kids, our kids love their parents. They can't. You know, none of us choose our parents, and in spite of anything that may be happening, children will always love their parents, and we should never deny them that opportunity.

Unknown Speaker  33:45  
Great.

Unknown Speaker  33:47  
Let me take a moment to remind you that we now have a podcast. Actually, I've had it now for almost two years. We now have a podcast where we can answer your questions. So send us your questions, we'll try to answer them in about five to 10 minutes. Great for you and great for our audience. So send us your questions at info at creating a family.org that's how you would email them. Info at creating a family.org or you can click in the show notes to submit them as well. So make sure you send us your questions, because we've gotten some great ones lately, and now back to the show.

Unknown Speaker  34:24  
Okay, well, let's move into some of the practical scenarios of raising a child whose parents either have substance abuse disorder or have mental illness or intellectual disabilities. Dawn's going to tackle kind of one of the biggest ones that we hear about first, and then I'll I'll start adding other scenarios as we go hands down, the thing we get asked the most about when it comes to substance abuse disorder is what to do if a birth parent shows up for a meeting with a child high or stoned, and that there seems.

Unknown Speaker  35:00  
To be two fairly divergent views on this, where some parents feel like, No way I will not let my child be around anyone who is higher stoned, even their parent. And others who say, if it's not harmful to the child, if the child is safe, if the child is willing to continue the meeting, then then we would. So I guess the first question there is, Is it harmful for kids to see or interact with their parent when they're high?

Unknown Speaker  35:28  
Yes, and here's why. My personal stance on that is that substances can cause people to have erratic behavior, and so when someone is under the influence being in the presence of a child, you don't know how they may react. The other part to that, if you're trying to mend this relationship, the child may not feel protected by the parents that are caring for them at the time, because they've seen this parent hide before, right? And so if we allow them to be in that same space. It can cause confusion for them. They're removed from the home because of the substances, but it's okay for you to go and see them while they're home. That can be very confusing for a child, even if their caretaker, the grandparent or the adoptive parent, is present with the child, you would still we're not talking the children visiting without the caretaker present? Yeah, well, I think my biggest concern would be safety, because when people are under the influence of substances, they can have erratic behavior, and you never know how it may affect them. Yes, I hear your point completely that if being high makes the birth parent act in erratic or certainly dangerous ways. I think we would all agree that if the birth parents behavior is dangerous, then then no. But if the birth parents behavior is that they are distracted, they're high, they are not they're not fully present, obviously, when they're stoned, what are your thoughts on men, on continuing the visit or canceling the visit, rescheduling the visit when they can be present, right? Because this child has often, I think we're continuing to harm the child, because this child has already been in an environment where that birth parent was distracted and not present because they were high, and so they come to a visit the same way. That's not fulfilling. It could leave that child feeling empty, and it can continue to add to those low self esteem. At what age will it be a parent to a child that their parent is high? I'm imagining a scenario where going to the park and the child is playing and the parent is watching the kids at that point, not really interacting, but but let's say that the child is interacting. At what age are they going to tune into the fact that there's something missing behind mom or dad's eyes? I would say

Unknown Speaker  37:51  
as early as eight. I know that sounds like a young age, but kids are very observant. They're extremely observant, and they know what their parents are like on days when they're not high, right? And so they notice changes. Our kids notice changes in us. If, you know, say we've had a bad day at work. Yeah, I don't think eight sounds too young at all. I would. I think even earlier, kids would clue in on something they may not be able to name it. So you're suggesting that we require that the birth parents be sober during a visit. How would an adoptive or a kinship parent enforce that even the caseworker? How do we set up a scenario that would at least increase the odds that a birth parent would be sober during them during the meeting.

Unknown Speaker  38:43  
In a perfect world, you could have them meet with you after they've left a meeting, right? An in a meeting or an AA meeting if they're in treatment, yeah, right, right. Well, you know, and they don't have to be in treatment to go to NA or a so a community meeting, setting up the perfect scenario for that? I don't know that there's one answer that will work with all individuals involved. It depends mostly on their will to reunite with that family, because addiction is a chronic relapsing disease. I've often time heard defects case managers say to me, I don't understand why they won't stop using Miss Theresa. We told them we were taking the kids, and I explained to them, it's a disease, right? And so I can honestly say, I mean, you could maybe do some contractual things to say, Hey, if you show up and we think you're high, it'll be ended. Maybe figuring out ways to motivate them, that parent to want to do the right thing. Because the thing with addiction, it is tricky, and oftentimes people are losing their families and they still just can't stop

Unknown Speaker  39:55  
it's why it's an addiction. Absolutely, you know one suggestion that we will make.

Unknown Speaker  40:00  
Is, and this doesn't always work, but if, for example, the birth parent gets up in the morning and doesn't immediately start using then scheduling visits, find out when and ask them when is the most likely time that you're not going to be stoned. And let's do that, stoned or drunk or whatever, let's find a time and let's work around that so giving them some input may or may not, one of the things that those who argue against having any meetings at all, if the birth parent is high, is that allowing these meetings is a form of enablement. We're enabling the addiction because we are allowing things a visit, to allowing something that they want to happen, even if they are high. What are your thoughts on that?

Unknown Speaker  40:47  
Yeah, it can look like it can look like enabling, right? Because, what is my motivation to stop using if I can come and see my child and I'm high, right? And I think that's probably the perspective that they're looking at it from, if I don't have to do anything to get what I want, right? If I don't have to make any changes to get what I want. You know, here it is, you're taking care of the kid. For me, I still get to see them, and I still get to get high. And so it could be, it definitely could look like enable.

Unknown Speaker  41:15  
I guess one last thing I would add is that we're talking about a child that's young enough for the parents to be making the exclusive decisions as our children age, and I would say even reaching their tweens, certainly their teen years, that we need to be bringing them into this discussion and letting them have input, because ultimately, as you point out, they're going to end up having to have relationships, not having to wanting to have a relationship with their parents, chances are good. And this is also refer adoptive families, a desire to have an ongoing contact with a birth family is very common, not universal, but very common. And I always think in terms of the fact that we as parents, caregivers are modeling for the child how to interact, how to handle this relationship, which can be a confusing relationship, to put it mildly. So it feels to me that when we have certainly by the time they've reached their teen years, they need to be having input as to what they want, which would include saying they don't want contact, and that we have to respect that absolutely I agree.

Unknown Speaker  42:25  
What would you suggest a parent do when birth parents fail to show up for visits? And is that different between adoptive parents, foster parents and kinship parents? How they would handle that?

Unknown Speaker  42:40  
So I think with kinship parents and foster parents, it could go either way, right? When you talk about kinship, that's family and so generally, those feelings towards that birth parent may look different from a foster parent that's not biologically attached, right? But I think setting some hard boundaries, you know, because ultimately, when visits are scheduled, children are informed, and so if you constantly not show up for these visits, is negatively impacting the kids. So kinship parents or foster parents, I think it's important that that expectation be put into place, and if they can't meet that expectation, then perhaps revisiting how often these visits will happen, you know, and then also considering that they, too, have lives, and so adjusting their schedules to make these visits happen. And then the birth parent not showing up, it has repercussions for that family as well. Say that person is taken off of work so they can be there, or they left work a little early to make sure that they're there, or maybe they had to pull the kid out of school. And so I think it would probably look the same, you know, if it began to impact their lives, right? And ultimately, with with the kinship families, you know, because of that relationship, they may be a little bit more lenient, but I think if the behavior persisted, ultimately they all end up in the same place. You know, there's an expectation because we make changes. Then let me throw something out there. One big distinction is that if you're the foster parent, it's not your decision, it is the state's decision. So that's the big distinction right here. It seems to me, if the parent fails to show up for a visit, it is the case worker who is going to make the decision you might voice. But quite frankly, what you voice probably won't matter. Yeah, that is true, yeah. And if you are the adoptive parent, you are making the decision. If you're the relative caregiver, it's going to be somewhat dependent on if you're a licensed foster parent, then you're not making the decision. But if you are the child's guardian or have full custody, then it'd be more similar to the adoptive where you can have the choice. If.

Unknown Speaker  45:00  
The other thing I would throw out is we often recommend that parents win this in this situation, whether the birth parent fails to show, or because of substance abuse or because of mental illness or even intellectual disability, to not tell the child about the visit until you are relatively certain that the parent is going to show. That doesn't always work. Kids, at some point catch on, oh, we're at that McDonald's again. I bet this is going to be a visit, or we're going to this park, and this is usually when I go to a park. So so they may catch on. But rather than tell the child in advance, wait until you can see and then if the parent doesn't show, then, you know, get yourself a Big Mac and let the kids play and get some chicken nuggets or enjoy the park. So it does. It's not 100% but it's it ups your odds. Awesome. I love that. Yeah, that's great advice, and it leads right into boundaries and the issues that you brought up around boundaries. How do any of these parenting scenarios? How do we inform ourselves or educate ourselves about what are reasonable and acceptable boundaries to set? Where do we? Where do we go to learn about those kinds of boundaries? I think ultimately you're learning those as you go along, right when you're making decisions and say that it is something inconveniences you, so you automatically begin to set that boundary. Oh, I'm not going to do that again. And I think maybe talking as a unit, the family as a whole, everyone involved, what works best for you again. What? When I shared the kinship care with the grandparents, not having that time for themselves made it really difficult, and so I think ultimately, it's important to just be true to yourself, you know what you can and can't handle, and put those boundaries in place to make sure that that parent that is caring for the child can remain healthy. And I would add to that, while you're while you're learning that, narrate that out loud around the kids. Talk about how you feel when one of your boundaries, not just related to the birth parents, but any of your boundaries may be crossed, and how you feel about it, and then how you plan to handle it, narrate that out loud, model it for the kids, so that they see you being consistent in all of your areas of life where you need to employ boundaries and they don't then get a message that these boundaries are just for my birth parents, Absolutely and they're holding my birth parents at a distance, but also so that they are learning self advocacy skills and how to set their own boundaries, because they've got a lifetime of relationship with this birth parent to navigate. That's powerful, Tracy, because I have a lifetime to navigate with other people as well, right? And boundaries are a tough issue for

Unknown Speaker  48:03  
but then you add someone who's got all of these pre existing issues like trauma and mental health and things like that, and boundaries can be really challenging for our kids, absolutely. So Don's got one last question for us, yeah, and this, this goes to the issue of what we were Tracy was talking about, about children wanting to ask, being fearful that they they too may get the mental illness that their parents have. They may worry, or may not worry, that they too are at risk for abusing substances. But we know that substance abuse disorder has at least some genetic connection. I think it's debatable how much we don't know how much, but we do know that children who have parents who are struggling with addictions are at a greater risk for also struggling with addiction. So how do we how do we discuss this? We don't want to terrify our children, but on the other hand, we want them to be, you know, forewarned as for armed. So we want them to go in with this knowledge. So suggestions on how to talk with our kids about this,

Unknown Speaker  49:11  
I think some of the things that you just said is a great place to start. As we educate ourselves, we educate our children, of course, age appropriate. You know, those older kids, you can have that conversation, especially when they get to middle school age, because that's the age where I'm seeing a lot of kids that are experimenting themselves, starting out with vaping. You know, they may be vaping just the nicotine, but that's creating a pattern, and so just having honest conversations with them. For the younger children, I don't know that that covers. I think maybe the conversation may come up more as they get older, and there may be a few young kids that are very inquisitive. To say, Hey, am I going to end up like Mommy, you know, and talking to them on a level at which they can understand, but being honest with them about it, showing the research, you know, for example.

Unknown Speaker  50:00  
So if you're born to two parents that suffer from depression, you may be at an increased risk of developing depression. Doesn't mean that you will, it just means that your your rate may increase, and then you can talk to them about preventive measures, right? You know, taking care of themselves. Same with addiction. If you have two parents that were addicted, you may be an increased risk. Here's how we make sure this doesn't happen with you. You don't use right things of that nature could be very beneficial. Yeah, thank you. This has been so helpful. Theresa Bradley, thank you for being with us today to talk about often a hard subject to be honest. So we appreciate your wisdom and your experience. Thank you so much for joining us. Thank you. Thank you.

Unknown Speaker  50:48  
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